Nonprofit hospitals in the U.S. are under scrutiny for potentially perpetuating health disparities through their community benefit spending. Recent research reveals that allocations of community support are disproportionately skewed towards affluent, predominantly white neighborhoods. A stark contrast is evident in the funding received by communities classified as socially vulnerable, which report significantly lower per capita benefits.
In examining data from 2,465 hospitals across more than 3,140 counties, findings suggest a worrying trend. For every 1% increase in Black or Hispanic residents, there is about a 1.6% and 0.88% reduction in community benefit spending, respectively. Furthermore, economically disadvantaged areas receive scant support; while wealthier communities can enjoy an average of $540 per capita, those in the lowest quintile see merely $22.
The evidence points to a systemic issue where the current nonprofit tax system may exacerbate health disparities, raising alarms about structural discrimination. Researchers stress the urgency for policy reforms aimed at ensuring that hospitals fulfill their commitments to provide equitable benefits to communities in greater need.
As Dr. Jose Figueroa highlighted, this inequity reflects deeper societal issues, necessitating a thorough reassessment of how community benefit investments are dictated and implemented, particularly in support of marginalized populations.
See: “Community benefit spending by nonprofit U.S. hospitals may be structurally discriminatory” (March 8, 2025)
