Which hospitals participate in community building? What medical anchors spend on community economic development

Sherman, Stephen Averill; Doussard, Marc

doi:10.1080/07352166.2018.1559649

Cited by 14 publications

(11 citation statements)

References 34 publications

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“…With deindustrialization, one strategy of economic development emphasizes medical and education institutions (“eds and meds”). Studies highlight their role in creating jobs, higher wages, and knowledge as anchor institutions (Adams, 2003; Bartik and Erickcek, 2008; Sherman and Doussard, 2018). Many local governments have embraced this economic development strategy, but it can exacerbate fiscal stress by weakening the property tax base, as these institutions are often exempt from local property taxes, which are the primary source of local revenue for many US localities (Aldag et al., 2018; Kenyon and Langley, 2011; Kim, 2017).…”

Section: Theory and Literature Reviewmentioning

confidence: 99%

Austerity urbanism or pragmatic municipalism? Local government responses to fiscal stress in New York State

2019

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As local governments respond to fiscal stress after the global financial crisis, some scholars warn about an austerity urbanism response wherein local governments cut and privatize services, while others see a pragmatic municipalism response that seeks to protect public services by sharing services, applying for more grants, or charging user fees. Existing empirical works lack detail about the types of local government responses and their drivers. Using a structural equation model with 2017 survey data of 919 counties and municipalities in New York State, we explore the drivers of perceived fiscal stress and two responses: cuts and pragmatic municipalism. We find economy, demography, and state policy drive perceptions of fiscal stress and differentiate responses. The dominant response is pragmatic municipalism, and cuts are only dominant in counties and places with more tax-exempt property. Pragmatic municipalism is found not only in places with larger college-educated populations, left-leaning governing boards, and stronger support for maintaining and providing services, but also in places with greater anti-tax sentiments, poverty, and lack of resources for innovation. These results show that local governments use pragmatic approaches to hold back the tide of austerity pressures and respond to local needs within constraints.

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Section: Theory and Literature Reviewmentioning

confidence: 99%

Austerity urbanism or pragmatic municipalism? Local government responses to fiscal stress in New York State

2019

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“…Following the 2010 Affordable Care Act requiring all nonprofit hospitals in the USA to conduct a Community Health Assessment at least every three years, there is increasing interest in looking beyond the traditional focus of hospitals on providing direct care for patients towards looking at their role as urban institutions, including on improving health and examining the social determinants of health in their surrounding local communities, and involving groups and organisations not typically represented in the healthcare delivery system in understanding the needs of geographic areas (Franz et al, 2019;Kaplan and Gourevitch, 2020;Wahowiak, 2017). Yet, analysis suggests that their contribution as anchor institutions in the USA varies by size and type of hospital (Cramer et al, 2017;Sherman and Doussard, 2019).…”

Section: Asset-based Development the Role Of Anchor Institutions And Migrant/refugee Integration In Citiesmentioning

confidence: 99%

Unlocking inclusive growth by linking micro assets to anchor institutions: The case of skilled overseas migrants and refugees and hospital jobs

Green

Parke²,

Hoole³

et al. 2021

European Urban and Regional Studies

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This paper contributes to anchor institution, migrant and refugee integration, skills utilisation and inclusive growth debates. Via a pioneering innovative approach to inclusive urban development linking together physical infrastructure development and neighbourhood management approaches to urban regeneration, it explores the potential for micro assets within communities to be linked to macro assets of large spatially immobile anchor institutions. Through a case study, it draws on experience, and identifies transferable learning points, from a skills-matching element of a large European Union funded project in a superdiverse inner-city deprived neighbourhood in Birmingham, UK. In contrast to the typical emphasis of area-based employment initiatives on people with low skills, the skills-matching initiative focuses specifically on connecting skilled overseas migrants and refugees to skilled and highly skilled jobs in a large local hospital. It underlines the central role of local partnership working and highlights the role of skills utilisation, not merely skills development, in inclusive growth. The evidence suggests that three components underlie success in unlocking and catalysing links between micro assets and a macro asset to realise anchor institution potential: (1) institutional entrepreneurship, which provides the strategic buy-in from the anchor institution; (2) innovative entrepreneurship, which provides the delegated responsibility for implementation; and (3) vision and place leadership, which provides the strategy and resources to build the bridge between the macro asset and the local community to help realise inclusive growth.

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“…Deindustrialization in the 1970s and 1980s shifted the U.S. economy away from manufacturing toward service industries, creating fiscal and economic development challenges for many cities and rural areas (Hobor 2013; Neumann 2016; Sherman and Doussard 2019; Xu and Warner 2015). These declining places struggle with unemployment and lower incomes, while having the additional burden of needing to maintain and/or upgrade physical infrastructure (Reese, Sands, and Skidmore 2014).…”

Section: Literature Reviewmentioning

confidence: 99%

Pragmatic Municipalism: U.S. Local Government Responses to Fiscal Stress

Warner

Aldag

Kim

2020

Public Administration Review

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This article updates cutback management theory and challenges austerity urbanism theory by showing that local governments practice pragmatic municipalism—protecting services with a balanced response to fiscal stress. Using a 2017 national survey of 2,341 U.S. municipalities and counties, the authors identify four responses—no specific action, cuts, revenue supplements, and deferrals. Structural equation models show that cuts are higher in places with older infrastructure and more unemployment but not in places with more poverty. Supplemental responses are higher in places with professional management and higher education. Deferrals are higher in places with more debt but lower in places with older infrastructure. Localities with less fiscal stress take no specific action. Most governments combine cuts, supplements, and deferrals; this balanced response is associated with more fiscal stress, more citizen engagement, and higher levels of unionization. These results show that local governments practice pragmatic municipalism, not austerity urbanism, when responding to fiscal stress.

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Which hospitals participate in community building? What medical anchors spend on community economic development

Cited by 14 publications

References 34 publications

Austerity urbanism or pragmatic municipalism? Local government responses to fiscal stress in New York State

Austerity urbanism or pragmatic municipalism? Local government responses to fiscal stress in New York State

Unlocking inclusive growth by linking micro assets to anchor institutions: The case of skilled overseas migrants and refugees and hospital jobs

Pragmatic Municipalism: U.S. Local Government Responses to Fiscal Stress

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