ArticleBMJ open2024
How can healthcare organisations improve the social determinants of health for their local communities? Findings from realist-informed case studies among secondary healthcare organisations in England.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Empowering health care staff to address health inequalities: A policy-focused evidence brief.Public health in practice (Oxford, England) · 2026Article
- Unpacking Sociocultural Barriers to Stunting Prevention: A Phenomenological Inquiry into Policy and Community Challenges.Portuguese journal of public health · 2026Article
- Article
- Relation between socio-economic deprivation and chronic pain-related burden: a cross-sectional evaluation in a secondary care pain rehabilitation clinic.BMJ public health · 2026Article
- Third sector perspectives on community link worker referrals in social prescribing: a realist analysis.Frontiers in public health · 2025Article
- Cesarean delivery and its determining factors: A hospital-based study in Jashore District, Bangladesh.Public health in practice (Oxford, England) · 2024Article
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Authors and funding
5 authors.
Funding
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Abstract
objectivesIncreasingly, healthcare and public health strategists invite us to look at healthcare organisations as not just care providers but as anchor institutions (ie, large community-rooted organisations with significant impact in the local economy, social fabric and overall community well-being). In response, this study explores the mechanisms through which healthcare organisations can impact social determinants of health and communities in their local areas.
designWe conducted case studies with interviews and synthesised the findings using a realist approach to produce a set of explanations (programme theory) of how healthcare organisations can have a positive impact on the overall well-being of local communities by operating as anchor institutions.
settingSecondary healthcare organisations in England, including mental health and community services.
participantsStaff from case study sites which were directly employed or actively engaged in the organisation's anchor institution strategy. Data collection took place from early June to the end of August 2023.
resultsWe found four building blocks for effective anchor activity including employment, spending, estates and sustainability. Healthcare organisations-as anchor institutions-can improve the social determinants of health for their local communities through enabling accessible paths for local community recruitment and career progression; empowering local businesses to join supply chains boosting income and wealth; transforming organisational spaces into community assets; and supporting local innovation and technology to achieve their sustainability goals. These blocks need to be integrated across organisations on the basis of a population health approach promoted by supportive leadership, and in collaboration with a diverse range of local partners.
conclusionsHealthcare organisations have the potential for a positive impact on the overall well-being of local communities. Policymakers should support healthcare organisations to leverage employment, spending, estates and sustainability to help address the unequal distribution of the social determinants of health.
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