The Moab Free Health Clinic is an unassuming building nestled between a corner store and a thrift shop on Moab’s west side of town. Hundreds of uninsured and underinsured rural Utahans’ pass through its doors each year.
Kolby Williams is the clinic’s community navigation coordinator. Williams said the clinic is on track to serve a record number of patients in 2021, and they’re now looking beyond the doctor’s office to do more for public health.
“Instead of just focusing solely on the medical aspect — we want to look at the conditions people are in,” Williams said, “the conditions that are resulting from poverty and generational things. Those have such strong impacts on health.”
Williams and the free health clinic are building the Moab Community Referral System. It’s a closed loop, digital system which will connect local medical providers to community aid organizations.
It will allow anyone who shows up at the free health clinic or one of their many partner organizations to easily get referrals for social needs like housing and childcare. Williams said it will cut down the burden for people who need to access these services.
“Obviously, if you're struggling to find something to do with your children on the weekends, it's going to be hard to sign up [with] 10 different nonprofits. You just don't have the time or energy to do that,” Williams said.
The referral system is aimed at directly addressing what’s known as social determinants of health. According to the World Health Organization, these are the conditions in which people are born, grow up, work and live. These all have big impacts on overall health outcomes. The Moab Free Health Clinic knows it, and so does the Governor of Utah.
During his first two weeks as Gov. Spencer Cox released a list of strategic priorities that would shape his first 500 days in office. He made social determinants of health a key priority of the One Utah Roadmap.
Cox said he became aware of the issue when he chaired a state commission on intergenerational poverty.
“What most people don't understand is that access to health care is actually a fairly small percentage of total health outcomes. It's all these other things, right?” Cox said. “Access to healthy food, access to transportation, access to housing — all of these things add up to determine not just how long we'll live, but the type of life that will live.”
Tracy Gruber is head of the Governor’s health security team, and for years, she was the senior advisor to the Intergenerational Poverty Initiative. Gruber said the research is clear.
“If you address the social determinants of health, not only are you going to improve health outcomes for individuals,” Gruber said, “but you [are] also going to improve overall wellbeing for children who were in or at risk of being in the cycle of intergenerational poverty.”
Cox said the COVID-19 pandemic has exposed gaps in a “very big way” when it comes to social determinants of health in Utah. At one point during the pandemic, he said Latinos represented as many as half of COVID-19 cases, while making up only about 14% of the state’s population.
Experts directly related those numbers to social determinants like access to healthcare and work conditions. The Governor’s health security team is expected to deliver actionable items to address social determinants in Utah by the end of April.
Williams said it’s time Utah looks closely at the root cause of health outcomes. He said while the government and the medical community at large have had success in rolling out initiatives like federal nutrition programs in schools, it’s been much harder to “overhaul an entire generation of redlining and housing crises that have popped up all over the country.”
Williams said that’s part of the reason healthcare providers need to start working more efficiently with organizations directly addressing social determinants like housing.
Intermountain Healthcare is working on a pilot project in Washington and Weber Counties, similar to the Moab Free Health Clinic. Both programs aim to close the loop on medical care and social needs. Cox said results from the Intermountain project will also influence his team’s recommendations.