Ep. 7: Provider Perspectives: From the Exam Room to the Community, with Dr. John Merrill-Steskal of Kittitas Valley Healthcare

In this episode of Care and Consequence, hosts Sharon Brown and Becky Betts sit down with Dr. John Merrill-Steskal of Kittitas Valley Healthcare for a provider’s view on the gap between clinical care and the social needs that drive health outcomes. They cover how unmet needs like housing, food, transportation, and isolation show up in the exam room and downstream in emergency department use and preventable readmissions, what changes when providers have a trusted community referral network instead of a list of phone numbers, and what’s possible in rural communities when relationships are treated as infrastructure.

Resources referenced in this episode:

Effects of Food and Nutrition Insecurity on Global Health.

The New England Journal of Medicine. 2025. Gallegos D.Review

Food Insecurity and Premature Mortality and Life Expectancy in the US.

JAMA Internal Medicine. 2024. Ma H, Wang X, Li X, et al.Opinion


The Association Between Food Insecurity and Adverse Health Outcomes in Adults: An Umbrella Review of Systematic Reviews and Meta-Analyses.

Nutrition Reviews. 2025. Moosavian SP, Awlqadr FH, Mehrabani S, et al.

The Health of Homeless People in High-Income Countries: Descriptive Epidemiology, Health Consequences, and Clinical and Policy Recommendations.

Lancet. 2014. Fazel S, Geddes JR, Kushel M.Review

Addressing Loneliness and Social Isolation in Older Adults.

American Family Physician. 2021. Lahlou RM, Daaleman TP.Rev


Health-Related Social Needs and Health Care Utilization in the Accountable Health Communities Model.

JAMA Network Open. 2025. Sidebottom AC, Martins S, Vacquier MC, Dechaine C, Behrens D.New

Relationship Between Social Risk Factors and Emergency Department Use: National Health Interview Survey 2016-2018.

The Western Journal of Emergency Medicine. 2025. Guleria I, Campbell JA, Thorgerson A, Bhandari S, Egede LE.