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Machine generated contents note: Foreword FORMER GOVERNOR OF OHIO TED STRICKLAND Introduction DANIEL SKINNER AND BERKELEY FRANZ PART ONE: ESTABLISHING PLACE 1 Ode to the Corner of the Drug House Down the Gravel Road Off the Two-Lane Highway DARREN C. DEMAREE (COLUMBUS) Reflections of a Recovery Writer ANNIE HIGHWATER (GROVE CITY) 6 3 A Place for "Total Recovery" MEMBERS OF TOLEDO RESTORATION CHURCH (TOLEDO) > 4 Building Community in the B. Riley Sober House RAFAEL "TONY" CORREA (CLEVELAND) 16 Walking Past Abandoned Houses, I Think of Eric BARBARA COSTAS-BIGGS (PORTSMOUTH) 20 6 How Are the Children? JOY EDGELL (BELPRE) A Haven from Human Trafficking and Addiction JEFF BARROWS (ZANESFIELD) 26 8 A New Home MARY LYNN ST. LAWRENCE (ATHENS) 30 CONTENTS v i C ontents 9 Collaboration in Middletown TRAVIS BAUTZ (MIDDLETOWN) 33 10 Defiance, Ohio Is the Name of a Band HANIF ABDURRAQIB (COLUMBUS) 37 11 A Heartache Not My Own CAITLIN SEIDA (THE PLAINS) 40 PART TWO: PROCESSING LOSS 12 What Addiction Gave Me TONY ANDERS (UPPER ARLINGTON) 47 13 The Stories Make It Real: A Mayor in the Heart of the Opioid Epidemic NAN WHALEY (DAYTON) 51 14 Jane's Story KERRI MONGENEL (ASHTABULA) 55 15 A Coach's Regrets MATT DENNISON (NEW PHILADELPHIA) 16 An Individual's Addiction, A Family's Loss AJ, JENNA, SHERIE, AND ALAN STEINBERGER (HIGHLAND HEIGHTS) 65 17 The Pain of Wanting to Help ANONYMOUS 71 18 My Reality at the Bedside HANK ROSSITER (KIDRON) 74 19 What Happens Under the Overpass NEIL CARPATHIOS (PORTSMOUTH) 78 20 Community and Vulnerability BRIAN SCHWEITZER (COLUMBUS) 80 21 Remaking a Family CHRIS, ESTELLA, AND TYLER FERRELL (MINFORD) 85 22 Dear Travis VICKI SCHARBACH (OLMSTED FALLS) 92 23 Despair GERALD E. GREENE (DAYTON) 98 C ontents v i i PART THREE: MAKING SENSE 24 A Predictable and Utterly Preventable Catastrophe MICHAEL HENSON (CINCINNATI) Standing Proud ERIC UNGARO (POLAND) 112 26 Uncle Sugar ANISI DANIELS-SMITH (HIRAM) 118 27 Potential Energy APRIL DEACON (WHEELERSBURG) 122 28 The Road to Recovery ALEX DRIEHAUS (CINCINNATI) 129 29 From Felon to Law Enforcement: A Retrospective BRANDY E. MORRIS-HAFNER (CHILLICOTHE) 141 30 A Little Too Close to Home KEITH F. DURKIN (ADA) 147 31 Deluded MARTY HELMS (CINCINNATI) 152 32 Opioid Encounters: Fragments from Training and Practice JENNY ZAMOR (COLUMBUS) 161 33 An Awakening JOE GAY (ATHENS) 165 PART FOUR: DEVISING SOLUTIONS This Is Not the Medicine I Want to Practice: One Physician's Journey to Heal, Not Harm KATY KROPF (ATHENS) 175 35 Problem-Solving in Colerain Township DANIEL MELOY (CINCINNATI) 182 36 The Buck Fifty DAVE HUGGINS, CHRIS SCOTT, AND ANGIE FERGUSON (CHILLICOTHE) Plans after Prison JONATHAN BECKER (AKRON) 194 v i i i C ontents 38 Avoiding the Abyss SHARON PARSONS (BEXLEY) 197 39 All the Narcan in the World DAVID KESEG (COLUMBUS) 201 40 Pause for Change NANCY POOK (DAYTON) 206 Reconnecting through Rhythm: A Symphony and Recovery WARREN W. HYER (DELAWARE) 211 42 Rural Challenges, Rural Solutions STEVEN MARTIN, AMY FANOUS, AND KATIE WESTGERDES (ADA) A Way Forward for Moms and Babies RICHARD MASSATTI (COLUMBUS) 223 44 From the Front Pages to the Front Lines DARREN ADAMS (PORTSMOUTH) 230 PART FIVE: CHALLENGING ASSUMPTIONS 45 A Good Family CHRISTINE HUNT (RUSSELLS POINT) Feral JESSICA HARPER AND SARAH BENEDUM (MADISON) Recovery Should Be Celebrated, Not Judged LACEY WHITLATCH (ATHENS) 247 48 Serve and Protect DENNIS WHALEY (TOLEDO) 251 49 What Do Libraries Do? NICK TEPE (ATHENS) 254 50 Confronting Stigma in Portsmouth TRACI MOLLOY 260 51 Everybody Played Along ANONYMOUS (COLUMBUS) 268 52 The Making of a Public Health Emergency YVONKA MARIE HALL (CLEVELAND) 271 53 The Addict, a Human Being STEPHANIE KENDRICK (ALBANY) 276 C ontents i x Acknowledgments 279 Glossary of Drugs 281.

