All Medicine is Social Medicine

Question 1

Social determinants are estimated to be responsible for ___% of the modifiable variance in health outcomes.

Answer 1

Social determinants are estimated to be responsible for 80-90% of the modifiable variance in health outcomes.

Question 2

Lack of stable housing is a major risk factor for. . .

Answer 2

• Tuberculosis
• Diabetes
• Asthma
• Hypertension
• HIV
• More frequent hospitalization

Question 3

Community Partners programs

Answer 3

Established under some ACOs. Community-based organizations with expertise in working with individuals with severe behavioral health issues or social challenges, as well as those with long-term support needs.

Question 4

MCSTAP

Answer 4

MA Consultation Service for Treatment of Addiction and Pain

Offer a free phone consultation service to primary care providers on safe perscribing habits and advice on caring for individuals with substance use disorders.

Question 5

Food insecurity costs the state of MA $___ in avoidable medical expenses anually.

Answer 5

Food insecurity costs the state of MA $1.9 billion in avoidable medical expenses anually.

Question 6

Food is Medicine initiative

Answer 6

Growing in popularity, especially under ACO models. Involves the dispensing of medically tailored meals and perscriptions for produce to be filled in grocery stores and billed to insurers or hospitals.

Question 7

Most ACO contracts require physicians to query patients about ____.

Answer 7

Most ACO contracts require physicians to query patients about health-related social needs.

Question 8

Recommended policy adjustments as part of the “Food is Medicine” initiative

Answer 8

• Improving nutritional standards in public schools
• Federal incentives to incorporate nutrition into corporate worksite wellness programs
• A federal excise tax on sugar-sweetened beverages and junk food
• Integrating nutrition into health care (including an expansion of healthful food perscriptions with insurance coverage)
• Leveraging of the SNAP program to provide more healthy meals and nutrition education
• Expansion of FDA’s role in regulating labeling standards and setting limits for certain substances in food (especially sugar, salt, and trans fats)
• Increased federal research funding, including a new National Institute of Nutrition at the National Institutes of Health

Question 9

The estimated US costs of diabetes, cardiovascular diseases, obesity-related cancers, and other obesity-related conditions (the diet-related diseases) are approximately $__ per year, or __% of the gross domestic product.

Answer 9

The estimated US costs of diabetes, cardiovascular diseases, obesity-related cancers, and other obesity-related conditions (the diet-related diseases) are approximately $1.72 trillion per year, or 9.3% of the gross domestic product.

Question 10

In one study published in JAMA, participants who received MTM were __% less likely to be admitted to a hospital relative to the control group during the test period.

Answer 10

In one study published in JAMA, participants who received MTM were 49% less likely to be admitted to a hospital relative to the control group during the test period.

Question 11

In absolute terms, the NNT to prevent one hospital admissions with MTMs was found to be. . .

Answer 11

. . . just 2.

Question 12

To date, MTM programs have relied primarily on ___.

Answer 12

To date, MTM programs have relied primarily on not-forprofit organizations

Question 13

Fire core features of ‘structural competency’

Answer 13

1. Recognizing the structures that shape medical interactions
2. Developing an extra-clinical language of structure
3. Rearticulating ‘cultural’ formations in structural terms
4. Observing and imagining structural interventions
5. Developing structural humility