A study led by Dr. Erik Carlton, assistant professor of health systems management and policy and MHA program director at the University of Memphis School of Public Health and Dr. Simone Singh, assistant professor of health management and policy at the University of Michigan School of Public Health examined the association between non-profit hospital–local health department (LHD) collaboration around community health needs assessments (CHNAs) and hospital investment in community health. Among LHDs nationally, 72 percent (n= 316) engaged in CHNA-related collaboration with nonprofit hospitals and 62 percent (n= 273) reported being involved to various extents in nonprofit hospitals’ implementation strategies. Among LHDs that did not engage in CHNA-related collaborations, less than 6 percent participated in the development of hospitals’ implementation strategies. Greater collaboration around hospitals’ implementation strategies also increased hospital investment in community health improvement activities.
[Photos: Dr. Erik Carlton (left) and Dr. Simone Singh]
Using a nationally representative sample of 439 local health departments, the study found that LHDs that collaborated with non-profit hospitals around CHNAs were significantly more likely to be involved in joint implementation planning activities than were those that did not. Importantly, LHD involvement in hospitals’ implementation strategies was associated with greater hospital investment in community health improvement initiatives. OLS regression models showed that each increase in the number of implementation planning activities reported by an LHD was associated with a statistically significant increase in the proportion of hospitals’ total budget spent on community health improvement initiatives. The study results suggest that joint CHNAs may improve coordination of community-wide health improvement efforts between hospitals and LHDs and encourage hospital investment in community health improvement activities.
The study combined data from the 2015 Forces of Change Study by the National Association of County and City Health Officials (NACCHO), 2013 NACCHO Profile, and 2014 – 2015 Area Health Resource File to identify a sample of LHDs (n = 439) across the United States. Data on hospitals’ community benefit from their 2014 tax filings (Internal Revenue Service Form 990, Schedule H) was also included.
Findings from this study were published online ahead of print on March 22 at the American Journal of Public Health.