Building a system of care that meets people where they are and improves the region’s health
Atlanta is a major metro area with top-tier health care resources, yet the region finds itself near the bottom of national health rankings. The challenges are even greater for Black people and other people of color in our community, who face higher rates of infant and maternal mortality and higher incidence of chronic disease, cancer, asthma, and premature death, as well as significantly lower life expectancy compared to white residents.
These differences are driven primarily by unequal access to the social determinants of health, including:
quality education and jobs
healthy, affordable housing
access to nutritious food and transportation
recreation spaces and opportunities for physical activity
To effectively address critical drivers of poor health and health inequities, Atlanta must invert the burden of navigation away from the individual on to the system of care.
An inverted system:
Centers individuals and families in a coordinated system of care
Streamlines intake, documentation, and verification processes to reduce duplication
Assesses needs and identifies priorities based on the client’s goals and objectives
Provides coaching, navigation support (e.g., community health workers) to those with the most complex needs
Shares data, coordinates care, and problem solves among agencies
Increases resources to service providers
Recognizes that people will need cycles of help; eases re-entry and maintains connections