Whose Community Benefit?: Exclusion and Neoliberal Mentalities in Central Ohio’s Community Health Needs Assessment
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Date
2015-05
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The Ohio State University
Abstract
The tax exemption of nonprofit hospitals has been an enduring policy issue in the United States, implicating thousands of hospitals that are exempt from income, property, and sales tax on the basis that they qualify as charitable organizations. Congressional hearings on the subject of whether nonprofit hospitals actually provide an appropriate level of charitable care to their community spurred a provision to the Patient Affordable Care Act (ACA) requiring nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA) to better engage with the community. CHNAs have potential to be an empowering mechanism for communities and individuals to voice their health problems and needs so that charitable care organizations can better cater to them. However, most public health programs aimed at improving the health of a community population are almost always accepted as scientifically objective and therefore rarely critically examined. My research situates the CHNA conducted by the Central Ohio Hospital Council within the larger context of public health discourse and programs throughout Columbus and the United States. Specifically, I position my research within the context of neoliberal public health that devolves the responsibility and outcomes of health status to the individual level. Often this conceptualization materializes with adverse effects, rendering long-standing political and cultural problems as technical problems that the individual is charged with correcting. My research critically examines the assumptions and overarching mentalities of hospital administrators and public health experts behind Central Ohio’s CHNA through analyzing programmatic documents and conducting one-on-one interviews. This research contributes to a growing interest in critical public health through examining how hospitals fill the demand to address community health.
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Keywords
public health, community, neoliberalism, post-structuralism