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Community Health Associated With Emergency Department Use, Study Finds

Alison Rodriguez
Study authors suggested that future research involve developing and testing strategies for business investment in building healthier communities.
There is limited research on the impact of community health on employers. However, a recent study found an association with the health of communities and emergency department use—yet a lack of such associations with hospitalizations or paid claims—suggesting a need for improving access to primary care.

The study, published by Preventing Chronic Disease, utilized a multi-employer database to determine adult employees and dependents with continuous employment across 31 ZIP code regions. Community health scores were calculated at a regional level and the data was assessed to evaluate the relationships between community health and 3 outcome variables, including emergency department use, hospital use, and paid claims. 

“Minimal research has examined the effect of poor community health on employees’ medical costs, use of emergency departments (EDs), and hospitalizations,” noted the authors. “Employers assess the prevalence of illness, service utilization rates, and costs of disease for employees and their dependents but typically do not explore associations between employee health and community health.”

The evaluation showed that poorer community health was associated with high use of emergency department services. However, the researchers noted that following a summary measure of racial composition at the ZIP code level, the association was not significant. Additionally, there were not significant relationships with the other variables—hospitalizations or paid claims.

Business leaders and executives in the focus group were interested in understanding the health needs of the communities of their employees. Many viewed this as an investment with an opportunity to use community and population health improvement to increase corporate philanthropy.

“Employers expressed that a strategic plan and guidance on how to implement change in their companies and communities, leveraging models from other communities and using existing financial and educational resources and government incentives for support, would be useful,” stated the authors.

Study authors suggested that future research involve developing and testing strategies for business investment in building healthier communities. Also, according to the researchers, future studies should consider the influence of benefit plan design, which could reveal more about the relationship between out-of-pocket costs and emergency department use and hospitalizations.


McIntire R, Romney M, Alonzo G, et al. Do employees from less-healthy communities use more care and cost more? Seeking to establish a business case for investment in community health [published online July 25, 2019]. Preven Chron Dis.

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