How Trauma-Informed Programming to Treat Social Determinants Unveils Challenges to Systems Alignment

Area of Science:

• Public Health
• Health Equity
• Social Determinants of Health

Background:

• Cross-sector collaboration and systems alignment are crucial for promoting a culture of health.
• Addressing social determinants of health (SDH) can improve family well-being and societal equity.
• Integrating health promotion into social assistance programs is a novel approach.

Purpose of the Study:

• To document the alignment of Temporary Assistance for Needy Families (TANF) and Medicaid programs.
• To evaluate the effectiveness of a trauma-informed program, The Building Wealth and Health Network (The Network), in addressing SDH.
• To identify challenges and propose solutions for aligning social assistance and health programs.

Main Methods:

• The Building Wealth and Health Network (The Network) was integrated into traditional TANF.
• Peer-group programming was utilized to address SDH, facilitate healing from adversity, and build financial skills among caregivers.
• A qualitative analysis of challenges encountered during program alignment was conducted.

Main Results:

• The Network successfully integrated into TANF, addressing SDH through peer support and financial education.
• Three key challenges to TANF and Medicaid alignment were identified: TANF's compliance culture, societal factors like racism, and misaligned partnerships.
• Proposed solutions include incentives for innovation, partnership development, and racial equity initiatives.

Conclusions:

• Systems alignment between TANF and Medicaid holds significant potential for addressing SDH and promoting health equity.
• Overcoming challenges related to program culture, societal barriers, and partnership structures is essential for successful integration.
• Further development of strategies promoting innovation and racial equity can strengthen these alignment efforts.