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The Health Action Plan: A Public Health Process for Affordable Housing

Written by Mary Ayala on August 19, 2020

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Enterprise Community Partners releases new tools to support the development of the Health Action Plan, a practice integrating health data, community engagement and health promotion into the affordable housing development process.

Aligning Housing Strategies with Residents’ Most Critical Health Needs

A doctor only writes a prescription after seeing their patient, learning their medical history and understanding their specific needs. Affordable housing developers can approach their selection of healthy building strategies and services in the same way.

The Health Action Plan was created to support affordable housing developers in doing just that by integrating evidence-based public health practices into the affordable housing development process. The Health Action Plan is a seven-step process where affordable housing developers: 1) commit to integrating health into the development process, 2) partner with a public health professional, 3) analyze health data on their community, 4) engage community members and residents to prioritize their health needs, fill in gaps, and identify potential strategies to promote resident health, 5) develop and select evidence-based strategies aligned with these health needs, 6) implement the strategies selected, and 7) monitor the use and impact of these strategies.

Expanding the Understanding and Use of the Health Action Plan

The impact of the steps of the Health Action Plan extend far beyond the strategies that are selected and include the development of critical relationships between different sectors, residents and community stakeholders. The importance of these relationships is even more critical during times of crisis or increased need.

Enterprise offers a suite of resources to support the implementation of the Health Action Plan. New tools have been released to further support the data analysis, community engagement, and strategy selection steps. These tools were developed in response to needs shared by a group of 35 Health Action Plan practitioners that Enterprise convened with the support of the Health Impact Project, a collaboration between the Robert Wood Johnson Foundation and Pew Charitable Trusts, three times in April and May of 2020.

Suite of Resources

  • Partnering with a public health professional: To find a public health professional partner, affordable housing developers can access Enterprise’s Technical Assistance Database. Public health professionals can submit their qualifications to be listed as a provider through the quarterly request for qualifications process. In forming the partnership, affordable housing developers can work from the Template Scope of Work for the Public Health Professional to see the typical expectations of the public health professional.
  • Data analysis: Once a partnership has been formed, the Health Indicators Template Guide provides a set of “go-to” indicators for the Health Action Plan along with considerations on how to tailor the data analysis to the appropriate resident population and geography.
  • Engaging the community: A focus group guide and resident flyer provide insight into how residents can be engaged in the Health Action Plan.
  • Selecting strategies: The prioritization exercise and template were created to guide the conversation between the public health professional and the developer when selecting a final list of strategies. This exercise allows considerations from both the public health professional and developer team around health impact, feasibility of implementation, and cost to be discussed in tandem.

Adapting Community Engagement Strategies During Covid-19

Despite the limitations to gather in person because of Covid-19, it is still critical that resident voices are embedded in the development and rehabilitation of affordable housing. Centering residents in the development process recognizes their expertise and better ensures resources are prioritized for their most critical needs and increases the utilization of the design and programming strategies that are eventually selected.

The Community Engagement for the Health Action Plan During a Time of Social Distancing guide details alternative methods for community engagement while maintaining social distancing guidelines, like photo journaling, surveys and one-on-one outreach.

Moving Toward a More Inclusive, Health-Promoting Affordable Housing Future

Everyone’s health is unique, and where you live has a profound impact on your health. The Health Action Plan presents a significant opportunity for the physical structure, design, and services of housing to align to promote the critical community health needs.

The steps within the Health Action Plan are not typical in the affordable housing development process or in typical requirements of state Qualified Allocation Plan (QAP). To see the growth of affordable housing’s impact on health it will be important to understand and prioritize health outcomes in state Qualified Allocation Plans in a way that centers the resident health needs rather than generic healthy housing strategies.

This can be done by first understanding how health is addressed in your state’s QAP in reference to design and construction and then consider how to start incorporating elements to promote health, including the inclusion of certain steps within the Health Action Plan, into your state’s QAP.

An encouraging policy landscape for the steps of the Health Action Plan would support the work of the many practitioners already committed to integrating health into affordable housing development. There are currently 10 active Health Action Plans taking place across the United States that are drawing on the tools detailed in this blog. For additional information, join Enterprise for a webinar on this new suite of tools on Wednesday, September 16 from 12 – 1:30 pm ET.


This Health Action Plan toolkit work was supported by the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The views expressed are those of the author and do not necessarily reflect the views of the Health Impact Project, The Pew Charitable Trusts or the Robert Wood Johnson Foundation.

About the Author


Mary Ayala

Mary Ayala is the Program Director for Enterprise Community Partners National Initiatives. As part of this work, Mary works on Enterprise’s Health and Housing Initiative on place-based work in several cities to help forge innovative partnerships and models to address housing as a health solution with community development and health care sector partners. Additionally, Mary works with Enterprise’s Building Resilience Futures team to inform how health can be further integrated in the affordable housing development process through the Enterprise Green Communities Criteria. This includes through technical assistance, material development, and dissemination of the Health Action Plan process.

Mary holds a Master of Public Health from Emory University and a Bachelor of Science from the University of North Carolina at Chapel Hill.