The significance of trauma has become an increasingly accepted tenet of complex care. While there is general agreement on the core principles of trauma-informed care and that trauma can negatively impact an individual’s health and wellbeing, there are many ways to apply a trauma-informed approach in different settings. Presenters Katy Davis from the University of California San Francisco Women’s HIV Program and Michelle Adyniec from the Camden Coalition of Healthcare Providers discussed how they implement trauma-informed principles in a women’s primary care HIV clinic and through authentic healing relationships in Camden, New Jersey. 

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Substance use disorder has received increased public attention due to rising rates of opioid-related overdose deaths and misuse of prescription opioids. While opioid use disorder is an important issue, alcohol use disorder can also be a significant contributor to individuals’ complex health and social needs, due in no small part to alcohol’s legal status, social acceptance, and wide availability. Individuals who accrue the highest medical expenditures are more likely to use or be dependent on alcohol. This type of substance use disorder can impact one’s ability to find and maintain housing and employment, manage chronic conditions, and maintain interpersonal relationships. Alcohol also has far greater secondary harm to others than other addictions.  

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It is widely recognized that good outcomes for patients with complex care needs are achievable when health care providers work locally and in tandem with community, government, and other partners. Interprofessional, cross-sector, and cross-agency collaboration between organizations that share responsibility for serving a group of individuals living in a community or particular geography is an effective way to stabilize health, decrease unnecessary utilization, improve care delivery, and reduce avoidable costs.  

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Rural areas present unique challenges and opportunities for individuals with complex needs and those providing their care. These environments may face healthcare workforce shortages, rising rates of opioid use, and geographical barriers to care. However, rural communities often foster close-knit social networks and an entrepreneurial approach to complex health and social issues.

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