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NYS FAM Research
Resource Guide

THE U.S. PLAYBOOK TO ADDRESS SOCIAL DETERMINANTS OF HEALTH

This report discusses the links between SDOH and health outcomes. It outlines key federal actions to-date. "President Biden made a clear commitment to ensuring equity for all by issuing Executive Order 13985, Advancing Racial. Equity and Support for Underserved Communities Through the Federal Government. The Order directs the federal government to implement an ambitious, whole-of government agenda to “affirmatively advance equity, civil rights, racial justice, and equal opportunity” by engaging with members of underserved communities to evaluate opportunities to increase coordination, communication, and engagement. The Order also seeks strategies for improvements in data collection programs, policies, and infrastructure across agencies."

Domestic Policy Council Office of Science and Technology Policy. (2023, November). The U.S. Playbook To Address Social Determinants Of Health. The White House. https://bidenwhitehouse.archives.gov/wp-content/uploads/2023/11/SDOH-Playbook-3.pdf

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Resources from the White House Conference on Hunger, Nutrition, and Health

2023

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Building Trust Between Communities of Color and Health Care Organizations: Lessons from New York State

"This CHCS webinar highlighted how two New York-based health care organizations — John R. Oishei Children’s Hospital and The New York Foundling — are engaging patients in new ways to transform their health care delivery practices. Lessons from these efforts can inform health care organizations across the country seeking to involve patients, particularly patients of color, in efforts to advance health equity. These organizations are participants in Engaging Patients of Color to Advance Health Equity, a CHCS learning collaborative supported by the New York Health Foundation."

Center for Health Care Strategies. (2022, November 9). Building Trust Between Communities of Color and Health Care Organizations: Lessons from New York State. [Video]. Webinar. https://www.chcs.org/resource/building-trust-between-communities-of-color-and-health-care-organizations-lessons-from-new-york-state/

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Lived Experiences

2022

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Voices from the 9/28/22 White House Conference on Hunger, Nutrition, and Health: Hunger, Nutrition, and Health Sessions, Pillar 2: Integrate Nutrition and Health; Mentions at minute 9:43, 21:46 and at 36:00.

This video's panel discusses food insecurity, the barriers to access quality healthy foods that are nutritious and tailored for people's particular circumstances. The discussion also touches on creating a community collaborative of partnerships that turn into systems that work to support Food as Medicine interventions and reimbursements for services. The panel also touches on the need for a fully reimbursable benefit that fuels the innovation and support of FAM initiatives. A network approach is suggested as well as inter-agency collaboration and coordination to work more seamlessly. There is conversation of culinary medicine as a strategy, along with cultural humility, to address the needs of patients while acknowledging their lived experiences with cultural sensitivity

The Biden White House. (2022, October 12). Hunger, Nutrition, and Health Sessions, Pillar 2: Integrate nutrition and health. [Video]. YouTube. https://www.youtube.com/watch?v=--CIDlsivcQ

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Lived Experiences

2022

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The Voices We Trust: Building Equity-Centered Community Data Ecosystems That Work For Everyone

This article shares a link to key findings and discusses how "RECoDE (Rising Equitable Community Data Ecosystems) project team set out to better understand how to undo antiquated and dangerous data systems and build in their place an ecosystem that provides all communities power over where, when, and how their data is used to improve individual and community outcomes".

Health Leads. (2022, March 31). The Voices We Trust: Building Equity-Centered Community Data Ecosystems That Work for Everyone. https://healthleadsusa.org/news-resources/the-voices-we-trust-building-equity-centered-community-data-ecosystems-that-work-for-everyone/

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Lived Experiences

2022

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Aligning Cross-Agency Efforts for Population Health

This article addresses the need for cross-agency and cross-sector partnerships to "advance equitable programs and policies in population health". "Medicaid and public health programs are well-positioned to advance health equity by collaborating on shared equity goals to reduce health disparities for communities of color. CHCS explored opportunities to promote health equity at the state level through cross-agency partnerships."
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Lived Experiences

2023

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Aligning Systems with Communities to Advance Equity through Shared Measurement

This article addresses the importance of system alignment within community settings to support a holistic view on health equity. Finding shared priorities among community members that results in a "common set of measurable goals" that positively affect communities that have "historically been harmed the most". This approach co-creates communities that are centered on stakeholder "values, needs, and actions" that are intentional and build lasting, sustainable, trustworthy systems to support community health.

