Leveraging Population Health Expertise to Enhance Community Benefit

Abstract

As the Internal Revenue Service strengthens the public health focus of community benefit regulations, and many states do the same with their tax codes, hospitals are being asked to look beyond patients in their delivery system to understand and address the needs of geographic areas. With the opportunities this affords come challenges to be addressed. The regulations' focus on population health is not limited to a defined clinical population-and the resulting emphasis on upstream determinants of health and community engagement is unfamiliar territory for many healthcare systems. At the same time, for many community residents and community-based organizations, large medical institutions can feel complicated to engage with or unwelcoming. And for neighborhoods that have experienced chronic underinvestment in upstream determinants of health-such as social services, housing and education-funds made available by hospitals through their community health improvement activities may seem insufficient and unreliable. Despite these regulatory requirements, many hospitals, focused as they are on managing patients in their delivery system, have not yet invested significantly in community health improvement. Moreover, although there are important exceptions, community health improvement projects have often lacked a strong evidence base, and true health system-community collaborations are relatively uncommon. This article describes how a large academic medical center tapped into the expertise of its population health research faculty to partner with local community-based organizations to oversee the community health needs assessment and to design, implement and evaluate a set of geographically based community-engaged health improvement projects. The resulting program offers a paradigm for health system investment in area-wide population health improvement.

Unlocking inclusive growth by linking micro assets to anchor institutions: The case of skilled overseas migrants and refugees and hospital jobs

“…Rather, most healthcare facilities are owned and operated by private sector businesses. Following the 2010 Affordable Care Act requiring all nonprofit hospitals in the USA to conduct a Community Health Assessment at least every three years, there is increasing interest in looking beyond the traditional focus of hospitals on providing direct care for patients towards looking at their role as urban institutions, including on improving health and examining the social determinants of health in their surrounding local communities, and involving groups and organisations not typically represented in the healthcare delivery system in understanding the needs of geographic areas (Franz et al, 2019;Kaplan and Gourevitch, 2020;Wahowiak, 2017). Yet, analysis suggests that their contribution as anchor institutions in the USA varies by size and type of hospital (Cramer et al, 2017;Sherman and Doussard, 2019).…”

Addressing population health inequities: investing in the social determinants of health for children and families to advance child health equity

“…Other areas of investments included education, food security, and transportation. NYU Langone's community-based program, ParentCorps, engages parents living in low-income households and belonging to historically marginalized racial and ethnic groups during school transitions [20]. And, the Kaiser Permanente system has invested in several youth social determinants programs, including $20 million in funding for youth workforce development in Seattle, WA [9].…”