Journal article
Addressing Social Determinants of Health in Rural Iowa Hospitals: Content Analysis of Community Health Needs Assessments
Journal of public health management and practice, Vol.31(5), pp.716-725
09/2025
DOI: 10.1097/PHH.0000000000002184
PMID: 40633119
Abstract
With the shift to value-based care, social needs screening and referrals and other means of addressing the social determinants of health (SDOH) have become important ways for hospitals to address population health, which is particularly important for rural communities. Our objective was to evaluate how Iowa rural hospitals identified SDOHs in their community health needs assessment (CHNAs).
We conducted content analysis on the most recent CHNAs, and corresponding implementation plans of 53 rural Iowa hospitals, capturing broad social needs terms (eg, social screening, social risk) and specific SDOH terms (eg, housing, food insecurity), and hospital-community partnerships. We conducted stratified analysis by hospital-level characteristics like ownership (not-for-profit, non-federal government), type, and Accountable Care Organizations participation, and sociodemographic characteristics of each hospital's defined community area.
The most frequently identified SDOH were food insecurity (94.4%), transportation (92.6%), and housing insecurity (83.3%). Implementation plans primarily addressed food insecurity (53.7%), transportation (48.1%), and housing insecurity (35.2%). The most common hospital partnerships were with schools (68.5%), local organizations (53.7%), and faith-based organizations (31.5%). A lower percentage of Critical Access Hospitals and non-federal government hospitals addressed SDOH in their implementation plans compared to rural prospective payment system hospitals and non-profit hospitals, respectively. Hospitals serving counties with higher social needs showed higher assessment but lower implementation addressing these needs.
The disparities in screening and implementation efforts by hospital type, ownership, and payment models highlight the need for tailored policy interventions and infrastructure support to enhance social needs strategies, particularly in rural contexts.
Details
- Title: Subtitle
- Addressing Social Determinants of Health in Rural Iowa Hospitals: Content Analysis of Community Health Needs Assessments
- Creators
- Khyathi Gadag - University of IowaUfuoma EjughemreKristin WilsonWhitney E Zahnd
- Resource Type
- Journal article
- Publication Details
- Journal of public health management and practice, Vol.31(5), pp.716-725
- DOI
- 10.1097/PHH.0000000000002184
- PMID
- 40633119
- NLM abbreviation
- J Public Health Manag Pract
- ISSN
- 1550-5022
- eISSN
- 1550-5022
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS): U48DP00638
This research was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a Cooperative Agreement Number (U48DP00638). The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government
- Language
- English
- Electronic publication date
- 07/09/2025
- Date published
- 09/2025
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984845654502771
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