LINDA BAHRKE. Administrator, Mosaic Life Care (St. Joseph, Mo.)
On the top challenge
"The most pressing concern is the lack of incorporating social determinants in the healthcare delivery system. What we're learning across the nation is that social determinants actually have a larger impact on the cost of healthcare in our country than actual health issues. What I like to say is health affects your life, and life affects your health. You really can't treat health alone.
For example, if I have a new diagnosis of cancer, that may affect my ability to earn an income and my relationships. Once that starts to happen, it becomes a snowball effect in terms of affecting the rest of my life, and I may end up in poverty because of a health issue. And the opposite occurs, obviously. If I have chronic stress in the home for whatever reason — I'm in poverty or experiencing abuse — that results in a chronic stress that impacts my health and results in high blood pressure and other conditions. The fact that our system is set up to deal with acute issues and not long-term relationships and understanding of a person's entire life results in this vicious cycle of continuing to need healthcare yet not really resolving the root cause of the issue."
On the hospital's response
"Our health system is focusing on integrating as much as we can with other agencies and services in our community to take more of a holistic approach in how we interface with each patient or member of our community. We want to talk about and address all those aspects of life, not just health. As an organization, we also have funding and donations streamed to various agencies that share that same philosophy and want to try new and innovative approaches to support people in our community around life care. We not only interface with them as we care for patients, but also interface with agencies in the community in how we can have the infrastructure set up to take care of our entire population."