Written by Randy Oostra, CEO of ProMedica (a member of the Healthcare Anchor Network) with the support of The Democracy Collaborative's David Zuckerman and Katie Parker, this report offers an in-depth look at how the Toledo, Ohio based health system aligned its institutional operations and clinical practice to better tackle the social determinants of health. From an innovative hospital-owned grocery store in a food desert to investments in preserving affordable housing, this exploration of ProMedica's decade-long journey to understand how their resources as a healthcare anchor could be used for the wellbeing of the communities they serve is a useful guide for hospitals and health systems embarking on similar shifts.

Our new report, Higher Education's Anchor Mission, examines how an ongoing—and expanding—effort to track the impact of colleges and universities on the financial and social well-being of their surrounding neighborhoods is helping these anchor institutions align their resources to build stronger community partnerships and create more inclusive local economies.

With income inequality in the United States at record high levels, employee ownership is increasingly being lauded as a potential solution to spreading wealth more broadly. Most recently, research from the National Center for Employee Ownership released in May shows that employee owners have a household net worth that is 92 percent higher than non-employee owners. They also make 33 percent higher wages, and are far less likely to be laid off. 

But employee ownership requires new investment in order to get to scale. A new report by Mary Ann Beyster, president and trustee of the Foundation for Enterprise Development (FED), published by the Fifty by Fifty initiative of The Democracy Collaborative, examines the investing landscape for potential opportunities in employee ownership. The report, Impact Investing and Employee Ownership, reports on the results from six months of research showing that the opportunities for impact investors to support employee ownership are limited, but that an investing infrastructure is beginning to emerge across asset classes. 

In The Next System Project’s first policy brief, Democracy Collaborative Fellow Ellen Brown, founder and president emeritus of the Public Banking Institute, explores what’s wrong with President Trump’s approach to infrastructure. By focusing on private investment and public-private partnerships (PPPs) to come up with the capital to invest in repairing and upgrading our infrastructure, his plan will accelerate (partial) privatization of public assets and impose huge costs upon local residents, to be repaid through local taxes and extractive and regressive user fees like tolls.

Drawing on the historical precedents of both Lincoln’s investments in railroad infrastructure and FDR’s financing strategies for the New Deal, Brown shows how public strategies for investing in infrastructure make far more sense than what Trump is likely to put on the table. She estimates that an approach grounded in the use of public depository banks, either at the federal level or spread across a state-by-state network, could cut the $1.18 Trillion financing costs associated with a $1 Trillion investment in infrastructure in the Trump plan, once the returns demanded by private investors are factored in, to a mere $200 Billion. Not only would such public banks be able to lend money for infrastructure projects at a far lower rate, the interest earned on such loans would return to the public coffers.

Brown also identifies an even bolder approach that could bring the costs of investment in infrastructure down to zero. By embracing its power to create money for the public good using an innovative “qualitative easing” approach to inject new money into the real economy, the federal government could directly cover the costs of the pressing upgrades and repairs to our nation’s roads, bridges, dams, water supplies, electrical grid, and transit lines without the need to borrow any money at all.

In December 2016, leaders from 40 health systems gathered in Washington, DC to explore the potential to more fully harness their economic power to inclusively and sustainably benefit the long-term well-being of American communities. Together, they discussed best practices and strategies to advance the Anchor Mission of healthcare.

At the conclusion of the convening, the Healthcare Anchor Network was formed to support health systems collaborating nationally to accelerate learning and local implementation of economic inclusion strategies.

This report summarizes the events of that convening and next steps, inviting your hospital or health system to join the Network and help advance the Anchor Mission of healthcare in your institution, in your community, and nationally. 

Learning + Design Session | January 18th , 2017 | New Brunswick, NJ

Across the country, healthcare institutions are recognizing that they can creatively leverage their supply chains to address the upstream economic and environmental conditions that have the greatest impact on the health of local residents. In doing so, they can create family-supporting local jobs and build community wealth. This toolkit on local and diverse purchasing showcases examples of how hospitals and health systems are reevaluating their roles as their community’s largest purchasers, understanding that a thriving local economy is fundamental to a healthy community.

The sourcing of goods, services, and food that your hospital or health system does every day, when aligned with your mission, can help build local wealth in the communities you serve. By supporting diverse and locally owned vendors and helping to incubate new community enterprises to fill supply chain gaps, hospital and health systems like yours can leverage existing resources to drive local economic growth and build a culture of health in their communities. This toolkit can help you get started

Cities are increasingly turning to their “anchor” institutions as drivers of economic development, harnessing the power of these major economic players to benefit the neighborhoods where they are rooted. This is especially true for cities that are struggling with widespread poverty and disinvestment. Urban anchors— typically hospitals and universities—have sometimes isolated themselves from the poor and struggling neighborhoods that surround them. But this is changing. Since the late 1990s, as population, jobs, and investment have migrated outward, these “rooted in place” institutions are becoming a key to the long, hard work of revitalization. In Cleveland, the Greater University Circle Initiative is a unique, multi-stakeholder initiative with a ten-year track record. What is the “secret sauce” that keeps this effort together?

As cities wrestle with the growing challenge of wealth inequality, more and more leaders are looking to broad-based ownership models as tools to create jobs and build community wealth. These models are highly effective, with a positive impact for low- and moderate-income individuals and communities. This report looks at six such models—ESOPs, Worker Cooperatives, CDFIs, Social Enterprises, Municipal Ownership, and Emerging Hybrids—with examples of best practices, and explores how these models can be used in community economic development.