Where you live has an outsized impact on your health. Digging into data by ZIP code reveals why. Certain neighborhoods lack enough stores with fresh produce, access to transportation, safe and affordable housing or open spaces to play and exercise—all social determinants of health linked to chronic disease or other health problems. Armed with the right data, advocates can make the case for change.
When Blue Shield of California Community Health Advocates “Z” Tarver and Kia Wilson want a better understanding of how to help a patient, they can check the80. It’s a new community mapping tool that provides more insight, by ZIP code and social determinant, into what might influence a patient’s health beyond the doctor’s office. Why the name, the80? Because 80% of your health is driven by social determinants, including where you live.
The role of a community health advocate
“A Community Health Advocate (CHA) supports patients and physician practices,” says Tarver. “We help patients navigate the health system and connect them with resources, whether it’s financial assistance, if they need someone to take care of them after surgery or food from a food bank.” Essentially, she says, “we help them not walk alone.”
Tarver and Wilson are among Blue Shield of California’s growing number of CHAs, a recognition of the fact that addressing social determinants of health helps patients get healthier. It’s also an acknowledgment of health inequities; many of the patients Tarver and Wilson support are people of color who live in ZIP codes with greater social needs.
Tarver and Wilson identify members who may benefit from their support and reach out to get a sense of their needs. They know many of the resources that exist for patients in need because of their deep roots in the communities. They also use databases and other tools to identify organizations and services that can help.
Tarver covers Sacramento. “I grew up in the Sacramento area. I’m familiar with what people are going through,” she says. Blue Shield of California focused on hiring CHAs who could connect with and understand the patients they serve on a deeper level. There’s evidence that CHAs who have shared experiences with their patients can help develop greater trust and better health outcomes.
She works with patients who need, for example, food assistance or help getting to doctor’s appointments. But her services go beyond helping a single patient. She emphasizes the community in Community Health Advocate. That’s where the80 comes in handy. She can use it to educate physicians in the area about some of the issues facing patients in certain neighborhoods.
Advocating for change with the80
“If I need to help a cause in the community, I can use the80 to show the facts,” says Tarver. That might mean speaking to a local group about how to advocate for more resources, like a farmer’s market or better transportation.
Kia Wilson lives in Los Angeles County. “I know a lot that goes on,” she says. “I know the diverse communities.” She also knows many of the resources that can help them. But her voice alone might not be loud enough to bring about the bigger changes a community needs to thrive.
Typing in a ZIP code, selecting a topic like housing or food, Wilson can pull a report on the80's website and show neighborhood residents facts about their community and how it compares to the rest of the city. For example, running a report on housing statistics in one of LA’s lowest income ZIP codes reveals a big percentage of residents live in overcrowded housing, housing that’s likelier to have lead paint, and that although residents have comparable rates of diabetes and heart disease, more of them die from it.
The tool helps Wilson ask questions about the link between neighborhood data and a patient’s health: for example, how might overcrowding affect asthma, or even safety from COVID-19?
She can also show the data to residents who want to improve their community. “I can help members organize,” she says. “They may want a farmers’ market or community kitchen.”
Expanding the role of community health advocates to address the root causes of disparities
CHAs are becoming more common members of health insurers’ case management programs as well as physician practices. With the80, Blue Shield of California is empowering CHAs to play an even greater role in addressing the root causes of the health inequities they encounter.
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The data can supplement what a CHA learns about a patient’s lived experience, giving them more insight into what might be contributing to a particular problem.
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Data can give them the information they need to spark discussions with healthcare providers about looking beyond a patient’s medical record.
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The reports also give CHAs important context around the data, and the language to use when speaking with patients, communities or healthcare providers who want to advocate for changes that promote health equity.
“It’s not a community’s fault they’re lacking a resource,” says Tarver. “There’s an area in Sacramento that has more liquor stores than places to buy fresh food. If they had other things, maybe more mental health clinics or places to exercise,” she says, the community might have a better chance of being healthier.
Now, there’s even more urgency to advocate for communities. Wilson says the pandemic has driven up the need for food banks, rent help and more. Helping more people understand the complexity of a community by sharing some key statistics and listening to patients could help create the momentum to address the underlying issues that put residents at greater risk.
Blue Shield of California is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.