Hospitals

Can Hospitals Heal America's Communities?

Ted Howard and Tyler Norris

Healthcare’s role in creating healthy communities through increasing access to quality care, research, and grantmaking is being complemented by a higher impact approach; hospitals and integrated health systems are increasingly stepping outside of their walls to address the social, economic, and environmental conditions that contribute to poor health outcomes, shortened lives, and higher costs in the first place.  

The Anchor Dashboard: Aligning Institutional Practice to Meet Low-Income Community Needs

Steve Dubb, Sarah McKinley and Ted Howard

This study seeks to introduce a framework that can assist anchor institutions in understanding their impact on the community and, in particular, their impact on the welfare of low-income children and families in those communities.

Download the report and learn more about our work to help anchors measure their impact on community wealth.

 

Editorial: Anchors aweigh on tackling the social determinants of health

Merrill Goozner
Modern Healthcare

Merrill Goozner writes in Modern Healthcare "Editorial: Anchors aweigh on tackling the social determinants of health." In this editorial, Goozner writes about the work of the Healthcare Anchor Network: 

Next week, a 2-year-old network of major healthcare systems dedicated to combating the social problems contributing to ill health in their own backyards will go public. They've chosen to highlight a San Francisco Bay Area food production center that will be up and running by the end of this year.

Located in Richmond, a working-class community that's two-thirds Hispanic and African-American, the center will employ about 200 people in what its sponsors promise will be living-wage jobs. Hospitals belonging to Kaiser Permanente, Dignity Health and the University of California at San Francisco will purchase fresh meals from the facility.

Organizers say this is just the start of a nationwide movement to use healthcare systems, often a community's largest employer and purchaser, as an "anchor" institution for local economic development. Three dozen major systems, which collectively represent 600 hospitals with over 1 million employees in more than 400 cities and towns, have already signed on to the Healthcare Anchor Network. They are pledging to use their hiring, purchasing and investment decisions to promote better-paying jobs.

It's a promising development in healthcare's evolving approach to population health. The core concept rests on the belief that achieving better health outcomes for the populations for which they're at risk financially will ultimately depend on improving the social conditions that spawned their diseases.

Read more in Modern Healthcare 

A Plan to Nationalize Fossil-Fuel Companies

Peter Gowan
Jacobin

Peter Gowan writes in Jacobin Magazine "A Plan to Nationalize Fossil-Fuel Companies." In this article, Gowan writes about the Democracy Collaborative's research on the cost of nationalizating fossil-fuel industry: 

"This could be quite costly — writers from The Democracy Collaborative recently estimated “the price tag to purchase outright the top 25 largest US-based publicly traded oil and gas companies, along with most of the remaining publicly traded coal companies” at $1.15 trillion. But there are ways to minimize this cost while still obtaining all of the benefits."

Read more in Jacobin.

A Second City

Nissa Rhee
Chicago Magazine

Writing in Chicago Magazine, Nissa Rhee writes a long-form article on the effects of poverty in Chicago; "A second city."  Rhee quotes David Zuckerman about the anchor strategy in Chicago's West Side Total Health Collaborative

“Our job as doctors is to heal and prevent suffering,” says Ansell. “In this situation, the healing needs to be aimed at neighborhoods.”

While most anchor institution strategies around the country have focused on one issue, employment or housing for example, the West Side Total Health Collaborative has a wide scope and an impressive goal: To improve life expectancy across region and halve the 16-year life expectancy gap between West Garfield Park and the Loop by 2030.

According to David Zuckerman, a manager for health care engagement at the Democracy Collaborative and organizer of the Healthcare Anchor Network, it is “the most ambitious collective strategy around anchor work” he’s seen to redirect money into a particular region.

Read more in Chicago Mag

Rush Hospital Wants to Tackle the West Side “Death Gap.” Will It Work?

