What is the top challenge or obstacle facing health care today?
One challenge is that many of the factors that impact health the most (e.g., housing, transportation, and access to healthy food) are beyond the walls of health institutions. Some pioneers are focusing on these factors, also known as the social determinants of health (SDOH), and experimenting with different strategies, though others have been slower to move. To improve health outcomes, we have to help hospitals and health systems deepen and accelerate efforts to address the root causes of poor health and inequities in the communities they serve.
What story or theme has impacted health care the most over the last two years?
There's been increased pressure on hospitals and health systems to be better community anchors and advocates. Health care is important, and a system may have an amazing facility that provides high quality care. But if their community still suffers from significant health disparities, what role should they play in addressing that? In response, hospitals and health systems are increasingly redefining their business from providing health care to ensuring the health of the communities they serve. Some are stepping outside the walls of their institutions and reducing barriers to accessing care by providing medical services in locations such as school-based clinics. Others are investing directly in their communities to help increase the availability of housing, transportation, education, healthy foods, and safe places. That's a big shift.
How are you preparing your organization for an uncertain future?
I would argue that one thing that is certain is that the places where patients live impact their health outcomes and risks. No matter how we decide to fix it, place matters. At CCI, we've been very focused on investments for healthy communities. It's not on health care alone to fix this. There's an extensive ecosystem of public officials, community workers, and others who are doing this, but health care is a field that's underutilized in community investment.
We encourage institutions to think differently and to focus their efforts on place as well as people. For example, a hospital concerned about local housing instability, which significantly affects health, might do a market study or land analysis, to show the impact of an investment in housing on their community, and then apply for grant dollars to be applied to that. We're helping to guide this transition.
What has you most optimistic about the future of health care?
I'm optimistic and inspired because of the institutions that we work with. The six hospitals and health systems in our Accelerating Investment for Healthy Communities initiative range from big national organizations such as Kaiser Permanente to smaller safety net hospitals such as Boston Medical Center (BMC). It excites me that there's no one-size-fits-all way to get hospitals to invest in social determinants. Instead, we have an opportunity to understand and tap into institutional motivations and drivers in a local way. For example, when BMC makes an investment in housing, it gets local institutions such as banks to match. As the city of Pittsburgh reinvents itself, UPMC is working to make sure that investments in housing benefit the people who live there.
Every time we speak on this issue, or any of our cohort members speak, we end up with multiple follow-up calls: "How do I do that?" "How do I take my SDOH program to the next level?" It gives me hope that people are interested and are taking the initiative, not waiting for others to figure it out.
What's the one piece of advice you would give to an aspiring health care leader?
Don't think you have to move your institution forward alone. There's power in collaboration. Whether you sit in population health management, community benefit, or finance, there's something you can bring to this work. Finding institutional allies that have data or resources or relationships can help you begin to build a comprehensive strategy and give you the scale of resources that you need to invest in your community.
About the Center for Community Investment
The Center for Community Investment at the Lincoln Institute of Land Policy works to overcome disinvestment and improve opportunity so that everyone has a fair chance to lead a healthy and productive life. We help communities achieve their environmental, social, and economic priorities by strengthening their ability to attract and leverage investments. For more information, visit centerforcommunityinvestment.org