Intro -- Contents -- Acronyms -- Introduction -- 1. Why Are So Many Hospital Neighborhoods Health Poor? -- 2. How History "Keys" the Hospital and Community Relationship -- 3. "What's Your Total Commitment to the Community?": Explicit and Implicit Hospital Development Strategies -- 4. Healthcare in the Contact Zone: Unconventional Spaces, Institutional Changes, and Communities of Color -- 5. Ambiguous Obligations and Mixed Expectations -- 6. Six Policy Ideas for Communities and Hospitals -- Acknowledgments -- Appendix A: On Methods -- Appendix B: Comparative Data -- Appendix C: Hospital-Identified Needs and Programs -- Notes -- References -- Index.

Hospitals have the ability to serve as anchor institutions that not only provide clinical care but make important community investments through employment, and outreach, and engagement efforts that address the social determinants of health. In doing so, hospitals may partner with community members and community-based organizations, but the extent to which local residents participate in directing local investments varies across organizations. This study looks at the role of hospitals as anchor institutions and the best practices for leveraging community participation in planning investments to improve social and economic health in communities. We used an inductive, qualitative approach to understand the incentives hospitals have to anchor themselves within their communities and how best practices can be leveraged. We conducted 28 in-depth interviews with 27 hospital leaders and personnel, and one interview with a member of a for-profit hospital advocacy organization. Drawing on thematic analysis, three primary themes were identified as critical to leveraging community-driven anchor activities: strong and intentional community-oriented leadership; direct community involvement; and non-regulatory incentives, including incentive programs. The more institutions, organizations, communities, and individuals expect community-oriented anchor activities from hospitals, the more likely they are to engage in such activities. Critical to this work is ensuring that community members themselves are able to help direct the investments of hospitals in alignment with community health needs. Community stakeholders, including elected officials, public health offices, and policymakers, have important leverage in creating expectations for hospitals to engage in anchor activities and facilitate community-based partnerships as a part of this process.

