Building Baltimore’s Accountable Health Community

While 96% of health care costs are spent on medical care delivered in hospitals, only 10% of what drives health outcomes is attributable to clinical care. This is markedly true in Baltimore, which is home to some of the best health care institutions in the country. Yet our city faces a mortality rate that is 30% higher than that of the rest of Maryland and ranks last in the state on nearly all key health outcomes.

These outcomes are compounded by a series of complex social, economic, and political determinants of health: more than 1 in 3 children in Baltimore live below the federal poverty line, and more than 30% of Baltimore households earn less than $25,000 per year. Stark disparities exist as a result: residents of the city’s wealthiest neighborhoods can expect to live up to 20 years longer than their less affluent peers, even though their homes may be less than a mile apart.

At the Baltimore City Health Department (BCHD), we know that tackling these health disparities requires a multi-pronged approach to social determinants of health. For decades, our public health programs and services have involved identifying and then addressing a wide range of health-related social needs and issues, including food insecurity, opioid addiction, lack of transportation, utilities assistance, homelessness, job training, and more.