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Social Determinants of Health Initiatives

Social Determinants of Health Initiatives at Mission Community Hospital

Social Determinants of Health

Los Angeles County is home to over 10 million people, making it the most populous county in the United States. While it is known for its cultural diversity, economic opportunity, and innovation, the region also faces stark health disparities rooted in longstanding social and economic inequities.

Mission Community Hospital Policy Statement:

Mission Statement:

At Mission Community Hospital, we are committed to advancing health equity by addressing the Social Determinants of Health (SDOH) that influence the well-being of the men, women, and children seeking treatment at our hospital. We recognize that health is shaped by more than medical care; it is deeply affected by factors such as housing, education, employment, food security, transportation, social connection, and access to safe environments.

Policy Statement:

To support our mission, Mission Community Hospital will:

1. Identify and Assess:
Integrate SDOH screening tools into patient care to identify social needs such as food insecurity, housing instability, transportation challenges, and barriers to accessing care.

2. Collaborate with Community Partners:
Build strategic partnerships with local organizations, public health agencies, housing authorities, food banks, and social service providers to create referral networks and improve resource access.

3. Culturally Competent Care:
Provide training for all staff on cultural humility, implicit bias, and trauma-informed care, reflecting the rich cultural and linguistic diversity of the San Fernando Valley and Los Angeles County.

4. Advocate for Equity:
Engage in local, state, and national policy advocacy to support initiatives that reduce health disparities and invest in upstream community development.

5. Track and Evaluate:
Monitor patient outcomes related to social needs interventions and use data to guide continuous quality improvement and equity-focused decision-making.

6. Empower and Educate:
Empower patients through education on health literacy and available community resources, supporting self-advocacy and long-term well-being.

Key Points of SDOH:

Housing Insecurity and Homelessness:

  • LA County has one of the largest unhoused populations in the U.S., with over 75,000 people experiencing homelessness as of the latest counts.
  • Lack of stable housing is closely linked to poor physical and mental health outcomes, higher rates of emergency room use, and lower life expectancy.

Poverty and Economic Inequality:

  • More than one in five residents live below the federal poverty level, with deep disparities across race, geography, and immigration status.
  • South LA, East LA, and parts of the Antelope Valley face concentrated poverty and under investment.

Access to Healthcare:

  • While LA has many top-tier healthcare facilities, low-income communities often face barriers such as lack of insurance, language barriers, transportation difficulties, and provider shortages.

Food Insecurity and Nutrition:

  • Over 1 million people in LA County experience food insecurity, with limited access to affordable, nutritious food—particularly in communities of color and low-income neighborhoods.

Environmental and Neighborhood Conditions:

  • Disadvantaged communities often live near industrial sites, freeways, or in areas with poor air and water quality.
  • Neighborhood safety, green spaces, and transportation access also vary significantly by ZIP code.

Commitment to our Community:

Mission Community Hospital is dedicated to being a catalyst for change in the San Fernando Valley, a community of extraordinary diversity and resilience. By addressing social and economic factors that drive health disparities, we aim to deliver care that not only heals, but also uplifts.

Social Services/Case Management:

Inpatient Admission & Intake Assessment

Social Services and Case Management Departments play a critical role in identifying and addressing non-medical needs that affect patient health. Below is a breakdown of Social Determinants of Health (SDOH) domains and common social services resources the hospital may use or refer to when conducting the assessment.

Housing instability & Homelessness

  • Emergency Shelter Referrals
  • Transitional Housing Programs
  • Rental & Utility Assistance

Food Insecurity

  • Food Pantries
  • Meal Delivery Services
  • Hospital-Based nourishment program

Transportation Barriers

  • Medical Transportation Services
  • Public Transit Voucher

Education & Literacy

  • Adult Education Referrals
  • Health Literacy

Employment & Income Support

  • Workforce Programs
  • Unemployment Benefit Navigation
  • SSI/SSDI Enrollment Support

Violence & Safety

  • Domestic Violence Resources
  • Human Trafficking Support Hotlines
  • Elder Abuse Reporting

Social Support and Community Engagement

  • Caregiver Support
  • Peer Support
  • Faith-Based or Cultural Community Groups

Emergency Department/Social Services:

Unhoused Service Kits upon Discharge from the Emergency Department

Mission Community Hospital will offer amenity kits containing essential hygiene and comfort items, and basic immediate nutrition to all patients identified as unhoused at the time of discharge from the Emergency Department. This initiative supports the hospital’s mission to provide compassionate care and promote the dignity and health of vulnerable populations.

Amenity Kit

  • A pre-packaged kit containing basic hygiene items such as toothbrush, toothpaste, socks, and other small items for comfort or cleanliness.

Ready-to-Eat Nutrition Kit

  • A pre-packaged kit containing non-perishable food and beverage items that require no cooking or refrigeration.

Social Services/Human Resources

Food Pantry
To set forth a hospital-based program that collects and stores food to distribute free of charge to employees and members of Mission Community Hospital (“MCH”). Food pantry will provide a nutritionally balanced supply of food to individuals and their families in need, typically for approximately three to five days, in an effective pre-planned approach of handling emergency food assistance to those in need.

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