Hospitals to Help Tackle Economic Drivers of Health Disparities

Fourteen hospital systems from across the United States in November announced plans to invest more than $700 million in community-based efforts to tackle the economic and environmental forces that contribute to disparities in health outcomes. Organization leaders said they would target the bulk of the investments toward projects that increase development of affordable housing.

The national campaign marks the first time that a number of large health systems—such as RWJBarnabas Health in New Jersey, UMass Memorial Health Care in Massachusetts, Advocate Aurora Health in Wisconsin, and Intermountain Healthcare in Utah—have collectively pledged to make such impact investments. Kaiser Permanente plans to make one of the largest, at $200 million, to help finance affordable housing in Northern California and elsewhere. The effort has been spearheaded by the Healthcare Anchor Network, the collaborative of hospitals and health care systems started in 2017 to help members learn about challenges, innovations, and best practices from peer institutions.

This initiative reflects a growing recognition of the strong connection between housing and health. Research has consistently demonstrated a strong link between the two, with key factors generally falling into four categories: housing quality, affordability, location, and social and community attributes. Expanding affordable housing options can improve community health by enabling people to pay for other basic needs, such as utilities, food, and medical care, which then reduces the incidence of negative health outcomes such as malnutrition.

Further, research shows the design and quality of housing can affect health outcomes such as asthma, cardiovascular disease, cancer, and injury. Meanwhile, the location and the social, economic, and built environments of the surrounding neighborhood can have implications for health through access to supportive resources, opportunities, and social networks and relationships.

Among the initiatives beyond affordable housing are plans to build grocery stores in food deserts, create childcare centers, open more community health center sites, and fund new local minority- and women-owned businesses. Important on their own, these projects also address some of the diverse drivers of health, such as employment, community development, and education.

This impact investment initiative demonstrates an increasing recognition that people’s choices and access to quality health care represent just part of the equation for ensuring all are as healthy as possible. As more institutions and communities look to address contributing factors beyond the health care and public health systems—gender, education, housing transportation, and employment policies, for example—those involved in decision-making should work across sectors to maximize the health impact and improve the well-being of underserved populations.

Stacey Millett directs the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.