AbstractNon‐profit hospitals are important anchors in Appalachian communities, in part because of the concentration of health care dollars within these institutions. Community benefit efforts of these hospitals, therefore, have the potential to fill gaps in public health and social service provision in underserved areas with documented health disparities and access barriers. To date, however, we do not fully understand how community benefit practices vary by hospital setting. Employing hierarchical linear modeling using a multilevel mixed‐effects approach, this study analyzes data from the years 2010 to 2016 to assess community benefit practices and spending between hospitals in Appalachia and non‐Appalachian counties. Findings indicate that hospitals within Appalachian counties, and rural hospitals in this region, in particular, spent less on community benefit than hospitals, not in this region. Given the potential for community benefit to impact health outcomes and access to care, this disparity is important to state and local public health efforts and suggests the need for additional support for hospitals to engage their communities around critical health needs.

The move to community-based practice is often accompanied by doubts about the veracity of the research or clinical data that might be generated. Critics contend that the introduction of subjectivity that accompanies this maneuver obscures the empirical side of social existence, and thus compromises the discovery of facts. But this erroneous conclusion rests on confusion about several key philosophical distinctions that are discussed in this paper. The clarification that results from addressing these issues enhances the utility of community-based health strategies.

Not-for-profit hospitals (NFPs) frequently partner with community organizations to conduct internal revenue service-mandated community health needs assessment (CHNA), yet little is known about the number of partnerships that hospitals enter into for this purpose. This article uses "American Hospital Associations' 2020 Annual Survey" data to examine hospital-community partnerships around the CHNA and the role that community social capital defined as, "the networks that cross various professional, political and social boundaries to reflect community level trust needed to pursue shared objectives" plays in hospitals' choices to partner with community organizations for the CHNA. After controlling for a set of hospital, community, and state characteristics, we found that hospitals present in communities with higher social capital were likely to partner with more community organizations to conduct CHNA. Greater social capital may thus promote community health by facilitating the partnerships NFPs develop with community organizations to conduct the CHNA.

The U.S. epidemic of opioid abuse calls for broad collaboration between a wide range of health care institutions and the various levels of government. Through the community benefit programs they provide, nonprofit hospitals are well positioned to be key partners in local efforts. Although substance abuse appears on approximately 90% of the most recent community health needs assessments completed by hospitals, many hospitals are not addressing substance abuse in their programmatic efforts. Given wide state variation in policies to combat opioid abuse, we assess whether state leadership to address the opioid crisis influences hospital decisions to invest in substance abuse programs. Our findings suggest that several key state policies are related to hospital investments in substance abuse initiatives. To capitalize on the community benefit responsibilities of local hospitals, policies that provide specific direction for and engagement with local hospitals may increase cooperation and investments to address substance abuse.

Preface -- Contents -- About the Authors -- Chapter 1: Introduction: Narratives, Local Knowledge, and World Entry -- Why Local Knowledge? -- World Entry -- End of Dualism -- Narratives Are Everywhere -- Conclusion -- References -- Chapter 2: Community and Narratives -- The Linguistic Turn -- No Message with Indicators -- The Elusive Community -- Narratives and Public Health Care -- Local Control -- Conclusion -- References -- Chapter 3: What Is Dialogue? -- Striving for Transparency -- Courting Intimacy -- Becoming Patient-Centered -- Elements of Dialogue -- Professionals and Dialogue -- Conclusion -- References -- Chapter 4: Storylines, Causes, and the Locus of Interventions -- A Causal Sequence -- A Narrative Framework -- Storylines and Interventions -- Conclusion -- References -- Chapter 5: Narratives, Methods, and World Entry -- The Standard Aim -- Thrown into the World -- Styles of Investigation -- Ways of Engaging Storylines -- Conclusion -- References -- Chapter 6: Community Mapping Tells a Story -- What Does a Typical Map Do? -- Traditional Disembodied Dimensions -- Embodied Dimensions -- Community Entrée -- Conclusion -- References -- Chapter 7: The Politics of Storytelling -- Questions About Dialogue -- Medicine and Realism -- The Road to Democratization -- Conclusion -- References -- Chapter 8: Conclusion: A Community-Based Strategy -- Why Community-Based? -- Becoming Community-Based Through Narratives -- Narratives and Change -- Final Thoughts -- References -- Bibliography -- Author Index -- Subject Index