However, we know that to increase the effects of our investments, we need to work with others whose expertise, resources, and missions add strength to our own so that together we can add health metrics to financial and other bottom-line indicators of success. This is where the finance and community development sectors come in.
The finance and community development sectors have traditionally joined together to improve neighborhoods, developing safe, affordable housing, child care centers, community health centers, and grocery stores. The health sector can help. We can provide the tools, evaluation research, and data to show what works: for example, the impact of developing a new transit line or building a grocery store in a food desert. Public health can provide a nationwide network of health departments, public health workers, and insights to increase support for on-the-ground community improvements. And philanthropies can serve as conveners, bringing together leaders from diverse fields and funding innovative approaches. Together, these partnerships can lead to smarter investments and new evidence-based solutions.
Each of these sectors has had the same goal for decades: improving the lives of low-income families. Together we spend billions of dollars each year. Joining forces is not about spending more money but about better targeting our efforts, sharing tools and data, and learning what is working and then replicating those programs and investments. There are promising examples sprinkled in communities across the country:
- In Seattle, public health and housing leaders are working together to reduce the allergens in low-income homes that can cause asthma, a scourge of low-income children that results in an estimated 13 million missed school days and $3.2 billion in treatment costs.12
- Mercy Housing, a nonprofit affordable housing developer, has created with its San Francisco Mission Creek Apartments a healthier environment for seniors and is saving the city nearly $1.5 million a year.13
- In San Diego, Market Creek Plaza, a $23.5 million real estate development project located in what was once one of the most distressed and dangerous communities in the city, has brought together affordable housing, healthful food, a community center, and jobs for community residents that include living wages, health insurance, and pension plans.14
We are energized by such examples. What is missing, however, is the pervasive will, momentum, infrastructure, and framework to take these efforts to a nationwide scale.
WORKING TOGETHER TO ACCELERATE CHANGE
To make working together the routine rather than the exception, we have recognized that we need better measures of the health outcomes of community development work. One response is the changes we are making to our annual County Health Rankings to better translate the value of improved health into economic terms, such as greater productivity and lower health care costs for businesses.
Another challenge is that whereas the community development sector is quite good at finding ways to attract all types of capital (government subsidy and below-market-rate and market-rate capital) to projects with good business fundamentals, the health sector has struggled with how to capture and explain returns on investments in health. This is another near-term goal. We believe we can create a powerful partnership, marrying public health’s ability to measure health outcomes with community development’s business acumen to make a stronger financial case for community-building work as a way to improve people’s lives and save on health expenditures down the road.
This work has begun, and it has been met with enormous response and interest across the health and community development sectors. It has gained federal attention as well, including from the Federal Reserve System and the U.S. Department of Housing and Urban Development. However, we need to do more to ensure that these cross-sector collaborations become the acceptable way to work.
I envision a time in the near future when our fields and the people who work in them do not need to make a special effort to develop partnerships because we will be working side by side in communities, in states, and nationally, with common aims, combining our best assets and skills to improve the lives of all Americans. In fact, we are likely to look back at this time and wonder why community development and health were ever separate industries.
- J. Michael McGinnis, Pamela Williams-Russo, and James R. Knickman, “The Case For More Active Policy Attention to Health Promotion,” Health Affairs 21 (2) (2002): 78–93.
- Paula Braveman and Susan Egerter, “Overcoming Obstacles to Health: Report from the Robert Wood Johnson Foundation to the Commission to Build a Healthier America,” Robert Wood Johnson Foundation (2008), available at http://commissiononhealth.org/PDF/ObstaclesToHealth-Report.pdf.
- Harris Interactive, “2011 Physicians’ Daily Life Report.” Survey findings presented for the Robert Wood Johnson Foundation, November 15, 2011, available at http://rwjf.org/files/research/73646rwjfphysicianssurveyrev.pdf.
- Risa Lavizzo-Mourey and Mark Pinsky, “A Win-Win: Job Creation Will Grow the Economy and Improve Health,” The Health Care Blog, January 16, 2012, available at http://thehealthcareblog.com/blog/2012/01/16/a-win-win-job-creation-will-grow-the-economy-and-improve-health.
- “County Health Rankings,” Robert Wood Johnson Foundation, available at http://www.countyhealthrankings.org.
- “County Health Roadmaps,” Robert Wood Johnson Foundation, available at http://www.countyhealthrankings.org/roadmaps.
- “HIA in the United States,” Health Impact Project, A Collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, available at http://healthimpactproject.org/hia/us.
- Shireen Malekafzali and Danielle Bergstrom, “Healthy Corridor for All: A Community Health Impact Assessment of Transit-Oriented Development Policy in Saint Paul, Minnesota,” PolicyLink (2011), available at http://healthimpactproject.org/news/project/body/Healthy-Corridor-Technical-Report_FINAL.pdf.
- “Healthy Kids, Healthy Communities: Supporting Community Action to Prevent Childhood Obesity,” Robert Wood Johnson Foundation, available at http://healthykidshealthycommunities.org.
- James K. Krieger et al. “The Seattle-King County Healthy Homes Project: Implementation of a Comprehensive Approach to Improving Indoor Environmental Quality for Low-Income Children with Asthma,” Environmental Health Perspectives 110 (suppl. 2) (2002): 311–322.
- The $1.45 million is a rough calculation based on the 50 residents who were shifted from higher cost facilities to Mission Creek, multiplied by per-person savings of $29,000 per year. This annual savings was estimated by the San Francisco Public Health Department and communicated to Mercy Housing in a letter titled “Cost and Housing Stability at Mission Creek Senior Supportive Housing,” dated July 14, 2009.
- Judith Bell and Marion Standish, “Building Healthy Communities Through Equitable Food Access,” Community Development Investment Review 5 (3) (2009): 75–83.