Hospitals need a community investment approach to improve health

If you provide health care, you know that children who live in slums too often come to emergency departments with conditions such as asthma, uncontrolled diabetes and bacterial pneumonia that could be effectively prevented. with better access to routine medical care, as well as other factors that influence health, such as safe and affordable housing and healthier food. As the COVID-19 pandemic has revealed, these barriers to health disproportionately impact people of color and low-income people.

As a pediatrician with the nation’s largest health philanthropy and CEO of one of the nation’s largest pediatric research hospitals, we see how important neighborhoods are to children’s health. In fact, neighborhoods matter to everyone’s health.

Because most of what affects our health happens outside of hospitals and clinics, institutions like Nationwide Children’s can do much more to eliminate the inequities that prevent communities from thriving and children from being healthy. This will force hospital leaders to think differently about their mission and adopt a community investment approach that takes a broader view of health and what it takes to produce it.

There is a perception that healthcare institutions are solely driven by economic drivers and will only invest in projects that meet narrowly defined return on investment goals. But we see a growing number of healthcare organizations embracing their mission to remove deep-rooted barriers to health through their role as anchor institutions. They recognize their unique ability to invest in communities to improve health, create affordable housing, develop workforce programs and support small local businesses. But this work cannot move forward without the support of the C suite and the conference room.

Nationwide Children’s is part of a cohort of nonprofit healthcare pioneers, from safety net hospitals to academic medical centers to health plans, who have identified best practices to guide others institutions interested in investing upstream to improve health. The Robert Wood Johnson Foundation supports this work so that it can grow.

The leaders of these institutions see the mutual benefits that accrue when they partner with neighborhoods to do this work. Investing in conditions that provide better opportunities for healthy living allows them to strengthen community relationships and fulfill their obligations to the residents who live there. It also allows hospitals to build their reputation and market position by leveraging their skills, power and assets to promote the value of care rather than the volume of services.

Investing upstream also offers those who lead healthcare facilities the opportunity to build and strengthen trust in the community and to engage meaningfully with residents, faith leaders, nonprofits and philanthropic organizations to improve neighborhood conditions that affect health; while fulfilling their mission to keep people healthy.

Hospitals are often among the most stable financial institutions in a community. They have resources and infrastructure. Hospitals own or can invest in land and bring in capital. Health systems can lend directly to affordable housing developers or partner with community development financial institutions. Hospitals also know how to leverage public and private funding sources to subsidize housing and promote home ownership and use their land for groceries and other amenities.

Their involvement can also unlock investment by others. Through a partnership with a faith-based community development organization, Nationwide Children’s Healthy Neighborhoods Healthy Families has raised nearly $50 million for the South Side of Columbus. He has guaranteed loans and his investments have multiplied many times over with the help of the city, United Way of Central Ohio and others, creating nearly 450 high-quality affordable housing units.

Nationwide Children’s is now working with residents of another neighborhood in Columbus. He committed the municipal land bank to using vacant land to build high-quality affordable housing. Our success is tied to our close collaboration with residents, churches and community organizations, working hand in hand.

Health systems can also use their influence. The average life expectancy of a person without stable housing is about 27 years less than that of a housed person. Kaiser Permanente has advocated preserving 17,000 affordable homes along a new light rail system that provides residents of Prince Georges County, Maryland with access to health-influencing opportunities.

The Affordable Care Act requires hospitals to conduct a community health needs assessment to identify the root causes of health problems; many hospital leaders are taking steps to improve health in their backyards.

But they must go further. If we want a nation where everyone has the opportunity to lead a healthy life, more hospital leaders need to start asking not if to invest, but how much and where, and then work as full partners to creating equitable and healthy communities.

Jill E. Washington