Access Is Everything: An Online Tool To Improve Health Outcomes

July 13, 2022. Duke Medium. By Kathryn Benson.

2021-22 NC Schweitzer Fellow Kathryn Benson

As a future physician, I had hoped that providing medical care alone would lead to healthy patients. However, recent studies indicate that clinical care accounts for less than 20% of a person’s overall health.1 The vast majority of health is actually determined by many social factors, including income, education, psychosocial support, diet, exercise, housing, etc. Disparities in these social drivers of health are responsible for vast disparities in health outcomes. So how should healthcare professionals and community members respond?

Many programs and supports at the local, state, and federal level address these varied determinants of health, and each of us has a valuable opportunity to educate ourselves and connect individuals to these programs. As a North Carolina Schweitzer Fellow, I came to understand how the NCCARE360 platform makes learning about resources and referring individuals much easier. This state-wide online platform provides a database of community agencies, searchable by services provided, and a system through which to make referrals and follow-up on referral outcomes. 

This platform was extremely helpful in my role as a fellow, working in partnership with the Duke Benefits Enrollment Center and End Hunger Durham to help provide social support and community resource connection to older adults in Durham. The mission of the program is to build trusting relationships with participants to facilitate discussions about their social drivers of health and provide referrals to address their needs. Through community partnership, we helped older adults enroll in services such as SNAP benefits to afford healthier food and cost defrayal programs to access their prescription medications. We also facilitated COVID-19 vaccinations for people who were homebound, arranged emergency food deliveries, and lessened social isolation through weekly wellness calls. It has been a privilege and an eye-opening experience to learn about the many resources in our community and the talented, dedicated people who make them possible.

In some cases, the available resources are underutilized. We can all contribute by learning about the organizations offering services, supporting their work, and referring individuals that can benefit from their resources. Duke Health providers can access NCCARE360 through the electronic medical record system and directly refer patients, as many providers are already doing. For organizations and individuals not on the platform, the wide array of resources can be searched through the online directory or accessed by calling 2-1-1. This presents a valuable opportunity for those inside and outside the healthcare system to help address social drivers of health. Through this work, we can all contribute to creating a healthier community. 

Kathryn Benson

Duke University MD Candidate, Class of 2023

North Carolina Albert Schweitzer Fellow 2021-2022


  1. Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med. 2016 Feb;50(2):129-35. doi: 10.1016/j.amepre.2015.08.024. Epub 2015 Oct 31. PMID: 26526164.