Hospitals and health equity: Examples of new strategies

Hospitals are paying more attention to reducing health care disparities in underserved communities, and some health systems are finding success with new approaches.

Ann Catalyst NEJM The analysis, released March 15, outlines some of the successes hospitals have had with their health equity efforts. Some focus directly on health care, while others focus on social needs that can impact health.

“By emphasizing health, not just health care, these hospital leaders are helping to achieve a broader good for the community as a whole,” the authors wrote.

The analysis points to the importance of working with community partners to achieve lasting success. In addition, hospitals can improve their brand reputation and potentially their financial results, the authors write.

Read more: Making health equity sustainable: Supporting patients and the bottom line

The analysis cited Boston Medical Center’s StreetCred program, which helps lower-income families file tax returns and claim reimbursements for hospital and clinic visits. Since StreetCred launched in 2016, the program has helped more than 6,000 families receive more than $14 million in tax refunds.

Building on this success, StreetCred created a coalition of 24 healthcare and financial services organizations to share best practices for startups and healthcare financial services. The coalition includes organizations in 10 states and Washington, DC

Sanford Health, based in Sioux Falls, South Dakota, has seen the benefits of reaching out to Native American communities, the authors write.

In South Dakota, Sanford proposed a health program aimed at low-income pregnant women. Participants received points for making healthy choices in nutrition, prenatal care and other areas, and participants could receive diapers, nursing pillows, tubs and other items. Between January 2019 and December 2022, 325 women participated in the program, including 173 Native Americans.

Read more: Moving health equity from goals to reality

In Wisconsin, 19 health systems joined together to create Be Well Fox Valley, a partnership of health, community and philanthropic organizations aiming to improve community health conditions, including diet. In one initiative, about 200 diabetes patients participated in a 13-week program that offered free, healthy meals.

Memorial Hermann Health System, based in Houston, Texas, has made efforts to help children become more active. The system created a soccer program for kids and also built a 1.1-mile sidewalk from the middle school to a local park. Efforts include additional safety lighting and remodeling of the park’s basketball court.

In conversations with leaders of some of the health systems, the authors highlighted some key elements of successful programs to improve health equity.

Rate the results

While it is laudable to attempt new efforts to improve health outcomes, health systems must evaluate their success. And that may mean ceasing or scaling back some efforts to focus on more successful efforts. In the StreetCred program, leaders closed some sites that didn’t serve as many low-income patients so that resources could be better directed to areas with higher demand, the authors wrote.

Listen to employees

Health workers interact with patients and can offer health systems and their leaders invaluable information about community needs.

“Well-run hospitals empower employees to listen, partner, and advocate for patients,” the authors write.

Work with partners

All of the health systems cited in the analysis collaborate with other organizations in the community, including financial institutions and other nonprofit organizations. By working with other groups on the social determinants of health, organizations can gain insights and expertise in other areas.

Focus on ‘caring for justice’

While hospitals must provide charity care to meet their government obligations as nonprofit institutions, health systems can receive a significant return on investment in health care investments. Leaders at Boston Medical Center told the authors that investing $1 million to provide 10 heart surgeries is worthwhile, but $1 million could also fund 10,000 prenatal visits for lower-income women, which could help entire communities.

Do research and do more

To address disparities, health systems must survey communities to assess their needs, including those that may not be immediately apparent. However, health systems cannot stop with research. Once they have good information, they should share findings with communities and plans to help meet those needs. If studies do not lead to action, community members may lose confidence in the health care system.

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