From medical home to health neighborhood: Transforming the medical home into a community-based health neighborhood

摘要

Social issues such as poor housing conditions, home-lessness, and food insecurity powerfully shape children's development and physical well-being and contribute to the physiological and psychological stress that can harm health throughout the life course. The American Academy of Pediatrics' medical home model promotes primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective. Less discussed, but critical for addressing social determinants of health, is the American Academy of Pediatrics' recognition that the medical home also includes "interaction with early intervention programs, schools, early childhood education and child care programs, and other public and private community agencies to be certain that the special needs of the child and family are addressed." We believe that effectively addressing families' unmet social needs will require much greater attention to developing connections between the medical home and community-based services. Although this approach is not new and is embedded in the Community Health Center movement and other initiatives, such as the collaborative mental health care model, health care reform, with its emphasis on linking outcomes with payment, provides a timely opportunity to create a more effective, integrated health services system.