Puro Neeraj, Kelly Reena Joseph
Department of Management Programs, College of Business, Florida Atlantic University, Boca Raton, FL, 33431, USA.
Health Administration and Policy Department, School of Health Sciences, University of New Haven, West Haven, CT, 06516, USA.
SSM Popul Health. 2022 May 21;18:101129. doi: 10.1016/j.ssmph.2022.101129. eCollection 2022 Jun.
Social determinants of health (SDOH) are strongly linked to individual and population health outcomes. Hospitals and health systems are in a unique position to initiate or partner on community-wide efforts address SDOH. However, such efforts typically require collaboration with other healthcare and local community organizations since SDOH affect more than just medical care. Despite studies that have identified specific organizational and environmental factors associated with hospital-community partnerships, the role of social capital and community health needs as drivers of such partnerships remains unexplored. This study examines whether hospital partnerships with community organizations in the United States are driven predominantly by community social capital or the prevailing health needs of the community, and whether these drivers are similar for overall partnerships as well as for partnerships with individual organizations. We use 2020 data from the American Hospital Association, US County Health Rankings, and Social Capital Project and employ ordinary least-squares (OLS) regression and logit models to assess the relationship between social capital, community health needs and hospital-community partnerships to address SDOH. Our results indicate that for community social capital was significantly and positively associated with total hospital partnerships (β = 0.05, p = 0.01). We also found that community social capital was significantly more likely to be associated with hospitals' partnerships with local/state public health agencies, schools, law enforcement agencies, other healthcare providers, and organizations that assist with food insecurity. On the other hand, community health needs were not associated with total partnerships and had limited associations with hospital partnerships with individual organizations. Overall, this research suggests that social capital is a critical determinant of hospital partnerships with community organizations, and hospitals may seek partnerships with organizations that allow them to address community health issues outside of their own expertise since such partnerships and collaborative efforts can help address SDOH and manage population health.
健康的社会决定因素（SDOH）与个人和人群的健康结果密切相关。医院和卫生系统在发起全社区解决SDOH的努力或与之合作方面具有独特地位。然而，由于SDOH的影响不仅仅局限于医疗保健，此类努力通常需要与其他医疗保健和当地社区组织合作。尽管已有研究确定了与医院 - 社区伙伴关系相关的特定组织和环境因素，但社会资本和社区健康需求作为此类伙伴关系驱动因素的作用仍未得到探索。本研究考察了美国医院与社区组织的伙伴关系主要是由社区社会资本还是社区普遍的健康需求驱动，以及这些驱动因素对于整体伙伴关系以及与单个组织的伙伴关系是否相似。我们使用了来自美国医院协会、美国县卫生排名和社会资本项目的2020年数据，并采用普通最小二乘法（OLS）回归和逻辑模型来评估社会资本、社区健康需求与医院 - 社区伙伴关系之间的关系，以解决SDOH问题。我们的结果表明，社区社会资本与医院总伙伴关系显著正相关（β = 0.05，p = 0.01）。我们还发现，社区社会资本更有可能与医院与地方/州公共卫生机构、学校、执法机构、其他医疗保健提供者以及协助解决粮食不安全问题的组织的伙伴关系相关。另一方面，社区健康需求与总伙伴关系无关，与医院与单个组织的伙伴关系的关联有限。总体而言，这项研究表明社会资本是医院与社区组织伙伴关系的关键决定因素，医院可能会寻求与那些能让它们解决自身专业领域之外的社区健康问题的组织建立伙伴关系，因为此类伙伴关系和合作努力有助于解决SDOH并管理人群健康。
