Horwitz Leora I, Chang Carol, Arcilla Harmony N, Knickman James R
Leora I. Horwitz ( leora. horwitz@nyulangone. org ) is an associate professor in the Department of Population Health, New York University (NYU) Grossman School of Medicine, in New York City.
Carol Chang is a program manager in the Department of Population Health, NYU Grossman School of Medicine.
Health Aff (Millwood). 2020 Feb;39(2):192-198. doi: 10.1377/hlthaff.2019.01246.
The past decade has seen a growing recognition of the importance of social determinants of health for health outcomes. However, the degree to which US health systems are directly investing in community programs to address social determinants of health as opposed to screening and referral is uncertain. We searched for all public announcements of new programs involving direct financial investments in social determinants of health by US health systems from January 1, 2017, to November 30, 2019. We identified seventy-eight unique programs involving fifty-seven health systems that collectively included 917 hospitals. The programs involved at least $2.5 billion of health system funds, of which $1.6 billion in fifty-two programs was specifically committed to housing-focused interventions. Additional focus areas were employment (twenty-eight programs, $1.1 billion), education (fourteen programs, $476.4 million), food security (twenty-five programs, $294.2 million), social and community context (thirteen programs, $253.1 million), and transportation (six programs, $32 million). Health systems are making sizable investments in social determinants of health.
在过去十年中,人们越来越认识到健康的社会决定因素对健康结果的重要性。然而,美国医疗系统直接投资于社区项目以解决健康的社会决定因素而非筛查和转诊的程度尚不确定。我们搜索了2017年1月1日至2019年11月30日期间美国医疗系统对涉及直接财政投资于健康的社会决定因素的新项目的所有公开声明。我们确定了78个独特项目,涉及57个医疗系统,总共包括917家医院。这些项目涉及至少25亿美元的医疗系统资金,其中52个项目中的16亿美元专门用于以住房为重点的干预措施。其他重点领域包括就业(28个项目,11亿美元)、教育(14个项目,4.764亿美元)、粮食安全(25个项目,2.942亿美元)、社会和社区环境(13个项目,2.531亿美元)以及交通(6个项目,3200万美元)。医疗系统正在对健康的社会决定因素进行大规模投资。