UH College of Medicine launches program to address social obstacles to health

With the goal of becoming a primary care physician, Nabeel Ahmad said he hadn’t thought much about how a doctor might be required to collaborate with a social worker.

But as a first-year medical student at University of Houston’s College of Medicine, Ahmad, 28, is getting a first-hand lesson on how essential it is for healthcare professionals and social workers to team up to improve the health of patients via the Household-Centered Care program.

“I really enjoy it,” Ahmad, 28, said of his second semester working with the program. “… It’s just such a different perspective of how to approach an illness and disease.”

Launched virtually last semester, the program aims to improve the health and overall well-being of Houston residents by addressing concerns among under-served populations that typically don’t come up during a standard doctor’s visit.

These concerns include “social determinants” of health, or factors that can influence a person’s health, like their environment, income, housing or food insecurity, said Dr. Donald Briscoe. He oversees the program and serves as UH’s College of Medicine’s director of the Longitudinal Primary Care course for the UH College of Medicine.

The program has assembled teams of trained community health workers, students and faculty from UH’s medical, social work and nursing schools and UH-Downtown’s social work program. The group plans to assist 100 family households in Third Ward and East End with such challenges, Briscoe said. Community health-workers who live and are in embedded in the neighborhoods will take on a bulk of the families, doing in-person visits once conditions during the pandemic allow.

Thirty students in UH College of Medicine’s inaugural class, all whom have worked on related simulations and virtual projects for the program starting last semester, will take on one household each.

Free of cost for participating residents, the program will also connect these teams and residents via Unite Us, a newly launched electronic platform that provides a network of resources, partners and service providers, like food banks or community organizations, that can help alleviate some obstacles to good health.

The platform “creates a way that household-centered teams can link to the participants, and it can be done efficiently and quickly so we can track” outcomes and identify service gaps, Briscoe said. Additionally, the system intends to simplify such processes. Once a participant is in a system, different providers can access their information electronically, which aims to simplify the referral process and reduce the amount of effort or paperwork professionals or residents must do.

“Wherever you enter, you can be screened for and access necessary services,” Briscoe said. He emphasized that participants will have control over their information and must consent or agree before using the platform. Families can also opt-in to receive notifications through email or text in regard to their account and will be able to access resources on their own.

“We are embracing the ‘no wrong door’ approach because once you’re in the Unite Us system, you’re linked to every other available resource,” Briscoe said in a written statement. “Being able to efficiently help people link to necessary services has the potential to have a much greater impact on overall health than anything we do in an examination room.”

Student team members also are expected to benefit from the program, allowing them to get firsthand experience with residents and those from other fields, while educating themselves on how social aspects of life might affect health. According to Briscoe, more than 80 percent of health outcomes are shaped by genetics and social determinants, meaning less than 20 percent are based on the medical care patients receive.

Ahmad said the program has show him how social aspects of life can contribute to social equity. For example, from the medical side of health, it’s easy to prescribe a prescription, he said, but some diseases are complicated by a lack of other resources.

“If a patient who has a clinical disease doesn’t have transportation, you have to think about the bigger picture. It’s not that the patient doesn’t want to access care. It’s that they can’t access care,” Ahmad said.

“It’s an important role that’s often overlooked. If we really want to target social determinants of health, we absolutely end social workers on the front line with other health workers.”

The Household-Centered Care program teams will eventually work out of two hubs — The Royal Palm Apartments in Third Ward and Tejano Center in the East End — but Briscoe anticipates that the program “will continue to grow and snowball,” eventually including the greater Houston area and Harris County.

Residents in Third Ward and East End can visit UH’s website to learn more about Household-Centered Care.

[email protected]