Nissa Rhee
Chicago Magazine

Nissa Rhee, writing for Chicago Magazine, in "Rush Hospital Wants to Tackle the West Side “Death Gap.” Will It Work?" In this piece, Rhee highlights in the work that the Healthcare Anchor Network: 

All this exemplifies a national movement by nonprofits and public institutions “to think differently about how to use its economic resources and social capital to really benefit not only its long-term wellbeing but that of the community,” says David Zuckerman, a manager for health care engagement at the Democracy Collaborative and organizer of the Healthcare Anchor Network, a group of 30 health systems that are doing this work.

Zuckerman says that hospitals have a lot of “sticky capital,” or “dollars that can’t pick up and leave the way that manufacturing or many corporate employers have left communities.” They are in essence grounded cruise ships, requiring a huge staff, thousands of meals for patients, medical supplies, and linen cleaning services. If hospitals are able to redirect some of their purchasing and hiring to their neighbors, say using a local laundromat instead of shipping soiled bed sheets further away, they could have a large impact on the community, says Zuckerman.

Read more in Chicago Mag

A New Role For Hospitals: Boosting the Local Economy

Kate King
Wall Street Journal

Kate King, writing for the Wall Street Journal, in 'A New Role For Hospitals: Boosting the Local Economy.' In this article, King highlights the anchor work by New Beth Israel Medical Center in Newark, NJ and the vision and leadership by the Democracy Collaborative:

“The current fee-for-service model, in which we’re not actually addressing the root causes for why people are showing up in the emergency room, just is not sustainable,” said David Zuckerman, director of health-care engagement for the Democracy Collaborative, a think tank and advisory group.

Read more in the Wall Street Journal

Leveling the Playing Field in City Contracting

Oscar Perry
Next City

Oscar Perry, writing for Next City, highlights the work of the Democracy Collaborative in "Leveling the Playing Field in City Contracting." In this long form piece, Perry writes about why New York City has doubled their contracts with women-and-minority-owned firm. As well as, the work of Democracy Collaborative's thought leadership, direction, and work with anchor instutitons through the Healthcare Anchor Network: 

Corporations and anchor institutions like hospitals and universities are stepping up MWBE contracting commitments and programs, too. The Democracy Collaborative, a nonprofit that does research and builds leadership around equitable, inclusive and sustainable development, has been working with anchor institutions to support more diverse contracting through the lens of building stronger local economies. In January 2017, it formed the Healthcare Anchor Network, consisting of 30 healthcare systems nationwide.

“Healthcare systems are recognizing the need for intentionality to overcome the history of discrimination,” says David Zuckerman, who manages the network. Yet such programs remain in danger of going away when there’s a leadership change, he notes.

“If you can institutionalize it, and build it into your strategic plan, that’s what’s powerful,” he says. “We’re not there yet, but I think in the next year we’re going to see more health systems build this local impact work into their strategic plans.”

One way to institutionalize it: Make it someone’s job.

“There might be an official statement that ‘we’re going to prioritize the effort to increase our spend to MWBEs,’ but it’s not any one person’s job, it’s something extra,” Zuckerman says.

Read more in Next City

Public Health & Wealth in Post-Bankruptcy Detroit

Suparana Bhaskaran
UC Berkeley

Published by the Haas Institute for a Fair and Inclusive Society at UC Berkeley, this new report discusses the relationship between health outcomes and wealth disparities in Detroit, Michigan. The authors detail how a lack of access to safe housing and water poses the greatest health threats to residents, and call for solutions outside the realm of clinical care. While noting the necessity of Medicaid expansion, the report calls for investments in the social determinants of health—including affordable housing and expanded social services.

Race-Explicit Strategies for Workforce Equity in Healthcare and IT

This new report from Race Forward focuses on the need to develop race-explicit strategies to advance equity in the fields of healthcare and information technology. While these sectors are growing quickly, many career pathways remain inaccessible to people of color in low-income communities due to patterns of discrimination and disinvestment. The report provides recommendations for workforce development practitioners to advance racial equity, both at the organizational level and across the field. 

