How Should Health Care Organizations and Communities Work Together to Improve Neighborhood Conditions?
Year: 2019
Type: article
Abstract: In the past few decades, scholars have begun to establish ethical principles for public health engagement.A key tension has been how to reconcile public health improvement with local autonomy in decision making so as to express respect for community members' on-theground experience.This article describes the experience of one children's hospital in learning to ethically engage a surrounding community in conversations about housing development in partnership with a local faith-based development organization. Making Neighborhoods BetterIn 2008, amidst the throes of economic recession, a major crossroads confronted the Nationwide Children's Hospital (NCH) in Columbus, Ohio's South Side.The hospital had decided to remain in its location of 126 years and invest more deeply in the community.The collapse of the nation's housing markets had left hundreds of vacant properties in the area just beyond the hospital's campus, and it was clear that addressing housing was key to improving pediatric health outcomes for 3 reasons: (1) housing plays a documented role in the health of children, 1 and this neighborhood had severe housing shortage; (2) outreach efforts made clear that housing was a neighborhood priority; and(3) because of instability in housing, children were moving too frequently to make school-based or neighborhood-based programs effective.Accordingly, the new hospital administration was committed to effecting change in the neighborhood.Because hospital collaboration with communities remains relatively uncharted territory, trial and error, financial risk, and humility would be integral components of the hospital's efforts.But the hospital needed to learn how to undertake this work ethically.Ethical problems can easily arise when large institutions work in local communities, especially communities with high levels of poverty and other socioeconomic challenges.Community members might feel ignored, or even bullied, if hospitals do not attempt to see proposed strategies for community improvement from residents' perspectives.Beginning this initiative required not only planning the practical aspects of improving
Source: The AMA Journal of Ethic
Authors: Daniel Skinner, Berkeley Franz, Kelly Kelleher
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
Funder: Nationwide Children's Hospital
OpenAlex ID: W2923253656