Essays on People, Place & Purpose

Investing in What Works for America's Communities

Why Health, Poverty, and Community Development Are Inseparable

by Risa Lavizzo-Mourey

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.


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.


  1. 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.
  2. 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
  3. Ibid.
  4. Ibid.
  5. Harris Interactive, “2011 Physicians’ Daily Life Report.” Survey findings presented for the Robert Wood Johnson Foundation, November 15, 2011, available at
  6. 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
  7. “County Health Rankings,” Robert Wood Johnson Foundation, available at
  8. “County Health Roadmaps,” Robert Wood Johnson Foundation, available at
  9. “HIA in the United States,” Health Impact Project, A Collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, available at
  10. 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
  11. “Healthy Kids, Healthy Communities: Supporting Community Action to Prevent Childhood Obesity,” Robert Wood Johnson Foundation, available at
  12. 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.
  13. 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.
  14. Judith Bell and Marion Standish, “Building Healthy Communities Through Equitable Food Access,” Community Development Investment Review 5 (3) (2009): 75–83.


  1. Maurice Saliba Reply

    I am 100% in agreement with this article. Picture Wellness specializes in community and corporate wellness focusing on the high risk population such as diabetes, BP and much more… the highest percentage of the high risk population is not only struggling with low income but with illiteracy and language barriers. We have created services that addresses the struggles of that population and understand that the ultimate goal is to incourage and support individuals in making life style change that can be, one day, inherited by future generations. Please visit our web site and read the latest report on how we are helping individuals come off medications and live a healthier lifestyle. We would love to partner with the RWF in helping to change the communities in our country.

  2. Vicki Nejtek, Ph.D. Reply

    Texas has one of the highest rates of obesity than any other state. In addition, our rate of homelessness is also on the rise. Taken together, merely living in Texas may be a risk factor provoking the increase of vulnerable populations. What funding initiatives are available to target these problems in Texas specifically?

  3. Harry Wiland Reply

    You might consider recommending the book and PBS series Designing Healthy Communities, hosted by Heinz Award winner and Sedgewick Award winner Dr. Richard Jackson. Dr. Jackson links how we build our communities has a direct impact on personal healthy.

  4. Judy Wait Reply

    Kings County in CA has the highest obesity rate for children in the state. We are trying desperately to get a children’s storybook garden & museum built in Hanford, CA to addresses this problem as well as issues of lack of literacy, fine arts, exercise and horticulture. We need some financial help to get this project off the ground. We are looking for contacts for funding this project to help families in lower income areas of our county as well as special needs children, and schools throughout KIng’s Co. Any help in ways we can pursue funding sources would be greatly appreciated.

  5. Mohammad Ali Barzegar Reply

    I am fully in agreement that Healt,Poverty and Community Development are Inseparable. because the needs of human being is interrelated and we as technical people and specialists devided the needs of the people according to our specialities, which does not match with the way of life. Therefor the resources are wasted without tackling the Peopl’s priorities. On the other hand as far as the people’s priorities are not met, they are not participating in the development program. While if we look at the package of inter-related needs of the people, two pillars of the community development i.e.. : community participation and Intersectoral collaboration will be materialized. Because the people will trust that program is addressing their needs and priority and will support it.Also the nature of wholistic approach requires collaboration of the different development sectors and agencies. In this connection. Since 1987 I am working in an integrated bottom-up, people centered socio- economic development program called Basic Needs in Africa and Asia. The aim of program is to fight poverty through income generation and job creation, empower people and improve the quality of life of the people. The evaluation of the program proved being useful specially in terms of poverty reduction, health and education improvement. I will be more than pleased to share my 25 years experiences in 4 countries of Africa&Asia with your Foundation. Warmest regards and Happy New Year. Mohammad Ali Barzegar, MD,MPH.

  6. driving lessons adelaide Reply

    A family member linked me to this site. Thanks for the details.

  7. Elaine Sanford Reply

    I am interested in successful development initiatives addressing the health of women and children in poverty. What type of intervention ideas are working? Do you know of any projects that have addressed ways to motivate this group to choose better health options (self-esteem, feelings of powerlessness, self-worth)?

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