One of the most fulfilling parts of my work at Center for Health Progress is getting to hit the open road and travel around the state to meet with some of Colorado’s brightest health care and community leaders. From Salida to Yuma, Lamar to Steamboat Springs, I have fond memories of countless conversations with local leaders about their community’s assets, the various challenges residents face, and their innovative solutions to creating a healthier community. And, nearly everywhere I visit, there is a common refrain: our local economy would be in dire straits without our hospital.
Indeed, local health care institutions are core drivers of local economies—especially in small towns. According to recent data, the health care industry currently provides 12 percent of all jobs in the US, and is projected to have the most growth over the next decade, making it our largest industry. For some rural communities in Colorado and across the country, the reliance on local health care institutions as an economic anchor is even greater. For these communities, the hospital isn’t just an employer, or just a health care provider—its purchases feed the local economy, its opinions shape local politics, and its land and buildings impact the local environment.
Recently, both national and local leaders have started using the anchor institution framework to advance a more nuanced analysis of both the economic benefits and negative, unintentional consequences of health care’s economic power. Anchor institutions are key assets in a community that, once established, tend not to move. They employ residents, purchase goods from local businesses, and invest in community infrastructure and community-based organizations. The theory goes, if health care entities fully embody their roles as anchor institutions and double down on their integration with and investment in their communities, then those neighborhoods would become better and healthier places to live. Without those intentional choices, though, the result is vast disparities and outright tension between world class—and wealthy—health care institutions, and the poor, neglected neighborhoods they’re situated within.
It’s a novel and worthy idea that holds some promise, as well as a significant amount of responsibility for hospitals and other major health care entities. Left unchecked, this economic power might lead to gentrification, disparities in access and opportunities, an increased disconnect between the institution and the surrounding communities, and other negative consequences. As such, anchor institutions must first lead with an equity lens to ensure their purchasing, hiring, and investments directly benefit those neighbors who have historically been denied a fair opportunity—people of color and people living in poverty.
As we deepen our understanding of the root causes of health inequities and explore the health care system’s role in addressing them, we hope to see Colorado’s hospitals and other health care institutions realize their potential as responsible anchor institutions. And, we believe that work starts with a strong health equity commitment. On my next trip around the state, you can be sure I’ll be listening with renewed interest as health care’s role continues to evolve.