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Rural Health Information Hub

Leveraging Position as an Economic Anchor to Improve Health Equity

Rural health organizations, such as rural hospitals and clinics, often play critical roles in the economic and social vitality of their communities. These organizations can explore ways to leverage their position as economic anchors to contribute to community development and promote economic inclusion of communities that experience health inequities. For example, rural organizations could examine their purchasing and contracting practices and investigate opportunities to engage businesses owned by communities that experience inequities. The Communities in Action: Pathways to Health Equity initiative provides additional information about how anchor institutions can influence health equity. Approaches include:

  • Hiring and retaining local staff, especially those who reflect local communities that experience inequities
  • Paying staff a fair and living wage
  • Contracting with diverse and local organizations
  • Investing in initiatives that affect upstream determinants of health, such as housing and community development efforts

Examples of Communities Leveraging their Position as Economic Anchors

  • The American Hospital Association explored how Carilion Clinic in Roanoke, Virginia, is investing in community initiatives to advance health equity. A key aspect of their community development strategy is funding education in their rural service region. In addition, Carilion partners with local businesses to promote employment opportunities for graduates of the education programs they fund.
  • The Community Food Bank of Southern Arizona (CFB) has built extensive partnerships to meet the needs of the rural border communities they serve. CFB started the Farm-to-Institution program to increase access to local produce and invest in local businesses. The program connects local small and midsize farms to other anchor institutions, like the Tucson Medical Center.

Questions for Consideration

  • What role does my organization play in the local economy? How does my organization influence local decision-making?
  • Do our community investments address upstream factors that affect health equity?
  • Are we using equitable contracting and procurement practices?

Resources to Learn More

Contracting for Equity Best Local Government Practices that Advance Racial Equity in Government Contracting and Procurement
Describes approaches to equitable contracting that local governments can employ.
Organization(s): Government Alliance on Race and Equity (GARE)
Date: 2015

Improving Community Health by Strengthening Community Investment
Describes how hospitals and health systems are investing in the communities they serve to address social determinants of health.
Organization(s): Robert Wood Johnson Foundation
Date: 3/2017