Report: A Roadmap For Hospitals To Better Address Community Health

A report from the National Academy of Sciences explores how hospitals could do more to address social issues that lead to health problems. These "social determinants of health" are the things outside of a doctor's office which have a huge impact on health, such as good jobs and stable housing.

The report recommends hospitals add social service experts to their care teams, as well as look for opportunities to invest in community programs that are making a difference in people’s ability to be healthy, like food banks or violence prevention efforts.

Every year, nonprofit hospitals spend money on what’s known as “community benefit” and many hospitals in Northeast Ohio have traditionally put the bulk of this money toward clinical care.

But Case Western Reserve University professor at the Mandel School of Applied Social Sciences  David Miller said ‘business as usual’ isn’t working.

"You bring someone in and we run the test, and that’s fine, but if they go back to the community with sub-adequate food, with failing housing, with poor water, with violence constantly on them adding to the stress, all the medicine and diagnostic programs that they might receive in the hospital — provided they have health insurance — doesn’t amount to much because they’re going back into that environment," he said.

Miller said that local hospitals could do much better when it comes to community health improvement and working upstream on health issues. "MetroHealth, hands down, is doing more in the community than Cleveland Clinic and University Hospitals, so they have some work to do."

Miller said hospitals need to get out into the community more, understand the full context of people's lives, and develop structural solutions.

The National Academy of Sciences report also highlights the importance of new financing models for healthcare that reward hospitals for keeping people healthy, rather than paying for sick care.