ANCHOR INSTITUTION

Nonprofit or public institutions including hospitals, universities, local governments, utilities, large cultural organizations, and place-based foundations. Anchor institutions are geographically tied to their community through their social or public-facing mission, invested capital, or clientele. Due to the scale of their operations, anchor institutions produce a significant economic impact in their surrounding community, and given their social mission and place-based focus, have a vested interest in the long-term health and well-being of their surrounding community.

ANCHOR MISSION

A commitment to intentionally apply an institution’s place-based economic power in partnership with the community in order to mutually benefit the long-term well-being of both.

COMMUNITY BENEFIT

Activities of hospitals and health systems that contribute to the health and well-being of their surrounding community. Nonprofit hospitals and health systems must report on their community benefit activities in order to maintain their federal tax-exempt status. Traditionally, community benefit reporting has included free and discounted care, unreimbursed care, community health improvement efforts, efforts to expand access to care, training for health professionals, and research. In 2011, the IRS issued guidance that “community building activities” also counted as community benefit. Defined as hospital activities that foster health improvement through physical and environmental improvements, community capacity-building, and economic development, this expanded the range of community benefit activities to include sectors such as housing and workforce development. 15

COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)

A research process that nonprofit hospitals must implement as part of their community benefit reporting. Instituted by the Affordable Care Act of 2010, CHNAs must be completed by hospitals and health systems every three years and identify the most pressing community health concerns. An implementation plan must then be developed to address identified community health needs. CHNAs and the resulting implementation plans are publicly reported, and subject to review by the IRS. 16

COMMUNITY WEALTH BUILDING

A system-changing approach to community economic development that works to produce broadly shared economic prosperity, racial equity, and ecological sustainability through the reconfiguration of institutions and local economies on the basis of greater democratic ownership, participation, and control (The Democracy Collaborative). 17

ECONOMICALLY UNDER-RESOURCED

A wide set of factors contribute to economic inequality. Economic instability may look different in different contexts. Anchor institutions and their partners may choose to focus on multiple factors when determining where to focus their efforts and how to allocate resources. A common strategy is to refer to Community Health Needs Assessments or other assessments of health disparities by geography, which can identify zip codes with high percentages of families living below the poverty level, high unemployment rates, or low median household incomes.

HEALTH EQUITY

Health equity refers to the notion that all people should be able to achieve their highest level of health, regardless of their race, gender, class, sexual orientation, or other identities. 18

IMPACT HIRES

Individuals hired from economically under-resourced communities through an intentional, outside-in pathway program into jobs that require less than a bachelor’s degree, pay a living wage, and offer benefits including health insurance, paid leave, retirement benefits, stable schedules, and growth opportunities.

IMPACT PROMOTIONS

Employees who are promoted from positions that require less than a bachelor’s degree into a higher-skilled, higher-wage position, or a lateral position with a comparable wage level but greater career ladder opportunities, due to their participation in an intentional internal pathway program. This can include impact hires and other incumbent employees coming from roles requiring less than a bachelor’s degree.

IMPACT WORKFORCE STRATEGIES

A comprehensive impact workforce strategy connects residents of economically under-resourced neighborhoods to quality jobs and to career pathways. Intentional, outside-in pathway programs prepare and provide specific entry points for individuals experiencing barriers to employment for high-demand, quality jobs at the institution through training and skills development, often in collaboration with community organizations. Inside-up, impact-promotion career pathways and workforce development programs connect these new hires and other incumbent employees to opportunities for career advancement through training, education and intentional programming. These strategies are complemented by policies that facilitate equitable advancement and provide benefits that help lower-wage employees achieve the financial security needed to maintain good health and live fuller lives.

LIVING WAGE

Per the MIT Living Wage Calculator (https://livingwage.mit.edu/), a living wage refers to the “local wage rate that a full-time worker requires to cover the costs of their family’s basic needs where they live”. The MIT Living Wage Calculator can be used to determine the local living wage for every county and metro area in the U.S. It provides hourly living-wage values that take into account the cost of living and household composition (family size), and estimates basic monthly expenses. Another living wage tool is ALICE (Asset Limited, Income Constrained, Employed), which was developed by United Way (https://unitedforalice.org/wage-tool).

QUALITY JOB

A quality job includes employer-paid/subsidized health insurance, paid leave, and employer-funded retirement benefits; pays at or above the local living wage; provides a stable schedule and stable hours; and has either an established career pathway or earning growth opportunities. For further reading, refer to the National Fund for Workforce Solutions’ Job Design Framework and Job Quality Outcome Maps.

SOCIAL DRIVERS OF HEALTH (SDOH)

A complex set of social, economic, and environmental factors that drive health outcomes; also known as social determinants of health. The World Health Organization defines the social determinants of health as “the conditions in which people are born, grow, work, live, and age.” They represent the wider set of forces and systems shaping the conditions of daily life that drive health outcomes, such as inequality, social mobility, community stability, and the quality of civic life. Sometimes referred to as upstream or structural drivers, research indicates that 40% of the factors that contribute to health are social and economic. 19

WORKFORCE DEVELOPMENT

A set of strategies, initiatives, and programs that have the dual focus of helping employers meet business needs and helping individuals obtain skills and competencies to gain employment and advance their careers in quality jobs. These strategies center around creating pathways to employment and educating and training people to build and improve their skills and knowledge to enhance their employability, further their career growth, and increase economic prosperity. These strategies are best deployed in a manner that meets current and future business needs in order to maintain a sustainable and competitive business environment.

Overall, workforce development aims to create a skilled and adaptable workforce that meets the demands of the business while supporting individual career growth.

WORKFORCE INTERMEDIARY

An organization that helps connect residents to jobs through training, access to employment opportunities, and wraparound support such as childcare and transportation assistance. They can be public agencies, nonprofits focused on job placement, community-based organizations focusing on serving specific populations—such as refugees or people leaving incarceration—educational and training organizations, union apprenticeship programs, or other workforce organizations. 20