The connection between health and community development is on everyone’s lips it seems, and for good reason. And yet the two sectors are really still at the beginning stages of learning how to work together.
A few weeks ago we published “7 Tips to Help You Forge Health and Housing Partnerships.” At last week’s People & Places conference, at a session titled “Health Equity and the Zip Code Improvement Business,” I picked up a set of additional, complementary ideas from the panelists—Katrina Badger, from the Robert Wood Johnson Foundation; Terri Baltimore, from Hill House Association, Pittsburgh; Doug Jutte from Build Health Places Network; and Destiny-Simone Ramjohn from Kaiser Permanente.
1. Don’t rely on monetizing everything. It was something of a revelation to start making the argument for housing investments in terms of saved costs from reduced emergency room visits. But once you move beyond the clear-cut case of putting a high-frequency emergency room user into stable housing, reduced health care costs from community development projects can be challenging to measure, says Jutte of the Build Healthy Places Network. (Baltimore of Hill House in Pittsburgh’s Hill District noted that measurable short-term health effects of putting a grocery store in the Hill District were inconsistent, even as everyone involved in the project is clear it has made a huge difference.) Many community development interventions will take some time to show results. That doesn’t mean people aren’t trying to figure out ways to quantify the benefits, but in the mean time, be cautious about promising (or demanding) short-term direct reduced costs.
2. The mechanisms for improved health might not be what you think they are. In discussing the project that brought a grocery store to the Hill District of Pittsburgh, Baltimore noted that the evaluation found greater positive effects among people who didn’t shop at the store than those who did! This doesn’t mean that access to fresh food in the neighborhood wasn’t important. She believes it means that the psychological impact of fighting for and winning a grocery store, and the broader experience knowing that the neighborhood now has a such a crucial amenity, was at least as important to the residents.
3. Look for unlikely alignments of needs. In Stamford, Connecticut, a hospital that wanted to build a new tower adjacent to its existing campus did a land swap with the public housing authority (PHA), which allowed the PHA the ability to finish redeveloping its one decrepit tower into multiple mixed-income, low-rise developments without losing a single unit of public housing.
4. Consider insurers as partners too. While there are good hospitals, their business models don’t necessarily incentivize them to improve health. Health insurance companies, however, are incentivized to improve the health of their customers. The challenge however, is that your constituents will have a mix of insurers.
5. Understand your potential partner’s mission. As our last post suggested, read their Community Health Needs Assessment (CHNA) and Community Health Improvement Plan (CHIP), which are public documents. While a health care organization might not always be fulfilling its mission, showing them how you can help them do so is a good foot forward (just like with a foundation!). Ramjohn explained that Kaiser Permanente’s most recent mid-Atlantic region CHNA listed socio-economic insecurity as the top health issue, as opposed to more traditional challenges like “diabetes.” That’s a great opening for a conversation with the community development field!
6. Start with those who are most likely to work with you. Jutte listed four types of hospitals that are particularly good prospects for partnerships based on their missions:
- Organizations that provide both care and coverage (like Kaiser Permanente, which as Ramjohn described, is already looking not only at community development partnerships, but also local purchasing, local hiring, and small business support as part of a mindset shift)
- Catholic hospitals (just be careful about reproductive rights issues)
- Children’s hospitals
- Safety net hospitals (America’s Essential Hospitals)
7. Find an intermediate partner that knows the hospitals better than you do. If you’re uncertain where to start, says Baltimore, see if you or any of your existing partners have any connections with the health care institution’s leadership. Hill House, for example, turned to the Pittsburgh Parks Conservancy to help them get an in with a desired health partner. (The conservancy had a pre-established relationship with a health partner.)
8. Look at boards—theirs and yours. Badger suggested looking at the hospital’s board and considering how your organization knows any of the members. Jutte suggested taking it a step further—to recruit someone from the hospital to your board, and to consider offering a community representative to the hospital’s board.
Are you working in a health/community development partnership? Do you have any lessons to share, either from things that worked well or things that didn’t? Share them in the comments!