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There is a significant body of academic work showing that economic and social conditions have a powerful impact on individual and population health outcomes as well as health care costs. These non-clinical factors – such as housing, food assistance, income, employment status, education and transportation – have the potential to contribute to health outcomes more than clinical health care. In fact, one widely cited study found that while 10 percent of premature deaths in the U.S. are due to clinical health care, social and environmental factors are estimated to account for 60 percent of health outcomes.

Recognizing this link, governors, public health officials and Medicaid directors throughout the country have engaged in efforts to address the ever-increasing cost of health care by integrating more social determinants of health into their approach to Medicaid. While there have been successes, many states and local governments have experienced challenges in embarking on and implementing cross-agency, cross-program coordination. Many who run state programs agree that the greatest challenge to realizing innovative, high-impact approaches to social determinants is the difficulty in wading through the fragmented and complex nature of federal and state funding and administrative requirements.

Through a combination of research and data collection, direct advocacy, coalition building, and media outreach, Aligning for Health is energizing stakeholders and policymakers around the need for targeted technical assistance and funding to states and communities to help them design high-impact, cross-system strategies that achieve better health outcomes for Medicaid beneficiaries, improve program effectiveness, and lower healthcare costs.