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Healthcare and Breaking the Cycle of Poverty
They say that money can’t buy happiness, but in the U.S., can money buy access to health care? Research says yes.
The ability to access the care one needs via the healthcare system is intrinsically linked to a person’s ability to pay for it. But what cuts even deeper than the link between poverty and health is the role hospitals and the health care system at large play in upholding - and even breaking - the cycle of poverty.
Since President Johnson’s launch of the “unconditional war on poverty" in the 1960s, which included the introduction of Medicaid, Medicare, and food stamp benefits, the rate of Americans living in poverty dropped steadily. Until it didn’t. Now, the rate of Americans living in poverty is more than double what it was when Johnson sought to bridge the gap between poverty and wealth, much of it driven by ballooning medical expenses.
According to the U.S. Census Bureau, more than 8 million people slipped further into poverty in 2018 as a result of medical expenses, securing healthcare’s position as one of the biggest drivers of poverty in our country. In a time where the political climate is rife with discussions on how to shake up the proverbial etch-a-sketch of the healthcare system (e.g. Medicare for All, Medicare for All who want it, a public option, repeal of the Affordable Care Act, etc.), acknowledging the critical link between rates of poverty and healthcare costs is essential.
But, also essential is shouting from the rooftops the things healthcare systems are doing to right the ship. The biggest takeaway from the role that the healthcare system plays in alleviating poverty comes from adopting a perspective that allows the focus of hospitals to be more than just providing clinical care.
The inception of the ACA brought forth the requirement that hospitals conduct community health needs assessments to better understand what ails their communities. And with that assessment came a slew of health systems that actively took on the results they found, often shifting millions of dollars into effecting change on negative health outcomes rather than waiting to treat them. This upstream approach has led to health systems like Kaiser Permanente and Boston Medical Center taking an approach focused on improving well-being, including looking to tackle affordable housing, viewing housing as intimately connected to overall health outcomes.
Health systems across the country are partnering with local governments to create health districts -- areas in communities geared at fostering healthy lifestyles for residents. In Canton, Ohio, Aultman Health Foundation, in partnership with state and local organizations, has opted to pursue a more comprehensive approach to health. The vision for a health district in Canton sees residents with safer roads and walkways, fewer blighted buildings, access to quality child care, and more greenspace - all things that contribute to the health of an individual but are often limited due to poverty.
More than Clinical Care
Contra Costa Health Services Director Anna Roth, RN, explained, “As health systems, we should be doing anything we can to produce health, and if that means figuring out a way to support people meeting their most basic needs, then that’s what we need to do.“And we should not apologize for that, or ask permission. It’s our responsibility to do this.”
From multi-million dollar community improvement investments through health systems like Dignity Health, to bus passes, lunch vouchers, and a whole-person approach to health with the Free Clinics and Bridges to Health program in Hendersonville, North Carolina, hospitals are understanding the role poverty alleviation plays in achieving positive health outcomes and are stepping up.