A low-cost program assisting people with social needs: The Health Advocacy Program

Publication/Presentation Date



As health systems increasingly screen for patients’ social needs, they are being challenged with how to address those needs while controlling costs. Most health systems have social workers and care managers who are able to connect patients to needed resources, however this can become very costly as more patients are identified with these social and economic needs.

According to Maslow’s Hierarchy of Needs, basic needs must be satisfied before an individual can achieve full potential. These basic needs impact people’s well-being, serving as impediments to accessing health care and performing healthy behaviors. Often individuals lack self-efficacy in their ability to address their needs and therefore may not obtain the benefits to which they are eligible.

The Health Advocacy Program (HAP) trains college students to serve as Health Advocates (HA) in a large health system. HAs perform in-depth social assessments and link clients to services. Among HAP clients, >50% need assistance with housing and/or food, 40% have financial concerns, and >30% need transportation. Clients who need civil legal assistance (30%) are referred to the health system’s medical-legal partnership. Over 450 clients have been referred to HAP and more than 1283 referrals have been made to community resources. HAs follow-up one week after making referrals to determine if needs were satisfied. Number of connections made and satisfaction with those connections are documented.

Health outcomes include reductions in average number of emergency department visits (2.07 to 1.87); hospitalizations (1.36 to 1.25) and no-shows for clinic appointments (2.68 to 2.64) measured 6 months prior and 6 months after enrollment in HAP. Other outcome measures include changes in perceived stress and depression.

Social needs can be addressed at a low annual cost (<$30,000) by engaging college students as compared with community health workers (>$60,000) or social workers (>$90,000) when wages and benefits are considered. Colleges, health systems, and clinical practices should partner to better address patients’ social needs and limited self-efficacy.


Patient Care Services / Nursing, Patient Care Services / Nursing Faculty, Department of Population Health, Department of Community Health and Health Studies

Document Type


This document is currently not available here.