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Can Healthcare Make Wealth Fair? Utilizing Community Benefit Reporting to Address Racial Wealth Inequity
Can Healthcare Make Wealth Fair? Utilizing Community Benefit Reporting to Address Racial W...
Can Healthcare Make Wealth Fair? Utilizing Community Benefit Reporting to Address Racial Wealth Inequity

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자료유형  
 학위논문 서양
최종처리일시  
20260202103013
ISBN  
9798315703662
DDC  
614
저자명  
South, Alonzo P.
서명/저자  
Can Healthcare Make Wealth Fair? Utilizing Community Benefit Reporting to Address Racial Wealth Inequity
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
202 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-11, Section: A.
주기사항  
Advisor: Zachary, Ciara.
학위논문주기  
Thesis (Dr.P.H.)--The University of North Carolina at Chapel Hill, 2025.
초록/해제  
요약The US' distribution of wealth is strikingly unequal, especially by race. For every $1.00 the median White family has, Black families have $0.16 and Hispanic families have $0.22. Nonprofit health systems have the potential, proximity, and purpose to address the racial wealth gap, especially in "eds and meds" cities like Philadelphia. This study has three goals: (1) determine the factors that have the greatest impact on wealth mobility, (2) identify the wealth mobility factors Philadelphia nonprofit hospitals are addressing, (3) assess how changes to community benefit reporting would impact hospital investments in wealth building factors.This dissertation used a literature review to identify the factors that contribute to absolute and relative intragenerational wealth mobility. The study focused on nonprofit hospitals in the Philadelphia metropolitan area. A review of publicly available information on hospital websites, municipal bond disclosures, and ProPublica produced a comprehensive view of hospital activity for these factors. Key informant interviews with 10 hospital executives at 6 (of the 8) nonprofit health systems in the Philadelphia area revealed how specific environmental conditions would impact hospital decision making and investing. Of the 11 factors that consistently built (and eroded) wealth in the literature, health systems could only impact six - income, occupation, education, homeownership, business ownership, and neighborhood effects. Profitable health systems, which were also larger and had flagship hospitals in the city of Philadelphia, generally had the most wealth mobility activity and impact. Overall, the greatest hospital wealth building activity occurred for income, education, and occupation. Hospitals executives largely rejected the scenarios that a more expansive community benefit definition, publicizing wealth mobility rankings, or government pressure would lead to increased investment in wealth mobility factors. However, interviews identified a promising catalyst that involved a 1) wealth addendum that communicated a hospital's total wealth building activity (above and beyond the Schedule H Form 990), 2) local government participation, 3) philanthropic support, and 4) savvy, supported leaders. These findings, and the accompanying plan for change, present a practical path forward to marshal increased support and resources for nonprofit hospitals to equitably build wealth (and thereby improve health) in their local communities.
일반주제명  
Public health
일반주제명  
Sociology
키워드  
Nonprofit health systems
키워드  
Hispanic families
키워드  
Business ownership
키워드  
Hospital wealth
기타저자  
The University of North Carolina at Chapel Hill Health Policy and Management
기본자료저록  
Dissertations Abstracts International. 86-11A.
전자적 위치 및 접속  
로그인 후 원문을 볼 수 있습니다.

MARC

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■1001  ▼aSouth,  Alonzo  P.
■24510▼aCan  Healthcare  Make  Wealth  Fair?  Utilizing  Community  Benefit  Reporting  to  Address  Racial  Wealth  Inequity
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a202  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-11,  Section:  A.
■500    ▼aAdvisor:  Zachary,  Ciara.
■5021  ▼aThesis  (Dr.P.H.)--The  University  of  North  Carolina  at  Chapel  Hill,  2025.
■520    ▼aThe  US'  distribution  of  wealth  is  strikingly  unequal,  especially  by  race.  For  every  $1.00  the  median  White  family  has,  Black  families  have  $0.16  and  Hispanic  families  have  $0.22.  Nonprofit  health  systems  have  the  potential,  proximity,  and  purpose  to  address  the  racial  wealth  gap,  especially  in  "eds  and  meds"  cities  like  Philadelphia.  This  study  has  three  goals:  (1)  determine  the  factors  that  have  the  greatest  impact  on  wealth  mobility,  (2)  identify  the  wealth  mobility  factors  Philadelphia  nonprofit  hospitals  are  addressing,  (3)  assess  how  changes  to  community  benefit  reporting  would  impact  hospital  investments  in  wealth  building  factors.This  dissertation  used  a  literature  review  to  identify  the  factors  that  contribute  to  absolute  and  relative  intragenerational  wealth  mobility.  The  study  focused  on  nonprofit  hospitals  in  the  Philadelphia  metropolitan  area.  A  review  of  publicly  available  information  on  hospital  websites,  municipal  bond  disclosures,  and  ProPublica  produced  a  comprehensive  view  of  hospital  activity  for  these  factors.  Key  informant  interviews  with  10  hospital  executives  at  6  (of  the  8)  nonprofit  health  systems  in  the  Philadelphia  area  revealed  how  specific  environmental  conditions  would  impact  hospital  decision  making  and  investing.  Of  the  11  factors  that  consistently  built  (and  eroded)  wealth  in  the  literature,  health  systems  could  only  impact  six  -  income,  occupation,  education,  homeownership,  business  ownership,  and  neighborhood  effects.  Profitable  health  systems,  which  were  also  larger  and  had  flagship  hospitals  in  the  city  of  Philadelphia,  generally  had  the  most  wealth  mobility  activity  and  impact.  Overall,  the  greatest  hospital  wealth  building  activity  occurred  for  income,  education,  and  occupation. Hospitals  executives  largely  rejected  the  scenarios  that  a  more  expansive  community  benefit  definition,  publicizing  wealth  mobility  rankings,  or  government  pressure  would  lead  to  increased  investment  in  wealth  mobility  factors.  However,  interviews  identified  a  promising  catalyst  that  involved  a  1)  wealth  addendum  that  communicated  a  hospital's  total  wealth  building  activity  (above  and  beyond  the  Schedule  H  Form  990),  2)  local  government  participation,  3)  philanthropic  support,  and  4)  savvy,  supported  leaders.  These  findings,  and  the  accompanying  plan  for  change,  present  a  practical  path  forward  to  marshal  increased  support  and  resources  for  nonprofit  hospitals  to  equitably  build  wealth  (and  thereby  improve  health)  in  their  local  communities.
■590    ▼aSchool  code:  0153.
■650  4▼aPublic  health
■650  4▼aSociology
■653    ▼aNonprofit  health  systems
■653    ▼aHispanic  families
■653    ▼aBusiness  ownership
■653    ▼aHospital  wealth
■690    ▼a0573
■690    ▼a0501
■690    ▼a0626
■690    ▼a0769
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bHealth  Policy  and  Management.
■7730  ▼tDissertations  Abstracts  International▼g86-11A.
■790    ▼a0153
■791    ▼aDr.P.H.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17356664▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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