October 28, 2020

Health and Housing Partnerships for Equitable Response, Recovery

The connection between health and housing is a frequent subject in public health, with health care providers and community developers collaborating to design ways to improve the health outcomes of residents living in low-income communities. Exacerbated by the effects of the Covid-19 pandemic, the increased need to address social inequities — including food insecurity, unemployment, homelessness and a lack of healthcare — becomes paramount as these factors create more obstacles that in turn hinder low-income households from achieving optimal health status.   

How is this Inequity Addressed? 

On Oct. 1, Enterprise’s Health Begins with Home Initiative and Citi brought together public health, health care and affordable housing practitioners for their Health and Housing Partnerships for an Equitable Response and Recovery from Covid-19 convening, to share thoughts and experience on how providing a stable home, connected to opportunity, can positively impact the outcome of one’s life.  

Priscilla Almodovar, Enterprise chief executive officer, reminded the group that 20% of our health is dependent on care delivered in the medical establishment and that the rest of our health and well-being depends on the physical and social environments and personal behavior. Creating a fair and equitable future through community engagement, partnerships and innovative health financing are methods supported by Hala Farid, Citi’s senior vice president and director of Community Development of Inclusive Housing, who worked closely with Enterprise to organize this convening to share the knowledge that will aid in closing the gap between the health care and housing sectors. 

Mobilizing Support and Engaging for Systems Change 

Keynote speaker Dr. Tiffany Manuel (DrT), president and CEO of TheCaseMade, said that because of Covid-19 “our communities are experiencing some of the toughest challenges they’ve experienced in more than a generation.” 

There has been a massive breakdown of our systems that have always contributed to inequities and the results are now laid bare by this pandemic, such as when a person’s access to health care is tied to a job or when affordable housing is disconnected from opportunity, she noted.   

Before initiating a campaign for health and housing, DrT encourages deliberative thought into how we build public will around pressing issues. As in her book Strategic Case Making, DrT prescribes a more strategic and thoughtful response from the conventional reactions we are programmed with today and urges the formation of partnerships that reimagine ways we can mobilize for action.  

We should inspire support for systems change fundamentally through: 

  • Understanding the history and context of the communities we are serving 
  • Engaging around the vision the community has for itself
  • Building agency within the community to work in partnership with cross-sector partners tackling the interconnected issues we are facing 

DrT cautioned, if you aren’t doing this then you are “missing the moment and missing the point.”  

Cross-sector Partnership Models that Promote Health Equity 

To highlight the models and strategies used to promote health equity and illustrate the strengths of affordable housing, a panel of speakers moderated by Juan Sebastian Arias, Chicago office of Neighborhood Development deputy director of policy, outlined strategies designed to improve health equity through innovative financing techniques and partnerships with community, private government and health care entities to provide a series of services that promote better health outcomes.   

Richard Gerwitz, co-head of Citi Community Capital, discussed how working with the federal government to stretch funds via methods like reducing the 50% rule for Low-Income Housing Tax Credit, reducing regulatory obstacles that add time and cost to affordable housing projects and implementing modular housing. These methods target preventing homelessness and improving the overall health in communities by making it easier to place residents in affordable housing units.   

Citing examples in states like New York and California where many families pay more than 50% of their household income on rent, Gerwitz claims working with state and local agencies toward system change could increase the availability of funds for families to spend on healthy food, medication and critical and preventative health care services. 

Angela Hurlock, Claretian Associates executive director, spoke about how engagement with the community through meetings and surveys helped develop their Sustainable and Affordable Commercial and Real Estate Development (SACRED) program. SACRED dedicates a stretch of Chicago land for the establishment of dedicated services like affordable housing, health and recreation, social and cultural space, food access and thriving businesses.  

Hurlock also emphasized how the SACRED program is community-led, allowing residents to speak on what opportunities they prefer to see. For example, a YMCA and grocery store are planned to be located near one of Claretian’s affordable housing developments, increasing access to healthy food and recreation. 

Public health professional Jacquelyn Thornton detailed a venture into a smart technology partnership between National Church Residences and Keenly Medical Device (KMD) to meet new needs around Covid-19, which will be useful in the long-term. KMD uses a small, easily installed monitoring device that connects to WiFi networks and gathers information about seniors living in affordable housing and relays that information to the resident’s primary care physician for health care utilization. The partnership addresses the disconnect from critical and preventive services that our disabled, elderly and isolated populations experience due to their immobility and susceptibility to disease. By providing this technological conduit to transfer information, providers will be able to better manage the care of isolated individuals.   

Stewardship, empowerment and collective ownership are the key qualities defined by community organizer Roberto Garcia Ceballos that make up community land trust (CLTs). Through CLTs, community-controlled organizations retain permanent ownership of purchased land and sell or rent housing units to lower-income families at affordable rates. Under CLTs, housing stability and affordability could be granted legal protections through bylaws, and with additional collaboration with industry experts, CLTs could manage community development for ensured growth and stability. 

The Future of Health and Housing 

The future health and housing practitioners are working toward is one where your health is not dependent on your zip code. This is a future that will be tied to healing and empowering communities as part of the systems change we seek in health and housing.  Through Enterprise and Citi’s Health and Housing inaugural convening, we explored a multitude of ways in which health inequities could be addressed with mobilization, innovation and partnerships targeting health through housing. Further exploration in ways to improve health and housing will demand more change but the challenge is not only possible but welcomed as we aim to provide a more equitable state.   

If you missed the convening, you can access a recording through Enterprise’s Resource Center. To stay connected with this work, please join the LinkedIn Group, Promoting Health Equity through Housing or share your feedback on needs and resources that would support your organization in promoting health equity through housing via Padlet

Join us on Nov. 17 at 2 p.m. ET for the second session of the Health & Housing series, supported by Citi, Promoting Health through Housing Quality: Exploring roles for healthcare and housing partnerships to promote well-being by improving housing conditions. Please register here.  

This blog was authored by Damarea Crain and Mary Ayala, program director, Enterprise National Initiatives.

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