Session: Program and Policy Influences on Health and Finances (Society for Social Work and Research 29th Annual Conference)

Health outcomes are influenced by a wide variety of factors, including policies, programs, and institutional practices by health delivery systems related to patient finances. Research findings have demonstrated that finances are interconnected with health, and are one of the social determinants of health. As such, household finances are of high importance to the healthcare delivery system; conversely, the affordability of care offered by the healthcare delivery system also has a strong influence on finances. The implementation of policy, programs, and institutional practices related to both health and finances, therefore, are important research subjects.

Potential links between financial health and physical health have emerged in the literature. Financial strain may indicate fewer resources, which can result in behaviors that negatively directly impact health (e.g., alcohol and drug consumption), as well as avoidance of health care services due to cost or the struggle with meeting daily needs. For example, financial strain can limit the ability of parents to keep primary healthcare visits for their children, which may result in more expensive acute care needs. Lack of ability to make appointments or afford medications, or unreasonable distance to healthcare facilities interferes with medical condition management. Financial strain can also result in stress, which creates poor health outcomes, such as higher rates of obesity, smoking, and chronic health conditions.

This symposium provides four papers that examine important unexamined aspects of the healthcare delivery model and social services related to household finances and community wealth. The first paper, The Effects of Medical-Financial Partnership Interventions on Financial and Health-Related Outcomes: A Systematic Review, examines a novel intervention of embedding various types of patient financial interventions within the healthcare delivery system. The authors find little evidence of effects on the health and financial outcomes measured in four studies, and recommend future rigorous research studies. The second paper, Triple Exclusion: A Geospatial Analysis of Healthcare, Food, and Banking Deserts addresses the spatial patterns of healthcare, food, and banking deserts. This examination presents a unique perspective on geospatial attributes of multidimensional social exclusion as a key determinant of health. Results suggest that a large population in the United States live in an area of different combinations of healthcare, food, and banking deserts. Turning to the cost of care, the third paper, Medical Financial Hardship Screening, Referral, and Payment Practices, provides new insights to help inform healthcare workers about the importance of screening for financial toxicity with patients with cancer. The authors find that prevention and mitigation efforts are needed to lessen the negative consequences of financial toxicity. The fourth paper, The Potential Effectiveness of a Financial Social Work Brief Intervention (FinSoc) on Clients' Financial Health, uses a mixed-method approach to focus on the effects of a brief intervention on the financial health of social work clients. Results suggest that financial anxiety, self-efficacy, and literacy can be improved through a brief intervention. Together, these four papers provide new insights into the program and policy influences on health and finances that provide guidance for practitioners and policymakers.