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Core values

- **Addressing Social Drivers of Health**: The initiative focuses on incorporating social drivers of health into adult primary care, which includes economic status, food, housing, access to healthcare, education level, health literacy, and discrimination. These factors are known to influence 50-60% of health outcomes and underlie health disparities in chronic diseases[1].
- **Improving Health Equity**: The project aims to improve health equity by systematically addressing social needs, which can substantially improve health outcomes for patients with multiple chronic conditions. This aligns with the broader goals of reducing health disparities and improving overall community health[1][2].
- **Community Collaboration**: The initiative involves collaboration with primary care physicians, patients, community organizations, and other stakeholders to ensure that the needs of the community are met effectively. This multi-level approach enhances the likelihood of sustainable positive change[1].
- **Systemic Impact**: The project is part of a larger framework that includes the Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities and is integrated with VUMC’s Racial Equity Plan. This indicates a comprehensive and systemic approach to addressing health inequities[1].
- **Community Health Needs Assessment**: The project is informed by a thorough Community Health Needs Assessment (CHNA) that identifies key health inequities, needs, and assets in the community. This ensures that the initiatives are tailored to the specific needs of the population[2].