Wellness = Health + Financial Literacy – South Seattle Emerald

by Dr Daniel Low


“I never asked a doctor,” he joked. “Well, taxes are important, Mr. Jones,” I laughed. Like many others, Mr. Jones had recently worked up the courage to come for his first visit to the clinic in nearly two years, previously avoiding the medical facility as COVID-19 raged across the country. With so much time between our last visits, he was expecting questions about managing his diabetes and getting screened for colon cancer (which we’ve covered), but what if he needed help filing his taxes? It wasn’t what he expected.

Yet, as COVID-19 prompts us to rethink what health care might look like, we need to start thinking about health centers as more than just places to treat illness; we need our health centers to promote well-being, and that also means helping to ensure financial well-being.

As a family physician working with predominantly low-income communities, I see my patients suffering from inflation and the economic impact of COVID-19. Health is intimately linked to wealth, and patients cannot effectively care for themselves when they struggle to pay rent and shop. To keep my patients healthy, I must help them achieve economic stability. And it starts with taxes. Virtually everyone working on Medicaid — most of my patients — is eligible for the Federal Earned Income Tax Credit (EITC), where they can receive hundreds or thousands of dollars in tax credits. The EITC program is the the biggest and the most effective anti-poverty program in the country. Still, more than 20% of those eligible for the EITC never claim it due to the difficulty of navigating our complex tax system. In Washington State, the numbers are even more sobering; more … than 25% of estimated beneficiaries do not ask their tax benefits.

That’s why I started asking my patients if they needed help with their tax returns and, if so, referring them to organizations such as United Way and the AARP Foundation, whose certified Tax-Aide volunteers help people in need file their taxes for free. But most people don’t know about the services these organizations offer, and many more don’t know they can access them. Others are understandably hesitant to disclose their financial information to strangers. Closing this chasm of trust and information requires longitudinal and caring relationships. These types of personal and community relationships are the basis of community health centers (CHCs), and the union of medical and financial institutions can be an innovative way to bridge the gap and promote economic and medical well-being.

Medico-financial partnerships can leverage the position and expertise of cross-sector organizations to reduce the number of tax beneficiaries who do not claim their reimbursements. CHCs nurture trusted intergenerational relationships with low-income individuals, families, and communities across the country, and could serve as pools of selection for those in need of tax assistance. These clinics could then serve as conduits to financial experts who could help patients access tax refunds. Such collaborations have emerged in recent years with remarkable success. In Boston, primary care clinics associated with StreetCred helped 750 families receive $1.6 million by providing free tax assistance at their clinics. With a similar model, DotHouse Health in Dorchester, Massachusetts, has helped more than 1,000 low-income patients with precision file taxes, which translates to an average of over $2,000 in refunds per attendee. Similar results have been seen in San Francisco, where San Francisco General Hospital and its affiliated clinics recently launched a financial fitness program to help patients file their taxes freely.

CHCs are the foundation of health care for our low-income communities. It is time for CHCs to be supported to serve more than just institutions that provide health care, but also as institutions that promote health. This means investing financially in CHCs to enable holistic and comprehensive care, including financial services. In turn, CSCs must think bigger and broader, be open to engaging with social entrepreneurs and partnering with cross-sector leaders. With the end of tax season, this coming year is an opportunity and an invitation for our medical and financial leaders to work together to reduce poverty and improve the health of people like Mr. Jones. It starts with a partnership to implement free tax preparation.


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Dr Daniel Low is a family physician at HealthPoint in Renton. He is Vice President of the King County Medical Society and an active member of the Washington Physicians for Social Responsibility Economic Inequality Task Force.

📸 Featured Image: Photo by Andy Dean Photography/Shutterstock.com

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