Hilliard-Boone, T., Lavelle, M., DePatie, H., Adhikari, S., Ali, Maliha, Childers, T., Firminger, K., Ogletree, A., Pathak-Sen, E., Powell, W., & Schultz, E. (2021). Aligning Systems with Communities to Advance Equity through Shared Measurement: Guiding Principles. AIR, (Prepared for the Robert Wood Johnson Foundation). https://www.air.org/sites/default/files/AIR-Shared-Measurement.pdf

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Lived Experiences

2021

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Data Collaboratives: Exchanging Data to Improve People’s Lives

DataCollaboratives.org is a resource on creating public value by exchanging data. In sync with the mission of The GovLab, the site seeks to provide insight on how responsible exchange of corporate data can improve people’s lives. It results from different partnerships with UNICEF and Omidyar Network. This article addresses the demand side of an initiative. In Phase 1, step 1 defines the problem to be solved. Step 2 defines the value proposition of the data collaborative.

GovLab. (n.d.). Phase 1: Demand. NYU - Tandon School of Engineering. https://datacollaboratives.org/canvas.html

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Lived Experiences

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Centering Racial Equity Throughout Data Integration

"This body of work seeks to encourage shifts of awareness and practice, by centering racial equity and community voice within the context of data integration and use. Our vision is one of ethical data use with a racial equity lens, that supports power sharing and building across agencies and community members. This toolkit is designed to help guide partnerships, collaboratives, agencies, and community initiatives seeking to center racial equity while using, sharing, and integrating administrative data."

Hawn Nelson, A., Jenkins, D., Zanti, S., Katz, M., Berkowitz, E., et al. (2020). A Toolkit for Centering Racial Equity Throughout Data Integration. Actionable Intelligence for Social Policy, University of Pennsylvania. https://assets.aecf.org/m/resourcedoc/aisp-atoolkitforcenteringracialequity-2020.pdf

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Lived Experiences

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Why is Community Engagement Important?

This article frames community engagement as inclusive when it involves building constructive relationships between communities and the institutions of government. It explores topics such as "building and sustaining cohesive communities, improving outcomes, ensuring access and community empowerment, helping local governments to promote sustainable decisions, driving social transformation, deepening democracies, as well as why we should use community engagement".

Granicus. (2026). Why Is Community Engagement Important?. https://granicus.com/blog/why-is-community-engagement-important/#sustainable-decisions

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Lived Experiences

2026

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Engaging Communities of Color to Promote Health Equity: Five Lessons from New York-Based Health Care Organizations  

"The Center for Health Care Strategies, with support from the New York Health Foundation and in partnership with ATW Health Solutions, assisted seven New York-based health care organizations in piloting strategies for engaging patients of color to advance health equity. Drawing on the pilot experiences, this brief outlines considerations for health care organizations in developing more robust patient engagement strategies."

Center for Health Care Strategies. (2022, December). Engaging Communities of Color to Promote Health Equity: Five Lessons from New York-Based Health Care Organizations. https://www.chcs.org/resource/engaging-communities-of-color-topromote-health-equity-five-lessons-from-new-york-based-health-care-organizations/

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Lived Experiences

2022

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The Road to Accountability: Promising Practices to Foster Meaningful Health System and Community Partnerships

"This Center for Health Care Strategies (CHCS) webinar, made possible by the Robert Wood Johnson Foundation, shared opportunities to achieve engagement and trust between safety-net health systems and communities drawn from a national exploration of emerging best practices. It featured a panel discussion with representatives from health systems and community-based organizations who provided their firsthand experiences and insights on developing more community-driven and accountable health systems."

