Department of Social Medicine, Heritage College of Osteopathic Medicine (Dr Franz and Ms Flint), and Department of Social and Public Health (Dr Cronin), Ohio University, Athens, Ohio.
J Public Health Manag Pract. 2022;28(1):E146-E154. doi: 10.1097/PHH.0000000000001227.
There is growing evidence that social factors contribute disproportionately to health outcomes in the United States as compared with health care services. As a result, nonprofit hospitals are incorporating strategies to address social needs into their Internal Revenue Service (IRS)-mandated community benefit work. Much of the research base on this subject, however, has focused on the efforts of adult-serving hospitals.
The aim of this study was to determine whether communities surrounding children's hospitals are unique with regard to social needs and categorize how children's hospitals are addressing social needs in their IRS-mandated community benefit work.
Using county-level health and economic data, we compared community characteristics of children's hospital counties with the national average. We then coded and analyzed the community benefit reports of all nonprofit children's hospitals in the United States to categorize the different strategies that hospitals adopt to address social needs.
Children's hospitals (N = 168) serve communities with greater social needs than the national average. In terms of community benefit investments, children's hospitals were more likely to identify social needs in their community health needs assessment than adult-serving hospitals, but still less than half identified or addressed 1 or more social needs. Children's hospitals were more likely to adopt interventions that address broader population health rather than strategies that focus on clinical services or children and adolescents in particular.
Pediatric health care institutions have a profound opportunity to reduce health disparities by altering the social environments in which children develop. Policy makers and scholars should provide support and resources to increase community benefit investments in this area.
越来越多的证据表明，与医疗保健服务相比，社会因素对美国的健康结果有不成比例的影响。因此，非营利性医院正在将解决社会需求的策略纳入其国内税收服务（IRS）授权的社区福利工作中。然而，关于这个主题的大部分研究都集中在成人服务医院的努力上。
本研究旨在确定儿童医院周围的社区在社会需求方面是否具有独特性，并对儿童医院在 IRS 授权的社区福利工作中解决社会需求的方式进行分类。
使用县级卫生和经济数据，我们将儿童医院所在县的社区特征与全国平均水平进行了比较。然后，我们对美国所有非营利性儿童医院的社区福利报告进行了编码和分析，以对医院采用的不同解决社会需求的策略进行分类。
儿童医院（N=168）服务的社区比全国平均水平有更大的社会需求。就社区福利投资而言，儿童医院在社区健康需求评估中比成人服务医院更有可能确定社会需求，但仍有不到一半的医院确定或解决了 1 个或多个社会需求。儿童医院更有可能采取干预措施来解决更广泛的人口健康问题，而不是专注于临床服务或特定儿童和青少年的策略。
儿科医疗机构有机会通过改变儿童成长的社会环境来减少健康差距。政策制定者和学者应该提供支持和资源，以增加这一领域的社区福利投资。
