Transforming America’s Hospitals : From Healing the Sick, to Building Healthy, Resilient Communities

Marydale DeBor

In the past decade, the rising costs of health care services, the obesity and chronic disease epidemic and the impact of social determinants on the health status of Americans have inspired a movement among hospitals to become more than walled venues that care for the acutely ill, to organizations that align all their considerable assets and economic power to build robust communities. Led by a few visionary health systems (Kaiser Permanente, Dignity Health and others) and think tanks such as the Democracy Collaborative and Health Care Without Harm, the “anchor institution” movement reached an important inflection point in December, 2016 with a convening of 40 healthcare institutions and the creation of the “Healthcare Anchor Network.”  The convening group issued a Call to Action to all US Hospitals to embrace the “Anchor Mission”: to intentionally align all of their assets in partnership with their community to benefit the long-term well-being of the places in which these institutions are rooted.  Together, hospitals and health systems nationwide spend more than $782 billion in goods and services annually, maintain investment portfolios of $400 billion, and employ more than 5.6 million people (4% of the nation’s workforce.) The potential, quite clearly, is enormous.

The working goal of this new network is that U.S. health systems adopt as an institutional priority to improve community health and wellbeing through leveraging all of their institutional assets, including intentionally integrating local economic inclusion strategies in areas such as hiring, workforce development purchasing, and investing. This asset-based, as opposed to needs-based, strategy is designed to build the wealth of communities and, in turn, the health of all residents of those communities, reversing the fact that as much as 70% of all illness is probably a result of environmental and social factors.

What does this mean for community-based organizations dedicated to the elimination of poverty, economic empowerment and safe, healthy communities?

Many organizations will need to “think different” about their engagement with hospitals: no longer will the boundaries of the partnership be limited to the small grants, partnerships or in-kind collaboration with “community benefit” programs. The new frontier being defined by hospitals adopting the Healthcare Anchor Network mission will mean discussion and engagement with their essential operations departments, such as human resources to hire local community members and purchasing to engage local vendors in the supply chain.  The “how to” of this transformation can be understood both by hospitals, community businesses and organizations by studying the toolkits published by the Democracy Collaborative, for example.

Ideally, “10 years out, if this approach takes off in cities across America, you’ll have hospitals and health systems helping create healthier and more sustainable communities as a core part of their healing mission. They will be partnering with school systems and universities to strengthen local food systems and investing in healthy housing as a vaccine against illness. They will be supporting community-based renewable energy systems as both a climate and health measure. And health systems will be using their economic power to catalyze equitable and sustainable local economies that improve the health of all.” —Gary Cohen, President, Health Care Without Harm.

Learn more about the “anchor institution” movement and community development at the April 29, 2017 Rootskills In-Person Training at the University of Southern Maine, Portland Maine.


Marydale DeBor JD

Fresh Advantage LLC