NYS Nonprofit Hospital Assessment and Response to Environmental Pollution as Community Health Need: Prevalence in Community Benefit Practices

CONTEXT: Given the impact of environmental pollution on health and health inequity, there may be substantial value in integrating assessment and response to pollution into nonprofit hospital community benefit processes. Such hospital engagement has not yet been studied. OBJECTIVES: We take a preliminary step of inquiry in investigating if nonprofit hospitals in New York State (NYS) assess, identify, or respond to environmental pollution as part of community benefit processes. DESIGN: This study is of retrospective, observational design. Data were abstracted from community health needs reports (2015-2017), associated implementation plans, and related IRS (Internal Revenue Service) filings from a randomly geographically stratified selection of NYS nonprofit hospitals. PARTICIPANTS: The sample includes 53 hospitals from 23 counties. The sampling frame consists of NYS nonspecialty private nonprofit hospitals. MAIN OUTCOME MEASURES: Dichotomous findings for the following: (1) engagement of environmental pollution in the process of assessment of community health needs; (2) environmental pollution concern identified as a priority community health need; (3) strategic planning present to address pollution identified as community health need; and (4) action taken on same. RESULTS: We found that 60.5% (95% confidence interval [CI], 0.46-0.74) of hospitals evidenced some form of assessment of environmental pollution and 18.9% (95% CI, 0.09-0.32) identified pollution as a priority community health need. However, no hospital went on to take independent or collaborative planning or action to address pollution. In additional analysis, we found that social justice in hospital mission was a positive predictor of assessment of environmental pollution. CONCLUSIONS: For NYS hospitals, we found a substantial presence of assessment and identification of pollution as a community health concern. Our finding of the absence of response to environmental pollution represents a gap in community benefit implementation. This indicates a yet untaken opportunity to address racial and economic environmental health injustices and to improve population health.