Post From Expert Insights
This article first appeared on the Urban Institute’s UrbanWire blog on July 20, 2017.
As the deputy executive director of Foundation Communities, a nonprofit affordable housing developer in Austin, Texas, Julian Huerta noticed his residents had high rates of mental illness, diabetes, HIV, and hypertension, which hindered their ability to become stably housed and self-sufficient. To improve and stabilize these residents’ lives, Foundation Communities launched free, on-site health programming focused on preventive care, chronic disease management, exercise, and nutrition.
But Foundation Communities is a housing developer, not a health provider. Huerta knew Foundation Communities would have a greater impact if it addressed health issues with the help of partners in the Austin community. Today, with the help of local health organizations, Foundation Communities’ health programs serve more than 3,000 people at its 19 sites around Austin.
One of six case studies featured in our new report Emerging Strategies for Integrating Health and Housing, Foundation Communities’ success highlights how housing leaders can partner with health care allies to better the lives of low-income residents. Its early successes show that we must break down cross-sector silos and engage new partners to make progress on social determinants of health.
Foundation Communities’ core team of community health workers, who lead health-related activities for residents, rely on partnerships with local health organizations to help deliver services. Partnerships allow the community health workers to provide residents a wider array of programming, which enables Foundation Communities to more frequently and flexibly respond to residents’ health needs.
Local organizations focused on healthy food access and nutrition, such as the Central Texas Food Bank and Keep Austin Fed, help Foundation Communities provide fresh, healthy food to residents.
Organizations focused on physical activity, like WeViva and Pure Action Yoga, provide Zumba, yoga, and strength training classes to residents.
For chronic care management, the City of Austin Health Department offers residents its Diabetes Empowerment Education Program.
Foundation Communities also found a powerful ally in Austin’s local health foundation. St. David’s Foundation recognized the importance of providing on-site services to low-income residents and has become Foundation Communities’ main funding source for its health work.
Foundation Communities understands that residents are important allies in its health work. Many local health and housing interventions do not have meaningful community engagement practices, but Foundation Communities has incorporated residents in managing, programming, and evaluating its health work.
Formal and informal resident feedback often helps chart new programs and offerings. For example, when residents asked to learn more about puberty and sexually transmitted diseases, Foundation Communities’ community health workers reached out to health educators at Planned Parenthood to assist on educational programming.
Resident participation is also baked into the organizational leadership. The two senior health specialists who oversee family properties and permanent supportive housing properties are both Foundation Communities residents, creating a direct line of oversight from residents in strategy and programming discussions.
Both residents bring professional and personal experience to their position, which, as one employee noted, “really helps integrate the work to make sure the needs of their residents are being met.”
By adopting evaluation practices early on, Foundation Communities hopes to avoid challenges faced by other health and housing interventions that struggle to find meaningful mechanisms and resources to track outcomes. Early successes are building the case for the collaborative approach, which connects affordable housing and diverse health partners to a significant vulnerable population within one city.
One respondent said, “Supportive services cannot do it alone, but when you put them at people’s doorstep, it’s logical.” Foundation Communities and its network of health care partners understand that providing housing to people struggling with health issues is essential to population health, well-being, and equity.
Foundation Communities’ work highlights larger trends and needs around health and housing initiatives. Without partnering externally with health players, organizations’ efforts to address housing as a social determinant of health will be limited and face threats to sustainability.
Integrating community engagement practices into program design and organizational structure also ensures these initiatives will better address participant needs. Cross-sector partnerships can lead to interventions that are more effective, efficient, and scalable, making them an essential component for addressing housing as a social determinant of health.