On September 21, 2021, Children’s HealthWatch responded to a request for information from the Congressional Social Determinants of Health (SDOH) Caucus. The first section of the response covers our experience with SDOH challenges, and we answer questions about which specific SDOH challenges our organization has seen to have the most impact on health, as well as the areas have changed the most during the COVID-19 pandemic. We also elaborate upon what types of gaps in care, programs, and services serve as a main barrier in addressing SDOH in the communities we serve. Here, Children’s HealthWatch recommends that Members of Congress work to improve and adequately fund public assistance programs, increase access to those programs, and promote economic mobility. We go on to elaborate on the role that technology can play to alleviate particular challenges, and the barriers to using technology in this way.

The second section of the response covers improving alignment of public assistance programs. We describe the way that federal programs such as Medicaid, CHIP, SNAP, and WIC could better align to holistically address social determinants of health, and make specific programmatic change recommendations. We go on to address key challenges relating to the exchange of SDOH data between health care and public health/social service organizations and describe how these challenges vary across social needs, and we provide recommendations for evidence-based policy solutions that would address these challenges.

The third section of the response outlines best practices and opportunities to better address social determinants of health. Children’s HealthWatch names particular programs that have provided evidence of effectiveness in reducing food insecurity and other hardships, such as expansions to the Child Tax Credit (CTC) and the Earned Income Tax Credit (EITC), the Emergency Rental Assistance Program, and a boost to SNAP benefit levels. We then recommend programs and practices that Congress should look into further that could be leveraged even more widely to help Americans during and after the pandemic, and detail promising opportunities for addressing SDOH and promoting equities for children and families.

The fourth and final section of the response is about transformative actions. In this section, we describe existing opportunities to expand SDOH interventions in outcome-based alternative payment models and bundled payment models, and point out the most critical elements to measure in models of care for adults and children. Finally, we delineate how Congress can best address the factors related to SDOH that influence overall health outcomes in rural, tribal, and/or underserved areas to improve health outcomes in those communities.