Modern health systems remain built around acute care in hospitals. These miracle factories have delivered dramatic improvements in life expectancy, but they were ill adapted to cope with the consequences of their success – an ageing population with a complex mix of chronic health conditions and social challenges. What is the point in handing out inhalers for asthma only to send people back to damp or unsanitary housing that is exacerbating their conditions? Is it enough to give courses of antibiotics to elderly people with pneumonia, without addressing the social isolation or poor nutrition that makes particular people vulnerable to infection? This presentation will discuss the broader role that hospitals – the healthcare organisations with the greatest influence and resources – can play in addressing the ‘social determinants’ of ill health and creating healthier communities. It argues that the greatest hospital systems are taking a broad perspective on their role and purpose, playing an active role in prevention rather than just treatment, and using their resources in ways that help to address the underlying social and economic factors causing ill-health.
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