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Only 20% of U.S. nonprofit hospitals invested in housing as part of the federal community benefit mandate

Most hospitals addressing housing are located in cities and serve people with more significant needs, suggesting certain populations lack access to housing interventions

2024-05-15
(Press-News.org) Waltham — May 15, 2024 — A nationwide assessment of how nonprofit hospitals are addressing housing-related needs in their communities appears in the latest issue of Medical Care, the official journal of the Medical Care Section of the American Public Health Association. The journal is published in the Lippincott portfolio by Wolters Kluwer. 

"Approximately 60% of hospitals in the United States are 501(c)(3) nonprofit organizations and are legally required to address substantial health needs in their communities as a condition for tax exemption," explain Berkeley Franz, PhD, Associate Professor of Community-based Health at Ohio University in Athens, Ohio, and colleagues. Housing-related factors are a well-documented social determinant of health, found in multiple studies to affect individual health conditions such as hypertension and chronic disease, child development disorders, and mental health disorders. 

The Patient Protection and Affordable Care Act introduced additional requirements: nonprofit hospitals must complete a triennial community health needs assessment and corresponding implementation strategy. Dr. Franz’s group, which included 7 medical students, analyzed a national dataset of those records, randomly sampling 20% of all nonspecialized nonprofit community hospitals within each state. 

The researchers found that of 433 hospitals studied, 346 (80%) did not mention their community’s housing needs within their implementation strategy. Of the other 87 hospitals, 29 (7%) documented only one strategy they are using to address housing needs. 

Multiple strategies are being used to address housing insecurity 

The hospitals that mentioned housing needs in their implementation strategies collectively listed 302 strategies for addressing housing insecurity. The most common was collaboration with community and hospital-based partners to increase access to affordable housing initiatives, housing assistance, and employment for low-income residents, mentioned in 103 strategies (34%). 

These strategies "may allow hospitals to work with the community organizations that have prior expertise and funding in housing, providing hospitals with a foundation upon which to build their own programs," the researchers note. 

The second most common strategy (21%) was to provide financial assistance for temporary and transitional housing. Directly asking patients about their housing status and other social determinants of health was one of the least common approaches (9%), even though it is perhaps one of the most actionable. 

Characteristics of nonprofit hospitals that address housing-related needs 

In general, hospitals that addressed housing in their implementation strategies were: 

Larger  Urban  Academic medical centers  In communities with high income inequality  More likely to be serving populations where severe housing needs are common (more than one person per room; monthly housing costs exceed 50% of income; lack of a sink, stove, or refrigerator; or lack of hot and cold water, a toilet, or a bathtub/shower)  The latter finding suggests that "at least for housing, hospitals are making charitable investments in ways that are in alignment with local needs," Dr. Franz and her co-authors say. They speculate that larger hospitals and major teaching hospitals are better positioned to obtain funding or federal grants than smaller hospitals with fewer resources for research and outreach. 

"Understanding the way hospitals currently address housing insecurity is an important step toward developing effective interventions," the authors point out. "Future work should focus on supporting cross-sector partnerships and the integration of social determinants of health into hospitals’ community health programming." 

Read Article: National Overview of Nonprofit Hospitals’ Community Benefit Programs to Address Housing 

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across health care. We support clinical effectiveness, learning and research, and clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health. 

### 

About Wolters Kluwer 

Wolters Kluwer (EURONEXT: WKL) is a global leader in information, software solutions and services for professionals in healthcare; tax and accounting; financial and corporate compliance; legal and regulatory; corporate performance and ESG. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with technology and services. 

Wolters Kluwer reported 2023 annual revenues of €5.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 21,400 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.  

For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Facebook, and YouTube. 

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[Press-News.org] Only 20% of U.S. nonprofit hospitals invested in housing as part of the federal community benefit mandate
Most hospitals addressing housing are located in cities and serve people with more significant needs, suggesting certain populations lack access to housing interventions