Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health

Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities....

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Bibliographic Details
Published in:	Preventing chronic disease Vol. 16; p. E95
Main Authors:	McIntire, Russell K, Romney, Martha C, Alonzo, Greg, Hutt, Jill, Bartolome, Lauren, Wood, Greg, Klein, Gary, Goldfarb, Neil I
Format:	Journal Article
Language:	English
Published:	United States Centers for Disease Control and Prevention 25-07-2019
Series:	Peer Reviewed
Subjects:	Adult Female Health Benefit Plans, Employee Health Care Costs Humans Implementation Evaluation Investments Male Patient Acceptance of Health Care Pennsylvania Primary Health Care Public Health - economics Workplace Pennsylvania
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Summary:	Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities. We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel linear modeling to explore relationships between community health and 3 outcome variables: emergency department (ED) use, hospital use, and paid claims. Business leaders reviewed findings and offered insights on preparedness to invest in community health improvement. Poorer community health was associated with high use of ED services, after controlling for age and sex. After including a summary measure of racial composition at the zip code region level, the relationship between community health and ED use became nonsignificant. No significant relationships between community health and hospitalizations or paid claims were identified. Business leaders expressed interest in further understanding health needs of communities where their employees live. The health of communities in which adult employees and dependents live was associated with ED use, but similar relationships were not seen for hospitalizations or paid claims. This finding suggests a need for more primary care access. Despite limited quantitative evidence, business leaders expressed interest in guidance on investing in community health improvement.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1545-1151 1545-1151
DOI:	10.5888/pcd16.180631