You can find the Moab Free Health Clinic between a corner store and a thrift shop on Moab’s west side of town. This unassuming building has become a mainstay for the local community. Hundreds and hundreds of uninsured and underinsured rural Utahns pass through its doors each year to access care from staff and medical volunteers.
I’m greeted today by Kolby Williams, the clinic’s community navigation coordinator. The Moab Free Health Clinic is on track to serve a record number of patients in 2021. But this year they’re looking beyond the doctor’s office to do more for public health.
“And so instead of just focusing solely on the medical aspect, which would be like the hospital, us, Green River [Medical Center]– we want to look at, like the conditions people are in,” Williams said. “The conditions that are resulting from poverty, and generational things. And 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 that will connect local medical providers to community aid organizations. It will essentially 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.
Which kind of like cuts down the burden on people,” Williams said. “Because 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.
This referral system, it’s aimed to directly address what’s known as the social determinants of health. According to the World Health Organization, these are the conditions in which people are born, grow, work, and live. And they can have big impacts on our overall health outcomes. The Moab Free Health Clinic knows it, and so does the governor of Utah.
“What most people don't understand is that access to health care is actually a fairly small percentage of total health outcomes,” Gov. Spencer Cox said. “It's all these other things, right? 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.”
Within two weeks of assuming his role as governor this January, Cox released a list of strategic priorities that would shape his first 500 days in office. Addressing social determinants made that list. He said he became aware of the issue when he chaired a state commission on intergenerational poverty.
For years, Tracy Gruber was the senior advisor to the Intergenerational Poverty Initiative. She’s now the head of the governor’s health security team. She said data increasingly finds “that if you address the social determinants of health, not only are you going to improve health outcomes for individuals, which then helps them stay connected to school, and connected to work and be successful, but you were also going to improve overall wellbeing for children who were in or at risk of being in the cycle of intergenerational poverty.”
And COVID-19 has unequivocally exposed gaps when it comes to these social determinants of health in Utah, according to Gov. Cox. At one point during the pandemic, he said Latinos represented as many as half of COVID-19 cases while making up only about 14 percent of the state’s population. Experts directly related those numbers to social determinants like access to healthcare and work conditions.
So Cox said the pandemic “exposed in a very big way, kind of with a microscope or a magnifying glass maybe is the better, the better analogy, what's happening out there.”
The governor’s health security team is expected to deliver actionable items to address social determinants in Utah by the end of April. Intermountain Healthcare is working on a pilot project in Washington and Weber Counties, similar to the Moab Free Health Clinic. Both aim to close the loop on medical care and social needs. Gov. Cox said results from the Intermountain project will also influence his team’s recommendations.
Thanks to Molly Marcello from KZMU in Moab for covering this story. Visit kzmu.org for more of her coverage.