The traditional way for health care systems to improve people's health is to provide them with the best medical care possible. In recent years, however, there has been a push to get hospitals to improve the health of their communities by supporting non-medical programs aimed at social determinants of health.

Social determinants of health include a variety of life circumstances that can affect health, such as stress, social isolation, poverty, food access, family support, access to education, unemployment and job safety, among many others.

There are well-established relationships between many of life's hardships, from poverty to stress, and common medical conditions, such as obesity, diabetes and heart disease.

Recognizing the significance of social determinants, the Affordable Care Act mandated that nonprofit hospitals conduct community needs assessments every three years and take part in community-level planning aimed at enhancing the health of the communities they operate in.

Despite the Trump administration's efforts to dismantle much of the ACA, it has been supportive of the law's emphasis on social determinants and has granted Medicaid waivers allowing states to provide coverage of services addressing certain non-medical needs. North Carolina's Medicaid program, for instance, will seek to connect beneficiaries with services that address issues such as "housing instability, transportation insecurity, food insecurity, and interpersonal violence and toxic stress," according to Kaiser Health News.

The political support, however, has not prompted hospitals to invest a great deal in efforts aimed at social determinants. Health Affairs recently conducted an analysis of news coverage related to 626 health systems across the country from 2017 to 2019 and only found evidence that 57 of them had made specific funding commitments to programs targeting social determinants.

Although the study authors conceded that some hospitals may have made investments without announcing them, they argue that it's unlikely that a hospital would make a significant contribution without alerting the press.

The commitments the study identified amounted to nearly $2.5 billion. The biggest area of investment is housing, followed by employment, education and food security.

The largest single investment came from Kaiser Permanente, which committed $760 million to eight different programs. Both the Johns Hopkins system and MetroHealth in Cleveland commited about $160 million.

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Health systems have committed $2.5 billion to addressing social determinants of health

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