Anchor Institutions

Can Hospitals Heal America's Communities?

Ted Howard and Tyler Norris

Healthcare’s role in creating healthy communities through increasing access to quality care, research, and grantmaking is being complemented by a higher impact approach; hospitals and integrated health systems are increasingly stepping outside of their walls to address the social, economic, and environmental conditions that contribute to poor health outcomes, shortened lives, and higher costs in the first place.  

Healthcare Small Business Gap Analysis

Jessica Bonanno, Steve Dubb, and Ted Howard

Our newest report, Healthcare Small Business Gap Analysis, prepared in partnership with New Orleans based DMM & Associates on behalf of the New Orleans Business Alliance (NOLABA), outlines procurement practices and supply chain needs of New Orleans healthcare institutions and the capacity local business to fulfill those needs. The report provides recommendations on how to leverage New Orleans’ hospitals’ $1.5 billion in procurement spending to promote greater local procurement and economic inclusion in a city where only 48 percent of African American adult males are in the formal labor force. This report is based on interviews with nearly  50 representatives from area hospitals, additional anchor buyers, technical assistance organizations, small businesses, and other public stakeholders.

The Anchor Dashboard: Aligning Institutional Practice to Meet Low-Income Community Needs

Steve Dubb, Sarah McKinley and Ted Howard

This study seeks to introduce a framework that can assist anchor institutions in understanding their impact on the community and, in particular, their impact on the welfare of low-income children and families in those communities.

Download the report and learn more about our work to help anchors measure their impact on community wealth.


The Anchor Mission: Leveraging the Power of Anchor Institutions to Build Community Wealth

Farzana Serang, J. Phillip Thompson and Ted Howard

This report from The Democracy Collaborative and the Department of Urban Studies and Planning at MIT focuses on the path-breaking Vision 2010 Program implemented in Cleveland and Northeast Ohio by University Hospitals System. Over a five year period, the initiative targeted more than $1 billion of procurement locally to create jobs, empower minority- and female-owned businesses, and create a “new normal” for responsible, community-focused business practices in the region.

The Denver Foundation

Founded in 1925, The Denver Foundation is Colorado’s oldest and largest community foundation. The nonprofit currently has $722 million in assets and manages more than 1,000 charitable funds.  Through its Economic Opportunity grant program, the foundation aims to build community wealth by developing and retaining economic resources in low-income communities and by supporting residents working to develop the local economy.  The foundation also has an impact investment program that it uses to provide low-cost capital to nonprofits or intermediaries making a positive impact in the Denver metro area.

Communities in Action: Pathways to Health Equity

National Academies of Sciences, Engineering, and Medicine

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health.

Only part of an individual’s health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways.

Hospitals Can Be Key to Healthy People, Healthy Economies

Next City

Democracy Collaborative is highlighted in Next City "With the U.S. medical care industry spending more than $340 billion on goods and services every year, health systems and hospitals have the type of money that could revitalize the communities where they save lives." 

Yale University

Founded in 1701, Yale University has grown to be New Haven’s largest employer with over 13,000 full-time workers.  As the primary supporter of New Haven Promise, Yale provides up to $4 million a year to public school graduates who attend a state college.  It also built, and now runs, the Dixwell-Yale Community Learning Center, which provides educational programs and meeting space for the community.  Since 1990, the university has contributed over $40 million to community economic development initiatives and $28 million to help more than 1,100 of its employees purchase homes in the area.

The Community Foundation for Greater New Haven

Established in 1928, the Community Foundation for Greater New Haven strives to create positive and sustainable change in the Greater New Haven region by increasing and enhancing the impact of community philanthropy.  The foundation manages over $530 million in charitable assets, and in 2015, made roughly $24 million in grants and distributions, making it the largest grantmaker in the area.

