Social Determinants of Health

Financial Stability Promotes Good Health

October 26, 2017 12:52 pm

As healthcare leaders, we understand that a person’s job status, living conditions, and educational level can greatly impact his or her health. Research indicates that approximately 20 percent of a person’s health is based on heredity and access to medical care, while the remaining 80 percent is determined by physical environment, health behaviors, and socioeconomic factors.

ProMedica is based in Lucas County, Ohio, where more than 20 percent of the population lives in poverty. For several years, we have been focused on how hunger impacts health. Within the past year, we have broadened our focus to address other health determinants, such as housing, employment, and education. 

One of our most ambitious initiatives is the Ebeid Financial Opportunity Center (FOC), a career and personal-finance service center that helps low- and moderate-income residents improve their financial status. 

In the first 10 months of operation, 389 clients used the FOC services—with dramatic results:

  • Fifty-six percent have seen an increase in their net income.
  • Fifteen percent have increased their credit score.
  • Thirty-five individuals have been approved for a credit card.
  • Nine have opened bank accounts.
  • Seven have been connected to stable housing.

What Is an FOC?

The FOC model is a national best practice based on the Annie E. Casey Foundation’s Center for Working Families model, developed and supported by the Local Initiatives Support Corporation (LISC). FOC staff work to help individuals obtain steady employment with higher wages, boost their credit ratings, and increase their net income and net worth. This approach, known as integrated service delivery, addresses the multiple needs of low- and moderate-income families striving to achieve long-term financial stability. 

There are about 80 FOCs in 30 cities nationwide. ProMedica is the first health system to establish an FOC. Ours was created in partnership with LISC Toledo and United Way of Greater Toledo and supported with seed grant money from the Toledo Community Foundation. 

Its three core services include:

  • Financial coaching to help individuals build personal financial management skills
  • Career coaching to help individuals secure and maintain employment
  • Access to public benefits (e.g., Medicaid) and free tax preparation services 

The services are provided by an FOC coach who guides clients through credit-building activities such as making regular payments on loans or credit cards. Additionally, the coach helps clients avoid predatory lenders, reestablish relationships with banks, repair credit, and set education and career goals.

LISC oversees FOCs nationwide and assists with some funding sources, but each is operated independently offering their own funding sources.   

Getting Started

The FOC is located in the ProMedica Ebeid Institute, a community health hub in the heart of Toledo’s UpTown neighborhood. The Institute was started with a generous gift from philanthropist Russell Ebeid, who believed that the best way to lift people out of poverty and improve their quality of life was to offer them “a hand up, not a handout.” 

The Institute houses a full-service grocery market, which is important because the neighborhood is categorized as a food desert. In addition to the FOC services, health screenings and classes in healthy cooking and nutrition are offered.

FOC services are available, free of charge, to all Toledo-area residents. Clients are referred by local community agencies such as our local job and family services office and the Area Office on Aging. ProMedica’s insurance company, Paramount, has referred several clients. Additionally, ProMedica refers patients from our primary care offices where we screen individuals for hunger and other health determinants, such as housing, employment, and education. The most common referral method is word-of-mouth. 

Where We Are Going

Because the FOC is a proven concept, we are confident that we have chosen the right model to help our community members improve their financial status. 

Nationally, FOC clients who take advantage of integrated services are 50 percent more likely to land a well-paying job compared with people who receive employment services alone. And they are twice as likely to likely to achieve long-term job retention—holding a job for a year or more—when financial coaching reinforces the work of employment counseling. (See Rankin, S., “Building Sustainable Communities: Integrated Services and Improved Financial Outcomes for Low-Income Families,” LISC, April 2015.) Additionally, FOC clients are more likely to reduce non-asset-related debt and build positive credit histories. (See Roder, A., “First Steps on the Road to Financial Well Being: Final Report from the Evaluation of LISC’s Financial Opportunity Centers,” Economic Mobility Corp., September 2016).

We are committed to improving people’s quality of life because we know that doing so improves health outcomes. One of the best things we can do to improve a person’s health is to help provide them with the tools, education, and resources to find employment.

Randy Oostra is president and CEO, Promedica, Toledo, Ohio.

Read more entries on the Leadership Blog.


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