All ETDs from UAB

Advisory Committee Chair

Allyson Hall

Advisory Committee Members

Melissa Biel

Christy Lemak

Ria Hearld

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


In America, the amount spent on community benefit as tax exemption justification for not-for-profit health care is approaching 100 billion dollars annually. There are multiple categories for community benefit as defined by the Internal Revenue Service (IRS). The overwhelming majority of these funds are spent on individual financial assistance rather than societal level community health investments to address social determinates of health. Societal level community benefit is defined as the total spending on community health improvement, cash & in-kind donations to community groups and community building as reported on IRS form 990 Schedule H. These three combined itemized areas of community benefit spending represent the most accurate insights into contributions that are focused on assisting society rather than one individual. Current research is lacking when it comes to indicating if health care systems executive leaders and state level policies influence the amount of societal level community benefit spending as a percentage of operating expense. This information could guide organizational decision making for achieving the fullest potential health for all citizens. This study is a retrospective analysis using publicly available not-for-profit health system community benefit tax data that found no statistically significant association between chief executive leadership characteristics, state level policy and year-over-year societal level community benefit spending as a percentage of operating expense.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.