Upstream Investments in Community Health: Focusing on Social Determinants of Health to Guide New COVID-19 Community Development Funds
The federal effort to support citizens and neighborhoods during the COVID-19 pandemic has led to large increases in grant money available for housing and community development.
Even though health care systems themselves often aren’t directing that money, there’s a clear role they should be taking to ensure that grantees like state, county and local governments use the funds to support health goals, says Arthur Jemison, Principal Deputy Assistant Secretary, Office of Community Planning and Development, U.S. Department of Housing and Urban Development.
“You’re talking about an unprecedented level of capital that is in the hands of grantees right now,” he says. “And in talking to grantees and hearing from them, I can tell you this is good, but it’s a different kind of challenge than they are used to. . .I don’t know a grantee that says they have a pipeline or a strategy to absorb all of that capital.”
State, county, and local governments may not have the strategic experience to plan for that amount of new money, but health care systems often do, Jemison says. Health care should work in partnership with local and state governments so that these community development and housing funds are used where they will have the biggest impact for population wellbeing.
Jemison’s comments came in conversation with Abbey Cofsky, managing director for Healthy Communities of the Robert Wood Johnson Foundation, during a plenary session of the recent From Roadmap to Reality: Implementation Strategies for Upstream Investments in Community Health Summit. The summit was co-hosted by the Center for Community Investment and Nationwide Children’s Hospital.
Cofsky, in her introductory remarks, pointed to hospital systems’ relatively recent focus on social determinants of health, and the understanding that housing has a crucial role to play in overall wellness. Many health systems, including Nationwide Children’s, are deeply involved in housing repair and development in disinvested neighborhoods.
The old way “was thinking that ‘health care’ would work on services, and ‘community development’ would work on buildings or the physical environment,” said Cofsky. “Our thinking has changed, and increasingly we see health and wellbeing as the outcome. . .”
These new, COVID-19-related funds can potentially tie health care and community development even more closely, said Jemison. He used what has recently occurred for the HOME Investment Partnerships Program as just one example.
HOME is the largest federal block grant to state and local governments designed exclusively to create affordable housing for low-income households. In a typical year, HOME may have a total of $1 billion to $1.5 billion for that purpose.
Through the American Rescue Plan, HOME now has $5 billion. A jurisdiction that may normally receive $5 million a year could now receive $25 million. Similar funding boosts have happened in the federal Community Development Block Grant program and the Emergency Solutions Grants program (to address the needs of people experiencing homelessness or a housing crisis).
The American Rescue Plan has also provided $350 billion in emergency funds for many local and state government purposes, including housing.
This funding could make an enormous contribution to health through community development and housing. Hospital executives should take this opportunity to meet with mayors and other government officials, to discuss the ways they can work together for everyone’s benefit.
“We have to go and seize the moment here,” says Jemison. “We have a chance to expand the ways that health interests help guide smart planning and development throughout the whole country. If we do this right. . .the new assets will reflect this moment, and health will be a real driver of transformation.”
For more information on HUD’s Office of Community Planning and Development and COVID-19 funds, visit the office’s grantee guidance page.
