In the wake of the Affordable Care Act (ACA), health care in the United States is in the midst of a large movement toward population health. That is to say, health care providers are now beginning to think more about the factors that influence health outcomes that can’t be treated in the hospital setting alone. These social determinants – such as education, housing, and access to healthy food – are now in the spotlight and are becoming more integrated into health plans.
One of the biggest legislative actions as part of this movement has been the new community benefit requirements for nonprofit hospitals. Under this ruling, tax-exempt hospitals must perform a community health needs assessment (CHNA) every three years, which will inform community-based practices, partnerships, and programs aimed at health promotion.
Old Face, New Look
While surveying the community to identify and execute improvement projects is becoming a new health care practice, this has long been the foundation of the community development field. There are a number of definitions for community development, but a publication from the Robert Wood Johnson Foundation explains, “Community development is an enterprise in which public, private, and not-for-profit organizations work to strengthen the economic, physical, and social environments of low-income neighborhoods.”
Community development organizations (often referred to as community development corporations or CDCs) and health care providers do not have a strong history of collaboration. However, with health care reform in full swing, hospitals may have more opportunities to pursue these partnerships.
Most importantly, while this seems like a newer field for health care providers, the resources for community development and health care enterprises are abundant. Databases such as the County Health Rankings and Community Commons offer a wealth of community-based data from all over the country. Similarly, health impact assessments and CHNAs are useful tools for providers and developers alike. Additionally, health care leaders such as Health Affairs (30[11] and 33[11]) and the Robert Wood Johnson Foundation’s NewPublicHealth have created a platform for discussion about this topic.
Also important is the fact that community development is an emerging area for funding. For example, in 2011 the Center for Disease Control and Prevention awarded $103 million in Community Transformation Grants.
The Irreplaceable Role of the Hospital
From a public health perspective, we know that neighborhoods and everything they comprise greatly impact health. The community development field has long been tackling these issues, but now is the time for essential hospitals to stake a claim in community development initiatives.
As providers at the heart of their communities, essential hospitals have an important voice for addressing community health issues and investing in sustainable solutions. Through CHNAs or independently partnering with local community development corporations, hospitals can leverage the shifting health care landscape to get more involved and promote healthier communities for their patients.