Hospital Toolkit highlighted in Stat

Stat News

Stat news highlights the importance of the Hospital toolkit as shows how "providers can channel their $340 billion annual purchasing power into disadvantaged communities. Currently, only about 2 percent of that money flows to businesses owned by minorities and women." ...Read More

Economic Impact Guidelines

Zoë Ambargis, Charles Ian Mead, Stanislaw J. Rzeznik, David Swenson and Janet Weisenberger

Intermediaries in Integrated Approaches to Health and Economic Mobility

Prabhjot Singh and Stuart M. Butler

For individuals to achieve upward economic mobility they must live in a supportive neighborhood with, among other things, high quality primary care and good public schools. But even when the key ingredients of success are present, households often find it hard to navigate services. A variety of intermediaries help address that problem.

Some are “embedded” in such organizations as hospitals or schools and help clients to obtain a range of supplementary services. Examples include Health Leads, City Health Works, and Grand Aids, along with local community health workers and school nurse programs.

Others are the result of hospital-led population health systems. Examples include the Parkland Health system in Texas, the Montefiore and the Mount Sinai health systems in New York, and Washington Adventist Hospital in Maryland.

Others still are organizations linking together institutions focused on the same goal by providing data sharing services, financing, or organizational support. Examples include community development financial institutions, but also integrated service systems, such as the Harlem Children’s Zone that organizes wraparound services for the families of its school students.

While intermediaries help households and can add value, they also face challenges in their operations. Often they are underfunded because budgets do not reflect their broad community value. Many regulatory and technical barriers impede information sharing with intermediaries, which is necessary to credibly show improved outcomes. There can also be a clash of culture between intermediaries and other organizations.

Policymakers in both the public and private sectors need to address these challenges so that intermediary institutions can demonstrate their value and fulfill their crucial role. 

Community Foundations: What Do They Offer Community Development?

Jeffrey S. Lowe

This article provides case studies of the role of three community foundations in facilitating the establishment of community development collaboratives to galvanize support for local community development corporations (CDCs): the Cleveland Foundation, the Dade Community Foundation, and the Greater New Orleans Foundation. Sentiments about community foundation support or influence upon CDC activity captured from person-to-person interviews with CDC staff and community foundation personnel and board members are included, in addition to secondary data documenting the character and activity of community foundation assistance. The article offers lessons drawn from the three cases. Although it makes no broad generalizations, the article concludes with some recommendations for community foundations interested in community development collaboratives as a means of supporting local CDCs and identifies some areas for future research. 

Ripple: The Potential Power of Purposeful Purchasing

David LePage

Like a stone thrown into a pond, every purchase creates a ripple. Unintentionally or intentionally, every decision to purchase causes not one, but multiple transactions affecting the community’s capital, whether social, environmental, cultural, structural, human, or economic. 

Building a More Inclusive National Park System for All Americans

Nidhi Thakar, Claire Moser and Laura E. Durso

Work remains to build a system of national parks and monuments that tells the stories of all Americans by reflecting the full scope of the nation’s history and meeting the demands of a diverse population. 

Hospital Community Benefits after the ACA

Cynthia H. Woodcock and Gayle D. Nelson

Leveraging hospital community benefit policy to improve community health

A Case to End US Hunger Using Collaboration to Improve Population Health

Randy Oostra

Over the last 50 years, every U.S. president has worked, in some fashion, to address healthcare spending while improving the fundamental healthcare conditions for those in need. As healthcare leaders we often think in terms of three- to ve-year plans. But if we think about the next 50 years, it brings into question ‘what’ and ‘how’ the investments we’re making now in our communities — whether new facilities, programs or initiatives — will impact the public by 2064. 

Diversity in Health Care: Examples from the Field

Health Research & Educational Trust

Diversity is becoming a key word in health care. Hospitals and health care systems are focusing on providing care that addresses the diversity of their patient populations. To better care for diverse patient populations, hospitals are working to increase the diversity of their leadership team, board and staff. And many hospital teams are building a culture of diversity and inclusion, to better engage all employees and provide high-quality, equitable care for all patients.