Tuesday, January 31, 2017

How are Community Development Organizations Helping Build Healthy Places?

by Alina Schnake-Mahl
Gramlich Fellow
The great majority of America’s high-performing community development organizations (CDOs) are actively tackling health challenges in their communities. In a new working paper* published by NeighborWorks® America and the Joint Center for Housing Studies, Sarah Norman (NeighborWorks’ Director of Healthy Homes & Communities) and I examine how CDOs engaged in activities at the nexus of health, housing and community development. 

Drawing on a survey of the 242 high-performing CDOs in the NeighborWorks network, we found that 89 percent of the surveyed organizations reported activities and strategies that explicitly promoted health in 2015 – from green and healthy building standards to on-site, coordinated health services. We also found that 83.3 percent of organizations worked with partners to support their efforts.  Increases in these activities, we noted, have been spurred by recent changes in the American health-care system and philanthropic grantmaking that together have provided new opportunities for CDOs to partner with other community entities to address health challenges.

CDOs used a variety of approaches, many of them focused on healthy homes and access to healthy food. For example, Foundation Communities, a nonprofit affordable housing provider based in north Texas since 1990, addresses the health and social needs of residents through health and wellness classes; smoke-free, green and healthy rental homes; community gardens and walking paths; as well as childcare and after school programming that addresses literacy and physical fitness. An evaluation of these programs showed improvements on measures of quality of life and well-being for program participants.

Photo courtesy of Foundation Communities

Similarly, REACH CDC – an affordable housing developer and property management company serving Portland, Oregon – is a member of a Limited Liability Corporation (LLC) that provides enhanced health and social service coordination for 1,400 residents at 11 federally subsidized, independent-living, affordable-housing properties in Portland. Project elements include an on-site Federally Qualified Health Center; culturally specific services for non-English-speaking residents; food distribution for homebound residents and other residents experiencing food insecurity; health navigators; and free mental health consultations. Multiple evaluations documented improvements in quality of life and well-being for residents as well as cost savings for Medicaid

Taken as a whole, the study shows that CDOs have undertaken significant efforts to explicitly improve the health of the communities they serve. Additionally, as the health care system increasingly targets the social determinants of health, there are new opportunities for engagement.  For example, housing-based services could help address gaps between formal medical care and community health to help older residents to age in their communities. More broadly, CDOs’ long-standing relationships with local communities provide a strong base to support cross-sector partnerships to tackle health inequities.

Alina Schnake-Mahl is a doctoral student in the Department of Social and Behavioral Sciences, at the Harvard T.H. Chan School of Public Health.  She was a 2016 recipient of the The Edward M. Gramlich Fellowship in Communityand Economic Development, which is co-sponsored by the Joint Center and NeighborWorks®America.

*The full article is under consideration in Cities & Health; the journal is available online. 

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