Bechara Choucair (left) with Adam Rogers (right) at From Day One San Francisco 2019. (Photos by Daniel Beck)

Big businesses have big responsibilities to their employees, their investors, and their customers. But do they owe anything to the world that they operate in?

Bechara Choucair, M.D., the chief community health officer for Kaiser Permanente, thinks so. Choucair spoke at the From Day One conference in San Francisco this week, offering insight on how and why Kaiser Permanente broadens its responsibility beyond its 12.4 million members to include the communities where they live.

With a background as a family physician and former commissioner of Chicago’s Department of Public Health, Choucair now oversees the efforts of the nation’s largest integrated health system to improve the lives of the 65 million people in those communities. In this leadership role, Choucair emphasizes that health does not simply stem from the hospital, but from the home as well.

“When you think about what really impacts health, only 10%, maybe 20% of what impacts health happens within the four walls of the medical office building,” Choucair told Adam Rogers, deputy editor at Wired, who interviewed him at the conference. “What impacts health are the social and economic factors and the communities where people live.”

Choucair spoke specifically about one major need that KP’s communities are facing: homelessness. The housing crisis is a health crisis, he asserted. Choucair brought a few statistics into the conversation to illustrate how detrimental homelessness is on the human body: life expectancy for those without a home is 20% lower and the homeless spend two to three days longer in a hospital once admitted, compared with the average patient.

Kaiser Permanente invested more than $2.8 billion last year to support and respond to community-health needs. Included in that sum was $200 million towards fighting homelessness and building affordable housing in eight states and the District of Columbia, which made headlines as one of the largest public-sector initiatives on homelessness.

Bechara Choucair and Adam Rogers at From Day One San

“We come to this with a lot of humility and we come to this with a lot of other partners,” Choucair said. “We’re never going to be experts on housing people, but we partner with the right community-based organizations that are experts on housing individuals.”

Some of the partnerships Choucair mentioned include Mayors & CEOs for U.S. Housing Investment, a coalition that Kaiser Permanente joined last year. The bipartisan group of more than 20 mayors and business leaders aims to identify key policy goals that need to be implemented with the help of the federal government.

Another partnership Kaiser Permanente is involved in is CityHealth, an initiative that offers city leaders innovative solutions to improve living conditions in their cities. Through these partnerships, KP is able to accurately identify community needs and is able to collaborate to find answers.

In order to determine what type of social needs communities are facing, whether it’s poverty, homelessness, food insecurity, or a combination of them all, Choucair said that Kaiser Permanente does extensive research across the U.S.

“We conduct community-health needs assessments and we do those on a regular basis where we have a fairly robust, systematic approach to looking at data in each one of our communities, doing interviews with ... key leaders in the community and looking at our own data,” Choucair said.

After issues are identified and community-benefit expenditures are made, Kaiser Permanente follows up to determine if its efforts are truly impacting communities and invoking change. Choucair said he tracks KP’s community-benefit expenditures monthly, even weekly.

One seemingly larger-than-life goal that Choucair said Kaiser Permanente continues to push for is universal health coverage.

“For us, it’s been very clear that it’s about expanding coverage and getting that coverage to be more affordable and making sure that the whole care is high quality,” Choucair said. “That’s really been our focus all along.”

Discussion of universal health care has been on the agenda of several Democratic presidential candidates, some of whom have called for “Medicare for all.” For Choucair, the way to get closer to universal health care is to build upon the Affordable Care Act. While it has been under political attack, its proponents make the case that it’s working.

Choucair’s personal goal within Kaiser Permanente boils down to continuing what the organization already doing—investing in communities—but in bigger and better ways, he said.

Julie Madsen studies at the University of California, Berkeley, and works as a freelance journalist and a beat reporter for the Daily Californian, where she covers higher education and breaking news. Follow her on Twitter