The Neighborhood As Patient: 1 Hospital’s Approach to Neighborhood Effects
Year: 2018
Type: article
Abstract: Kelleher et al2 described Nationwide Children’s Hospital’s use of the medical model to present a case of the surrounding neighborhood, Southern Orchards, as a patient suffering from a “syndrome” comprised of concentrated poverty, housing instability, racial segregation, environmental toxins, violence, property crimes, and poorly performing schools. The patient is suffering from a diagnosis called “community trauma,” the etiology of which is structural violence: the harm that individuals, families, and communities experience from inequitable economic and social structures, social institutions, relations of power, privilege, and inequality that prevent them from meeting their basic needs.3,4After completing a detailed neighborhood diagnostic assessment using multiple sources of data, the authors conclude that this syndrome was driven primarily by a lack of housing stability, created and sustained by an ongoing housing crisis and exacerbated by the subprime mortgage collapse of 2008. The treatment plan included a multifaceted strategy aimed at stabilizing the housing market and improving the built environment. These interventions included home repair programs, home ownership programs, home construction, career development, and rental agency development. The hospital acted as the lender and financier of housing interventions, community-based organizations provided the grassroots community connections to residents living in the neighborhood, and the Mayor’s Office of Economic Development facilitated a range of financial mechanisms to support these efforts.The metaphor of the neighborhood as the patient is a novel approach and is accessible to clinicians and health care administrators. This case example illustrates how health care systems, in concert with community and civic partners, can function as anchor institutions to effect structural changes that may have positive impacts on population health. We find their approach to be highly commendable. Following the model advanced by Pinderhughes et al,3 we offer Homes for Health the following suggestions for next steps and areas for concentrated focus that may increase their return on investment:Finally, it is imperative to recognize that the condition of this
Source: PEDIATRICS
Authors: Irene Yen, Susan Neufeld, Leslie Dubbin
Language: English
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2887094583