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Hilltop Releases Issue Brief on Social and Economic Factors that Shape Health

The Hilltop Institute’s Hospital Community Benefit Program has just released the ninth issue brief in its series, Hospital Community Benefits after the ACA.

This brief, Addressing Social and Economic Factors that Shape Health, continues the program’s examination of state-level community benefit oversight by focusing on the ten states that require hospitals to develop implementation strategies: California, Illinois, Indiana, Maryland, New Hampshire, New York, Rhode Island, Texas, Vermont, and Washington.

Hilltop reviewed more than 500 state-required implementation strategies (or reports of implementation strategies) from these ten states to examine the level of currently reported activities that address specific social and economic factors that shape community health.

Based on the review, the brief identifies standard regulatory tools and characteristics of implementation strategies used by those states that could facilitate hospital investment in activities that address social and economic determinants. The brief also offers conclusions, recommendations, and policy options for state and local policymakers and decision makers.

For more information, contact Gayle Nelson.


Hilltop’s Hospital Community Benefit Program is a central resource created specifically for state and local policymakers who seek to ensure that tax-exempt hospital community benefit activities are responsive to pressing community health needs. The program provides tools to these and other stakeholders to use as they develop approaches that will best suit their communities. Support for this issue brief was provided by a grant from the Robert Wood Johnson Foundation® (

The Hilltop Institute at the University of Maryland, Baltimore County (UMBC) is a non-partisan health research organization dedicated to improving the health and wellbeing of vulnerable populations.  Hilltop conducts research, analysis, and evaluations on behalf of government agencies, foundations, and nonprofit organizations at the national, state, and local levels. Hilltop is committed to addressing complex issues through informed, objective, and innovative research and analysis. To learn more about The Hilltop Institute, please visit


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