{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T04:20:26Z","timestamp":1729916426726,"version":"3.28.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T00:00:00Z","timestamp":1727481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Nonprofit hospitals are required to annually report spending on community-building activities (CBAs) to the Internal Revenue Service. CBAs are actions that address root causes of community health problems such as housing and food insecurity. While addressing these issues is important regardless of location, CBA spending could particularly benefit rural residents who, on average, experience worse health outcomes. However, national CBA spending has historically been extremely low, potentially due to confusion surrounding reporting. This explanatory mixed-methods study sought to illuminate nonprofit hospital spending patterns on CBAs in one state, Minnesota, to understand why spending in this important category is so low. Authors first conducted quantitative analyses of publicly available tax return data for the year 2019\u2019 which revealed no statistically significant differences in CBA spending by rural location or hospital system affiliation. Authors then performed a case study of the top spending hospitals\u2019 narrative statements provided in nonprofit hospital tax return documents and found significant variation in what is reported as a CBA. We suggest CBA spending be reported differently to reduce confusion and render tax documents more accurate portrayals of nonprofit hospital spending, thereby providing policymakers with needed information to ensure nonprofit hospitals are financially supporting community health.<\/jats:p>","DOI":"10.1093\/hsw\/hlae032","type":"journal-article","created":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:26:41Z","timestamp":1727569601000},"page":"255-263","source":"Crossref","is-referenced-by-count":0,"title":["Mixed-Methods Analysis of Community-Building Activities in Minnesota Hospitals"],"prefix":"10.1093","volume":"49","author":[{"given":"Hannah","family":"MacDougall","sequence":"first","affiliation":[{"name":"School of Social Work, College of Education and Human Development, University of Minnesota Hannah MacDougall, PhD, MSW, is assistant professor, , St. Paul, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Libal","sequence":"additional","affiliation":[{"name":"Association of Minnesota Counties Robert Libal, MPH, is project manager, , St. Paul, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lacey","family":"Loomer","sequence":"additional","affiliation":[{"name":"Department of Economics and Health Care Management, University of Minnesota Duluth Lacey Loomer, PhD, MSPH, is associate professor of health care management, , Duluth, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,28]]},"reference":[{"year":"2021","author":"Akinlotan","key":"2024102512521183400_hlae032-B1"},{"key":"2024102512521183400_hlae032-B2","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1001\/jamainternmed.2019.7415","article-title":"Charity care provision by US nonprofit hospitals","volume":"180","author":"Bai","year":"2020","journal-title":"JAMA Internal Medicine"},{"key":"2024102512521183400_hlae032-B3","doi-asserted-by":"publisher","first-page":"278","DOI":"10.17161\/kjm.vol15.16221","article-title":"Preventive care utilization among rural versus urban women 12 months prior to pregnancy","volume":"15","author":"Burns","year":"2022","journal-title":"Kansas Journal of Medicine"},{"year":"2015","author":"Catholic Health Association","key":"2024102512521183400_hlae032-B4"},{"key":"2024102512521183400_hlae032-B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.21898","article-title":"Investments in community building among nonprofit hospital organizations in the United States","volume":"3","author":"Chen","year":"2020","journal-title":"JAMA Network Open"},{"volume-title":"Designing and conducting mixed methods research","year":"2017","author":"Creswell","key":"2024102512521183400_hlae032-B6"},{"key":"2024102512521183400_hlae032-B7","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.3445","article-title":"Health systems and social services\u2014A bridge too far?","volume":"4","author":"Glied","year":"2023","journal-title":"JAMA Health Forum"},{"year":"2023","author":"Godwin","key":"2024102512521183400_hlae032-B8"},{"year":"2023","author":"Internal Revenue Service","key":"2024102512521183400_hlae032-B9"},{"year":"2023","author":"Kliff","key":"2024102512521183400_hlae032-B10"},{"year":"2023","author":"Levey","key":"2024102512521183400_hlae032-B11"},{"year":"2023","author":"Levinson","key":"2024102512521183400_hlae032-B12"},{"key":"2024102512521183400_hlae032-B13","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1093\/hsw\/hlaa020","article-title":"Social work leadership in the provision of nonprofit hospital community benefits","volume":"45","author":"MacDougall","year":"2020","journal-title":"Health & Social Work"},{"key":"2024102512521183400_hlae032-B14","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1377\/hlthaff.2019.00914","article-title":"Structural urbanism contributes to poorer health outcomes for rural America","volume":"38","author":"Probst","year":"2019","journal-title":"Health Affairs"},{"year":"2024","author":"Rakshit","key":"2024102512521183400_hlae032-B15"},{"key":"2024102512521183400_hlae032-B16","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1377\/hlthaff.2014.1424","article-title":"The value of the nonprofit hospital tax exemption was $24.6 billion in 2011","volume":"34","author":"Rosenbaum","year":"2015","journal-title":"Health Affairs (Project Hope)"},{"year":"2023","author":"RTI International","key":"2024102512521183400_hlae032-B17"},{"key":"2024102512521183400_hlae032-B18","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1097\/PHH.0000000000000253","article-title":"Hospital community benefit in the context of the larger public health system: A state-level analysis of hospital and governmental public health spending across the United States","volume":"22","author":"Singh","year":"2016","journal-title":"Journal of Public Health Management and Practice"},{"key":"2024102512521183400_hlae032-B19","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1097\/PHH.0000000000001697","article-title":"Trends in the provision of community-building activities by nonprofit hospitals, 2010\u20132019","volume":"29","author":"Singh","year":"2023","journal-title":"Journal of Public Health Management and Practice"},{"volume-title":"Hospital community benefits after the ACA: Community building and the root causes of poor health","year":"2012","author":"Somerville","key":"2024102512521183400_hlae032-B20"},{"key":"2024102512521183400_hlae032-B21","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1097\/PHH.0000000000000591","article-title":"The role of 2 Boston journals in shaping today\u2019s community benefit programs","volume":"23","author":"Trocchio","year":"2017","journal-title":"Journal of Public Health Management and Practice"},{"key":"2024102512521183400_hlae032-B22","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1097\/JHM-D-22-00156","article-title":"When states mandate hospital community benefit reports, provision increases","volume":"68","author":"Zare","year":"2023","journal-title":"Journal of Healthcare Management"}],"container-title":["Health &amp; Social Work"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/hsw\/article-pdf\/49\/4\/255\/60072488\/hlae032.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/hsw\/article-pdf\/49\/4\/255\/60072488\/hlae032.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T12:52:20Z","timestamp":1729860740000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/hsw\/article\/49\/4\/255\/7789577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,28]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,9,28]]},"published-print":{"date-parts":[[2024,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/hsw\/hlae032","relation":{},"ISSN":["0360-7283","1545-6854"],"issn-type":[{"type":"print","value":"0360-7283"},{"type":"electronic","value":"1545-6854"}],"subject":[],"published-other":{"date-parts":[[2024,11]]},"published":{"date-parts":[[2024,9,28]]}}}