Academic medical centers’ new obligation: healing our neighborhoods and communities
Academic medical centers are not doing enough in their communities. It’s true, of course, that these institutions fulfill what we have traditionally considered the tripartite mission of clinical care, research and education. This will always be important.
We have the resources for this mission, however, because of public support. Medicaid, Medicare, the National Institutes of Health and individual donors have made us the powerful institutions we are. So has the trust our communities have placed in us.
At the same time, 75% of academic medical centers are located in areas considered underserved, home to people who struggle with housing, employment and educational achievement. Our gleaming hospital buildings can be reminders of what our neighbors don’t have.
Just as we have an obligation to fulfill our traditional mission, we also have an obligation to our neighborhoods. Because of our community standing and our increasing knowledge of the social determinants of health, we should be conveners, organizers, underwriters and partners in our cities. Housing, workforce training and public safety should be parts of our mission.
Over the last two decades, a few academic medical centers have taken these issues on, and their efforts are showing promise. UPMC for example helps fund a number of community development and planning organizations that create or renovate affordable housing and provide other services such as distributing fresh food. A related UPMC program, Cultivating Health for Success, helps place homeless people in stable housing and provides them regular care.
Boston Medical Center announced nearly a dozen investments in 2017 throughout its home city to address the intersection of homelessness and complex health needs. In some cases, the investments are funding new housing. In others, the investments are helping people stay in housing they already have.
The institution I have led for 13 years, Nationwide Children’s Hospital, has taken a targeted approach to the ZIP codes immediately adjacent to our Columbus, Ohio, facility because that is where we believe we can have the greatest impact. A decade ago, a 30-block area just to the hospital’s south had 50% of its children living below the poverty line, with nearly a third of all properties vacant, abandoned or derelict.
With those statistics in mind, Nationwide Children’s began the Healthy Neighborhoods Healthy Families initiative in 2008, in partnership with other groups already at work on the south side of Columbus. The initiative has now invested $30 million to build or rehabilitate 350 homes near our hospital campus.
Our partners also helped us announce a $20 million fund to focus on rental housing in our neighborhoods last year. Healthy Neighborhoods Healthy Families runs education and workforce development programs as well. Nationwide Children’s hired 183 people from our immediate neighborhood last year alone.
The first study of its kind, conducted through our Abigail Wexner Research Institute and published in the journal Pediatrics in 2018, showed that the initiative is having an effect. The neighborhood vacancy rate is now less than 6%. The high school graduation rate is up, and the homicide rate is down. Nationwide Children’s relationship with our neighbors has deepened as they have seen our commitment to them.
Beyond our local success, Nationwide Children’s joined in early 2018 with UPMC, Boston Medical Center and a small number of other medical centers in a national initiative called Accelerating Investments for Healthy Communities, funded by the Robert Wood Johnson Foundation. Among our goals is creating new pathways for other hospitals to help their cities.
The public helped create academic medical centers; our resources should be resources for the common good. We know that people’s local environment affects their overall well-being. Academic medical centers have the unique ability to influence health through treatment, training and research. We should also recognize that because of our resources and locations, we have a unique responsibility to influence health by improving our communities. ●