HIA and Health Care Working Group

Bringing HIA into health care: An exploration of potential opportunities in hospital community health efforts and beyond

Leads

Please contact SOPHIA if you are interested in this topic.

Overview

This workgroup explored opportunities to bring Health Impact Assessment (HIA) more purposely into the health care sector, specifically through hospital community benefit and community health needs assessment (CHNA) efforts and how those changes can alter the strategic direction of health care institutions more broadly. The 2016 HIA Practitioner Workshop discussion will inform the development of a white paper on this topic, and will dive into: the current landscape of hospital community health work and the movement towards population health; areas of overlap and shared learning between hospital community benefit/CHNA and HIA processes; definition of terms critical to the development of health care/HIA understanding and collaboration; opportunities to bring HIA into hospital community health efforts and connect to the organization’s mission and strategic plan; and the potential challenges of bringing HIA into health care. The working group will also brainstorm ideas to address and overcome those challenges to ensure a successful partnership between HIA and the health care community. The session discussion will build on initial efforts by SOPHIA members to outline the opportunities for HIA and health care.

The connection between HIA and the development of community health programs provided by health care systems seems apparent; however there have been very few examples of this collaboration to date. The long-term shift away from fee-for service health care will require health care systems to understand how to keep groups of people healthy rather than solely treating illness. This requires a deep understanding of the structural issues (e.g. disenfranchisement, racism, etc.) and community level conditions (social, economic, physical) that are strong contributors to chronic health conditions, and determinants of overall community health. In addition to understanding these issues, health care systems need to be able to invest in strategic ways to positively impact them. Public health and “non-traditional” partners have the knowledge to assist this transformation, and one of the tools to also assist this transformation is HIA.

Additionally, HIA practitioners are seeking ways to integrate HIA and HIA-like activities into the way other sectors do business. Bringing HIA into the health care sector may offer one strategy to create the infrastructure and funding mechanisms necessary to make HIA practice more routine.

Objectives

This working group will:

• Provide an overview of hospital community benefit, CHNAs and the movement towards population health, especially post-ACA. Include examples of programs and processes from one health system in southern California (Sharp HealthCare).
  
• Identify ways that HIAs support and align with hospital efforts to identify the health needs of their communities (community health needs assessments – CHNAs).
  
• Identify the potential role of HIAs to serve as a tool for hospitals to screen, identify and develop programs that address community health needs and that support the mission and strategic direction of their organization.
  
• Identify additional areas of opportunity for HIA and health care professionals to collaborate.
  
• Identify the potential issues/challenges in bringing HIA deliberately into health care.
  
• Help to inform the development of a whitepaper focused on integrating HIA into health care.
  

Summary of 2016 HIA Practitioner Workshop

This was the first in-person convening of the new working group on HIA and health care. This session built on a post-conference discussion session at the 2015 National HIA Meeting as well as subsequent conference calls to establish a working group on the topic. During the SOPHIA Workshop, Jillian Barber, program manager of community benefits and health improvement at Sharp HealthCare (Sharp), provided an overview of the changing context in which many health systems are operating. Ms. Barber discussed how many hospitals and health systems are increasingly interested in working to improve population health and address social determinants of health in their patient and community health programs; and provided examples of these types of programs being explored and implemented at Sharp. During the session, working group participants broke into four small discussion sections to inform development of a white paper that will explore the potential for HIA in health care programs: 1) Defining terms; 2) Community benefit and hospital, and health care system operations; 3) CHNA and CHIP processes; and 4) Perspectives and partnerships. Over the next 12-18 months, the working group seeks to publish the white paper (and possibly other related products). Additional participants are welcome to join a follow-up call to be scheduled.