Addressing Social Determinants of Health through Family Advocate Support in Cumberland, Gloucester, and Salem Counties

Posted in Cumberland County, Gloucester County, IMPACT Blog, Salem County, Social Services Delivery

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Authors: Madeliene Alger, Kristin Curtis, and Priyal Shah

The Family Strengthening Network (FSN), an initiative (project) of the United Advocacy Group, is a non-profit organization working in Cumberland, Gloucester, and Salem counties to empower families in achieving their goals by pairing each family with a Family Advocate (FA) free of charge. The FA collaborates with families to develop goal plans based on the family’s articulated priorities and implements solutions for meeting the family’s needs, many focusing on social determinants of health – e.g., housing, education, and transportation. Additionally, FAs support the family in navigating the sometimes complicated systems needed to access critical resources.

Families in this tri-county region often grapple with multiple intersecting issues, such as economic instability and limited access to transportation and other resources. Additionally, these three counties have poorer health outcomes when compared to the rest of New Jersey. With this in mind – and with support from the South Jersey Institute for Population Health (SJIPH) – we embarked on a research project over the past year with two goals: (1) to understand the impacts of the FAs on the social determinants of health (SDOH), and (2) to highlight existing strengths, barriers, and recommendations around addressing social determinants of health for families in those areas. This research builds on a decade-long evaluation of the Whole Family Approach program, where we found improvements in SDOH-relevant areas after families worked with an FA.

Our deeper dive into the impact of FAs through interviews and focus groups revealed personal stories that shed light on the ways that they helped families address various social determinants of health:  

  • Education: Many families shared that they faced significant hurdles when working to obtain an IEP (Individualized Education Plan) for their child. The FAs discussed how they “coach the caregivers/parents through the process.” FAs help students by aiding caregivers in navigating the complex process of the Individualized Education Program (IEP). As one person shared, “…She [the FA] helped me to advocate with the school’s CST [child study team] that she would review the IEP [individual education plan] meetings with me and attend the IEP meetings. So, for items –the things that she thinks my kids should be eligible for and the school is not providing, she will help me advocate for that. … Having a second person attending these meetings with me, someone that knows the rules and what’s available – it’s really helpful.”
  • Transportation: Many families mentioned how the lack of transportation options created resource barriers resulting in challenges related to accessing food, healthcare services, and employment opportunities. Family Advocates agreed that transportation was a barrier and shared how they supported families in navigating it: “..Yeah, I have clients in three counties…But its [resource for family] not close enough…Because most of our clients are here [in Cumberland, Gloucester, or Salem Counties] and we get a lot of resources for other places…transportation is such a big deal, right now…Volunteers of America has bus transportation, bus tickets. I got in touch with the health department [that has] cards for some of my clients for getting back and forth to work…We also are in the process of getting bus tickets ourselves [to give to families].” 
  • Domestic Violence: At the Family Strengthening Network, there are FAs that specifically work to support survivors and families affected by domestic violence. They connect those impacted with resources, such as legal, housing, and emotional support. As one FA shared: “Our role is different because we’re not just Family Advocates we are also Domestic Violence advocates, so our [work] is more like, you know, nobody’s out there for you. And that’s what you think [when] you’ve been told that. And that’s why it’s really important for us to let them know, like, we are here for you, even though you’ve been told that you are nothing and you’re nobody, you have one of us, or you have our whole team, and we will always be here for you…”
  • Housing: Both families and FAs reported significant challenges around housing, such as shortage of affordable housing, including long waitlists and increases in rent prices that squeezed tight family budgets. One person shared that the FA was “…able to guide me in the right place for safe housing…They were able to guide me in the right direction for therapy.  [They] even gave me this big old gift bag gift basket the first day we met with like appliances for the home and stuff like that…Every other week my advocate is checking in on me making sure everything’s going okay with the court and she even went out her way to help me find a new housing if needed.”
  • Economic Stability: The families FSN serves struggle with financial barriers that make daily life difficult. For example, some shared that they are not making enough money to support their families. The FAs shared that they work to provide “a lot of assistance with emergency food boxes, donations, clothing, diapers, and feminine care items…” 

These perspectives from families and their service providers lay a foundation to help understand the importance of the kind of personalized support that FAs provide. The impact of these strategies for supporting families in addressing the social determinants of health are echoed and deeply felt throughout the stories of families in this tri-county region of South Jersey. To learn more, please see here for the full report.

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Funding Acknowledgement: This research project was funded by the South Jersey Institute for Population Health (SJIPH). The opinions, findings, and views presented are those of the author(s) and do not necessarily represent the official policies of SJIPH or the Rowan University/Rutgers-Camden Board of Governors.