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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1514085
This article is part of the Research Topic Empowering Community Stakeholders: Novel Approaches to Address Health Inequities View all articles
A Racial Equity Approach to Nonprofit Hospitals' Community Benefit Programs: An Exploratory Study
Provisionally accepted- 1 School of Nursing, University of Michigan, Ann Arbor, United States
- 2 The Ohio State University, Columbus, Ohio, United States
- 3 School of Public Health, University of Michigan, Ann Arbor, Michigan, United States
The aim of this study was to explore the factors and processes that drive nonprofit hospitals' willingness and ability to implement equity-focused community benefit initiatives -specifically initiatives aimed at addressing social and structural determinants of health and inequities associated with racism. We conducted a cross-sectional qualitative study using semi structured interviews guided by the EquIR Implementation science framework and Browne's racial equity approach to community benefit program implementation. Browne's racial equity approach includes five strategies: 1) prioritizing community building strategies in communities impacted most by racism, 2) allocating resources to address structural determinants that reflect racism, 3) providing leadership and employment opportunities for community members and organizations impacted by racism, 4) addressing and considering multiple intersecting identities, and 5) removing organizational barriers to allocating resources to address health inequities along racial lines. We conducted twenty-four interviews with leaders of 23 hospitals and health systems representing the Northeast, South, Midwest and West US regions. We used directed content analysis to analyze interview data. The racial equity strategies most often used were 1, 2, and 3. The strategies least likely to be mentioned were 4 and 5. Two of the 23 health systems engaged in all five strategies. Health systems have the potential, partnerships, and resources to incorporate a racial equity lens into the planning, design, and implementation of their community-based initiatives. Utilizing a racial equity approach that includes prioritizing affected communities and providing resources and strategies to overcome barriers to accessing those resources is a template that can be used by hospitals to get closer to more effectively achieving this goal.
Keywords: nonprofit hospitals, Community Benefit, Equity, racial equity, Health Policy
Received: 19 Oct 2024; Accepted: 21 Mar 2025.
Copyright: © 2025 Conley, Lewis and Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Cherie Conley, School of Nursing, University of Michigan, Ann Arbor, United States
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