Center for Health Care Strategies. (2023, February 1). The Road to Accountability: Promising Practices to Foster Meaningful Health System and Community Partnerships. Robert Wood Johnson Foundation. https://www.chcs.org/resource/the-road-to-accountability-promising-practices-to-foster-meaningful-health-system-and-community-partnerships/

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Lived Experiences

2023

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COVID-19 Health Equity Studies Prompt Policy Recommendations to Prioritize Community Health Workers

This article discusses the important work that CHWs do in their communities. Because CHWs are active members of their community they are uniquely aware of the needs of their community and the social determinants of health in which members are most affected by. The expertise of CHWs is highly valued and warrants a sustainable funding mechanisms "to ensuring their full participation in the nation’s public health infrastructure and a health equity intervention in its own right". To foster sustainability "and maximize the effect on participants’ psychosocial and health outcomes and CHWs’ professional advancement, it is suggested in this article that "federal, state, and local governments, as well as private funders, extend grant terms for CHW initiatives". "Legislation that adds CHWs as an optional benefit in Medicaid should deem tasks related to addressing individuals’ health-related social needs as eligible for Medicaid coverage."

Ibe CA, Hickman D, Cooper LA. (2021). To Advance Health Equity During COVID-19 and Beyond, Elevate and Support Community Health Workers. JAMA Health Forum. 2(7):e212724. doi:10.1001/jamahealthforum.2021.2724

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Lived Experiences

2021

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Enhancing cultural humility in food is medicine services: A mixed-methods investigation of patient food and dietary preferences 

"This initiative is a model for hospitals aiming to improve educational resources within FIM services and tailor content to the specific needs of diverse patient populations. This project is the first step in programmatic improvement, and continuous refinement is crucial for sustained improvements and advancing health equity at our institution."

Thomas, O.W., et al. (2024). Enhancing cultural humility in food is medicine services: A mixed-methods investigation of patient food and dietary preferences. ScienceDirect. 12(3). https://doi.org/10.1016/j.hjdsi.2024.100749

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Lived Experiences

2024

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Food as medicine, community as medicine: Mental health effects of a social care intervention - Thompson‐Lastad - Health Services Research - Wiley Online Library

This article draws on the science that physical and mental health are interconnected. "Food as medicine programs may benefit mental health symptoms. The Recipe4Health program improved short-term, self-reported depression and anxiety symptoms, with greater improvements for those with worse mental health before program participation. For people with depression and anxiety, participation in produce prescriptions and group medical visits together was associated with greater improvements in short-term, self-reported mental health symptoms. Food as medicine programs serving people with nutrition-sensitive chronic conditions should consider including mental health conditions in their eligibility criteria."

Thompson-Lastad, A., et al. (2025, January 7). Food as medicine, community as medicine: Mental health effects of a social care intervention. Health Service Research. https://doi.org/10.1111/1475-6773.14431

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Lived Experiences

2025

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Food for Thought: The Impact of a Nutritional Toolkit on Well-Being in Children - ScienceDirect

"This study investigated whether attendance by a cohort of pediatric patients at an educational/interventional nutritional program could impact dietary habits, physical health and mental well-being." The finding concluded that "a diet intervention program where children and their parents are educated on healthy food choices had a significant influence on children's diet and well-being. For pediatric surgery patients with obesity and cancer, these changes could have a significant impact on long term outcomes and warrant further study".

Stone, M.M. (2025, April). Food for Thought: The Impact of a Nutritional Toolkit on Well-being of Children. ScienceDirect. 60(4). https://doi.org/10.1016/j.jpedsurg.2025.162185

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Lived Experiences

2025

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