The Anchor Mission Playbook

Rush University Medical Center
with support from Chicago Anchors for a Strong Economy (CASE), the Civic Consulting Alliance, and The Democracy Collaborative

Anchor institutions can play a key role in helping the low-income communities they serve by better aligning their institutional resources—like hiring, purchasing, investment, and volunteer base—with the needs of those of communities. The recommendations in this “playbook,” drawn from research carried out to help Rush University Medical Center (RUMC) align around its Anchor Mission, are being published to help other hospitals and health systems accelerate their own efforts to drive institutional alignment with community needs.

Single-Payer Would Be a Good Start, but Real Health Equity Means Tackling Economic Disparities

Dana Brown
Truthout

Dana Brown, of the Democracy Collaborative, writes for Truthout about tackling the healthcare gap by addressing economic inequality. 

The horrifying specter of Trumpcare, the shortfalls of Obamacare and the continued rise in overall health care costs in the United States have provided an important opening for proponents to put single-payer back on the table. Attempts at creating a national health insurance scheme have come close but failed several times before in US history. However, while it is imperative to ensure that every American has equal access to quality care, single-payer is insufficient when it comes to ensuring our right to health and well-being.

Read more in Truthout 

Partners HealthCare

Founded in 1994 by Brigham and Women's Hospital and Massachusetts General Hospital, Partners HealthCare employs 6,000 physicians working across 9 hospitals, 5 community health centers, and numerous home care and other health-related facilities.  To ensure community residents can access employment opportunities that offer family-sustaining wages, benefits, and opportunities for advancement, Partners has several workforce development programs.  To date, its health care training program has graduated 571 adult community residents, and its youth-focused programs employ more than 450 youth on an annual basis.  Aiming to procure goods and services from more diverse suppliers, in 2004 Partners launched a Supplier Diversity Program, which now includes over 3,000 certified/categorized Historically Underserved Businesses.

Reflecting and Planning Using a Community Wealth Building Lens

Brent Kakesako
Shelterforce

Writing for Shelterforce, Brent Kakesako takes a look at the 25th annivisary of the community wealth building field:

Our growing community wealth building field has the goal of building 'a new economic system where shared ownership and control creates more equitable and inclusive outcomes, fosters ecological sustainability, and promotes flourishing democratic and community life.'

Read more about the history of community wealth building in in Shelterforce ...

How radical co-ops are leading the way to a new, democratic political economy

Miles Hadfield
Coop News

Organisations like Cleveland’s Evergreen Co-operatives are creating opportunities for co-ops in poor urban communities and helping to decentralise planning

Coop news cover's Gar Alperovitz Principles of a Pluralist Commonwealth highlighting the link between The Democracy Collaborative work with hospitals and the long term vision of a new socierty with The Next Sytem Project... read more 

 

Communities in Action: Pathways to Health Equity

National Academies of Sciences, Engineering, and Medicine

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health.

Only part of an individual’s health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways.

Can Hospitals Heal America's Communities?

Ted Howard and Tyler Norris
The Democracy Collaborative

Healthcare’s role in creating healthy communities through increasing access to quality care, research, and grantmaking is being complemented by a higher impact approach; hospitals and integrated health systems are increasingly stepping outside of their walls to address the social, economic, and environmental conditions that contribute to poor health outcomes, shortened lives, and higher costs in the first place.  

 

Advancing the Anchor Mission of Healthcare

Inaugural convening brought together health system leaders dedicated to reimagining role of healthcare

This past December, the Democracy Collaborative joined eight sponsor health systems and organizations to host Advancing the Anchor Mission of Healthcare, a two day convening of over 80 health system leaders and key stakeholders, representing 40 health systems from across the U.S. Read more about Advancing the Anchor Mission of Healthcare...