The Association Of Environment And Organizational Factors And Community Collaboration To Address ‘Social Determinants Of Health'

Authors

• Ishwari Venkataraman, University of Alabama at Birmingham

Advisor(s)

Nancy Borkowski

Committee Member(s)

Allyson Hall
Christy Lemak
Kristine Ria Hearld

School

School of Health Professions

Document Type

Dissertation

Department (new version)

Health Professions

Date of Award

9-9-2024

Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions

Abstract

Upstream social and non-medical factors, known as social determinants of health (SDOH), significantly impact an individual and community’s health status. (SDOH includes housing, food, utility, transportation, education, and employment). It is not a hospital’s core competency to address SDOH. The preferred way to address SDOH and achieve health equity in a community is through a multi-sector collaborative effort. This study aimed to explore the association between a hospital’s environmental and organizational factors and the reported levels of collaboration with its community partners in addressing SDOH. The conceptual framework used in this study included the Interorganizational Collaboration Theory (IOC) and Contingency Theory. The study results were mixed. The results found an association between environmental factors determining a healthy county's outcomes rank and the number of community collaborations to address SDOH. For every rank decrease in Healthy County outcomes ranking, hospitals were less likely to engage in community collaborations. For every rank decrease in healthy county outcomes ranking, the relative risk for hospitals involved in 1-5 community collaborations versus no collaborations decreased by a factor of 0.995 (RRR: 0.995, p: 0.014). For every rank decrease in healthy county outcomes ranking, the relative risk for hospitals engaged in 6-10 community collaborations versus no collaboration decreased by a factor of 0.995% (RRR:0.995, p: 0.011). For every rank decrease in the Healthy County outcomes ranking, the relative risk of hospitals engaging in 11-16 community collaboration versus no collaboration decreased by a factor of 0.993 (RRR: 0.993, p: 0.001). The study results found a partial association between the operating margin and the reported number of community collaborations. The study results found no association between the percentage of patients in accountable care contracts and the reported number of community collaborations. The results of this study highlight the need to ensure that adequate resources are dedicated to healthcare organizations located in counties with lower health rankings. This support is vital to enabling hospitals to collaborate effectively with other community organizations, address SDOH, and improve health outcomes in these communities.

ProQuest ID

https://proquest.com/docview/3101918081