Commentary: Community Economic Development as a Driver of Rural Health
Tim Size, Executive Director, Rural Wisconsin Health Cooperative, Sauk City, WI. RWHC is owned and operated by 43 rural hospitals, including Tomah Health.
“The coronavirus pandemic pits all of humanity against the virus. The damage to health, wealth, and well-being has already been enormous. Everyone can work together to learn about the disease and develop tools to fight it. I see global innovation as the key to limiting the damage.” (Bill Gates from the blog, “The First Modern Pandemic,” 4/23/20)
Rural Health Innovation Must Expand Its Focus–The Rural Wisconsin Health Cooperative (RWHC) and many of its networked 43 nonprofit rural community hospitals are expanding their focus to include rural community economic development. The historic number of farm bankruptcies, shuttered employers and dramatic financial realities healthcare providers are facing as they continue to respond to COVID-19 are present day examples of why innovation in the actual role of rural health leaders is needed now more than ever before.
Economic Stability is a Key Social Determinant of Health–The 2019 County Health Rankings show that two-thirds of Wisconsin’s rural counties had health outcomes below the state average–driven by health factors such as lower levels of employment, income, education, affordable housing and childcare. The WI Department of Workforce Development has documented rural Wisconsin counties as having been very slow to recover from the Great Recession. Two-thirds of Wisconsin’s rural counties saw their populations drop between 2010-18, according to Forward Analytics, a division of the Wisconsin Counties Association. “The economic consequences of depopulation are real–a shrinking workforce, fewer jobs in the county, fewer businesses, and slower income growth.”
Place is a critical factor in determining our ability to thrive. But while our place is rural, we know that for rural to succeed we need to find common ground with those working statewide and in our urban communities. RWHC is committed to prosperity for all.
The RWHC Plan–Rural hospitals across Wisconsin are uniquely positioned to have an important impact on the health outcomes and socioeconomic well-being of rural Wisconsin residents.
The most obvious contribution is in the access and quality of clinical health care. Further, rural hospitals are increasingly taking leadership roles with the aim to improve health behaviors.
Less obvious is the role of rural Wisconsin hospitals in community economic development (CED) initiatives undertaken at the local and regional levels to improve the socioeconomic wellbeing of rural residents. Examples include expanding childcare and housing as well as assisting business new starts and expansions. As anchor institutions, rural hospitals are well positioned to join with others in providing a leadership role to foster more vibrant and resilient communities.
RWHC and rural hospital health leaders in Wisconsin have begun work to:
(1) Increase rural hospital engagement and leadership with local multisector CED,
(2) Increase the effectiveness of rural hospital engagement and leadership with CED,
(3) Increase a rural health perspective in statewide CED and
(4) Increase a statewide CED perspective in rural health.
Working Together We Can Make a Real Difference–RWHC believes that rural hospitals, together and individually, are well positioned to contribute a “spark” to many rural Wisconsin CED efforts. As anchor institutions we are often well established within the community and can provide a bridge to resources outside the community. Rural hospitals can provide leadership, facilitation and networking resources to their home communities.
RWHC and rural hospitals across Wisconsin realize that in order to revitalize the communities that they serve they must take on a stronger role in community efforts. All of us working together can assure that we have the training, experience and support to become effective innovators for rural community and economic development.
This challenge is not unique to Wisconsin. It is our hope that as we expand collaboration between health care providers and their communities we can serve as a model for the rest of rural America while at the same time learning from our colleagues across the country.