Partnerships between anchor-med institutions and community organizations to address social determinants of health in urban populations: Do institutional pressures play a role?

Abstract

ABSTRACT Social determinants of health (SDOH), the external environmental factors that determine health and well-being, often play a key role in health disparities and health inequities, and are outside the control of individuals. In urban and rural settings, hospitals have a critical role to play in addressing these SDOH; however, they cannot do so as a lone entity. Hospitals may function as anchor institution and form multi-sector partnerships with other community organizations (educational institutions, organizations addressing food insecurity, public health agencies, other healthcare provider organizations, etc.) to address these complex SDOH. However, as anchor institutions, urban hospitals may also face strong institutional pressures from their stakeholders and society at large. Based on institutional theory and resource dependency theory framework, we examine 1,191 urban hospitals in the United States reporting partnerships with community organizations to address SDOH. Our findings indicate that while addressing SDOH may be a driver, partnerships between hospitals and community organizations may also be in response to institutional pressures.