Anchor Companies in Small and Mid-Sized Cities: How do Health Outcomes Affect Organizational Stress and Costs?

To better understand the business case for promoting community-wide health, this study will examine the influence of community-level health outcomes on organizational function, sustainability, and cost for anchor companies. We propose to conduct a comparative case study in four small or medium-sized cities that have an anchor company in the manufacturing sector. We are limiting our focus to manufacturing cities because manufacturing is a large industry (14 percent of workers are in manufacturing) and previous studies have shown that manufacturing communities typically have poorer health (Vitality Institute, Beyond the Four Walls, 2015). Limiting our focus to manufacturing cities also improves the comparability of the cases. The cases will vary on a key dimension – health outcomes. We will select two cities with relatively good health outcomes based on a composite score from the 2016 County Health Rakings data. We will also select two cities with relatively poor health outcome scores. We hypothesize that 1) the anchor companies in cities with relatively poor health outcomes are more likely to be hindered by the communities’ health status through greater organizational stress and uncertainty regarding sustainability; and 2) this organizational stress and uncertainty is costly.