The median investment for a health system program that addresses a social determinant of health is $2 million, according to a survey of investments made from 2017-19.
The study, published by Health Affairs, aimed to track just how much U.S. health systems have directly invested in community programs, given the considerable level of attention social determinants of health have had from policymakers and the media. To determine this, researchers tracked public announcements of direct financial investment in social determinants of health by U.S. health systems from Jan. 1, 2017, to Nov. 30, 2019.
Seven key takeaways:
1. Fifty-seven health systems, which include 917 hospitals, invested in programs related to social determinants of health during the two-year period. They invested in 78 unique programs.
2. Of those 78 programs, 29 did not specify how much they were investing in the cause. The remaining 49 that did publish dollar amounts gave $2.5 billion to their causes.
3. The median investment per program was $2 million, and the average was $31.5 million.
4. The bulk of the programs — 52 programs, representing $1.6 billion in investments — were dedicated to housing-related efforts.
5. Employment-related programs also saw significant investment (28 programs; $1.1 billion), followed by education (14 programs; $476.4 million) and food security (25 programs; $294.2 million). Programs that focused on social and community context also attracted $253.1 million, and transportation-related programs attracted $32 million from health systems.
6. The initiatives were spread across 30 states but were most common in California, Ohio, Maryland, Illinois and Massachusetts.
7. The research to justify these investments is "poor," according to the authors, which may be why hospitals haven't invested more in these initiatives. "These investments still represent a small fraction of overall spending by health systems, which at present are much more likely to be developing screening and referral programs than directly investing in social determinants of health," the authors concluded.
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