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.
Our newest report, Healthcare Small Business Gap Analysis, prepared in partnership with New Orleans based DMM & Associates on behalf of the New Orleans Business Alliance (NOLABA), outlines procurement practices and supply chain needs of New Orleans healthcare institutions and the capacity local business to fulfill those needs. The report provides recommendations on how to leverage New Orleans’ hospitals’ $1.5 billion in procurement spending to promote greater local procurement and economic inclusion in a city where only 48 percent of African American adult males are in the formal labor force. This report is based on interviews with nearly 50 representatives from area hospitals, additional anchor buyers, technical assistance organizations, small businesses, and other public stakeholders.
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.
Study after study demonstrates that poverty is a powerful driver of poor health. Many of America's leading hospitals exist in poor communities. Could these powerful institutions (in economic as well as medical terms) help overcome the deeper sources of failing health among the 46 million Americans living in poverty?
A little-known provision of Obamacare provides an unexpected opening.
"Buying locally. Offering job training. Investing in budding businesses. Medical schools and teaching hospitals increasingly collaborate with local communities to improve health and help cure economic ills...."
TDC's public comments discussed how anchor mission and anchor collaborative work helps to address the social determinants of health and builds community wealth.
Many anchor institutions are also major landowners in their communities, and many are already engaged in housing programs such as employer-assisted housing. Anchor institutions can and should employ CLTs to maximize the impact of their long-term investments in housing for their workforce, and utilize and support CLTs to help build more inclusive communities around their institutions more generally.
A growing number of forward-thinking healthcare anchor institutions have taken up an “Anchor Mission” to realign all institutional resources to fight long-standing inequities at their root by building community wealth.
Anchor collaboratives are stronger and can accomplish goals that once seemed out of reach by combining efforts and resources. However, forming an anchor collaboration isn’t automatic; it takes effort and time to get institutions to see their common interests and potential alignment. The article discusses some ways it can work.
Steven Johnson writes for Modern Healthcare on "In Depth: Hospitals tackling social determinants are setting the course for the industry." In this article, Johnson writes about the Democracy Collaborative anchor work.
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.
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."
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.
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.
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.
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.
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.
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.
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
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.'