Upstream Investments in Community Health: The Power of The Partnership

Health systems that want to invest in their neighborhoods — to go upstream of medical care to make whole populations healthier — can’t do it alone. They need funding partners, the buy-in of local government, the support of residents and the expertise of people with experience in community development.

For more than a decade, Nationwide Children’s Hospital has used this collaborative model to fuel the Healthy Neighborhoods Healthy Families initiative, and especially its core housing improvement and construction program, Healthy Homes.

As part of the population health summit hosted by the Center for Community Investment and Nationwide Children’s, From Roadmap to Reality: Implementation Strategies for Upstream Investments in Community Health, four key players in this collaboration discussed the ways they have long worked together to improve neighborhoods in central Ohio:

• Gretchen West, MCRP, Executive Director, Healthy Homes and Nationwide Children’s Hospital
• Rev. John Edgar, Executive Director and Pastor Emeritus, Community Development for All People, a faith-based non-profit on the South Side of Columbus
• Jonathan Welty, President, Ohio Capital Finance Corporation, a non-profit Community Development Financial Institution
• Carla Williams-Scott, Director, City of Columbus Department of Neighborhoods

“Their shared commitment to promoting vibrant communities and working in unison with the residents served allows us to build deeper, more meaningful relationships,” said West. “As a result, Healthy Neighborhoods Healthy Families offerings are more readily shared with families. . .these change agents exemplify effective implementation partners whose collective strengths have resulted in securing equity, grants and capital funds necessary to scale our impact.”

Rev. Edgar’s organization, which provides direct services to 40,000 people per year on the South Side of Columbus, first collaborated with Nationwide Children’s to form Healthy Homes in 2008. Community Development for All People has the deep trust of the community’s residents, and is the “community connector or neighborhood quarterback,” in the words of Rev. Edgar.

“It’s the strength of these (neighborhood) relationships that allow us to listen as people talk about their hopes and dreams, and we believe those folks are the primary assets,” he said. “Then we work with the hospital and others to bring additional resources to bear so those aspirations can come to fruition.”

With the credibility of Community Development for All People and the financial and planning resources of Nationwide Children’s, Healthy Neighborhoods Healthy Families began. But to build it to a level with population-level impact – it has now invested more than $50 million and improved or built more than 400 homes, with a new focus on rental properties to mitigate gentrification – it needed the partnership of Columbus’ city government.

The City of Columbus has invested millions of dollars in Healthy Neighborhoods Healthy Families, and as the initiative looked to expand beyond the South Side, was crucial in bringing it to the Linden community. Williams-Scott and the Department of Neighborhoods had led the creation of the “One Linden Plan” for community revitalization beginning in 2017, and many of the challenges and goals that residents identified in the plan were the same ones addressed by Healthy Neighborhoods Healthy Families.

“What the city brings, in addition to other resources, is our ability to engage the residents in the community in this work so that all of the work we do is truly resident focused,” Williams-Scott said.    

Among many projects underway or completed in Linden is a combination free fresh food market and charitable pharmacy. A city-funded nonprofit organization led the development of that site, while Nationwide Children’s and Community Development for All People share management duties.

None of this is possible without funding. While Nationwide Children’s, the City of Columbus and other partners provide some, traditional lenders like banks can also play a role. Ohio Capital Finance Corporation has helped bring them to the table.

Those banks would not typically lend capital for projects like the ones carried out by Healthy Neighborhoods Healthy Families, said Welty. Those funds must be flexible to allow for construction and repayment to happen over years. So in the case of the work on the South Side of Columbus, the Ohio Capital Finance Corporation helped structure a $20 million “Southside Renaissance Fund” that brought in low-interest loan funds from a number of banks along with grants from non-profits. Nationwide Children’s and Ohio Capital Finance Corporation each provided guarantees for some of the capital.

Because of the Southside Renaissance Fund’s success, Ohio Capital Finance Corporation is looking to replicate it in other places, said Welty.

“As you look at having the anchor institutions and high-performing CDCs (community development corporations) in the right locations. . .a model like this, where you have banking institutions with flexible money or who are willing to be flexible is completely doable,” he said.

Healthy Neighborhoods Healthy Families works because so many partners have come together, said West. It’s never too late, or too early, for hospital systems wishing to invest upstream to begin working on their own partnerships.

“Even if you don’t have a fully formed plan, be brave, start talking to people in your communities about your ideas, your dreams, your aspirations,” she said. “You’ll find that you aren’t alone. Be open, be intentional, be authentic. The relationships will follow.”