The BUILD Health Challenge: Improving Health through Community, Health System and Public Health Collaboration

The BUILD Health Challenge has announced that it will award up to $7.5 million in grants and low-interest loans over two years to support up to 14 community-driven efforts. BUILD stands for Bold, Upstream, Integrated, Local and Data-Driven, words that represent the core principles of the Challenge. These core principles serve as guidelines for the types of strategies the Challenge hopes to support: strategies that are innovative when facing complex problems, that focus on social, environmental and economic factors rather than direct service, that are committed to true partnerships between many different players in community health, that focus on solutions that are led by an urban community, and that use data to identify the needs of their communities and to measure their impact.

Eligible to partnerships located in cities with populations greater than 150,000, the awardees will also be given support in the form of technical assistance, coaching and networks of health innovators. The BUILD Challenge will give two types of awards: planning and implementation. These awards are designed to support community collaborations that strengthen partnerships among hospitals, nonprofits, local health departments and other community organizations around health in low-income neighborhoods. The partners in the BUILD Health Challenge are the Kresge Foundation, the Advisory Board Company, the Robert Wood Johnson Foundation and the de Beaumont Foundation.
 

Round 1 of applications for the Challenge are due by January 16, 2015.  Invitations will then be extended to a number of select applications for Round 2 on February 20^th.  Awardees will be announced in June 2015.

Connect 4 Mental Health 2014 Community Innovation Awards Opportunity

Looking for an opportunity to put your strategy to address mental illness and affect positive community change to action? Connect 4 Mental Health (C4MH) released a request for submissions for its 2014 Community Innovation Awards. Connect 4 Mental health is a nationwide initiative that calls for communities to prioritize serious mental illness by encouraging collaboration among the mental health community and other community-based organizations to implement mental health programs and services in their communities.

Connect 4 Mental Health seeks U.S.-based community organizations implementing strategies that support individuals with serious mental illness and their families, with the potential to positively impact their surrounding communities. Four programs will receive an award, one for each of the four C4MH pillars – early intervention, creative use of technology, continuity of care, and service integration. Winners will receive a $10,000 award and access to a one-on-one mentorship program featuring exemplary community-based programs with expertise in the four categories. Winners will also be featured on the C4MH website and highlighted in future media announcements.

Award submissions will be judged based on the program’s impact on the community, measurability/sustainability and effectiveness in building community partnerships, among other considerations.

C4MH requests an intent to apply before submitting a full application no later than October 3, 2014. For eligibility and additional information, please visit the Connect 4 Mental Health website here.

School Justice Collaboration Program: Keeping Kids in School and Out of Court

The Office of Juvenile Justice and Delinquency Prevention (OJJDP), the Department of Education and the Substance Abuse and Mental Health Services Administration (SAMHSA) have announced the School Justice Collaboration Program: Keeping Kids in School and Out of Court. Recognizing the need for coordination among schools, mental health providers and juvenile justice systems, the program aims to ensure that these systems have a shared framework for working with and supporting youth.

According to the announcement, there is a growing body of evidence highlighting community-based approaches to juvenile crime. Furthermore, evidence suggests that that using secure placements has a limited impact on reducing juvenile crime. OJJDP is committed to helping schools, mental health providers and juvenile justice systems to coordinate and strengthen their efforts to ensure that youth and families have access to support services that reduce juvenile crime and improve communities. The School Justice Collaboration Program will engage these stakeholders in improving school climates, responding early and appropriately to student mental health and behavioral needs and using positive, alternative responses - such as diversion programs - to avoid referring students to law enforcement and juvenile justice.

Applicants may apply to two categories:

1. Local School Justice Collaboration Program – This category will provide grants to local juvenile and family courts to address their coordination of services. Applicants are limited to local juvenile and family courts (including rural and tribal juvenile and family courts) that partner with a local education agency that has applied for the Department of Education’s School Climate Transformation Grants-LEA (SCTC) and the SAMHSA Now is the Time Project AWARE-LEA program. Applicants must also partner with local law enforcement as part of their collaborative effort. OJJDP anticipates selecting up to four grantees that will be awarded up to $600,000 each for a 36-month project period.
2. School Justice Collaboration Program National Training and Technical Assistance – OJJDP will select a training and technical assistance provider that will support the implementation of and sustainability of these initiatives, develop tools and resources to help stakeholders and work with a limited number of sites to support the implementation of school discipline approaches. Applicants are limited to nonprofit and for-profit organizations (including tribal nonprofit and for-profit organizations) and institutions of higher education (including tribal institutions of higher education). One cooperative agreement of as much as $2 million will be made for a 24-month period. 

Applications are due July 21, 2014.

For the complete grant announcement, click here.

Summer Food Service Program

The USDA is hosting a webinar highlighting the Summer Food Service Program to help end summertime hunger for children and teenagers. Millions of children and teenagers rely on free or reduced-cost school lunches during the school year, but during the summer, these students are at increased risk of going hungry because they no longer have access to the free and reduced-price meals they received while they were in school. The U.S. Department of Agriculture (USDA) created the Summer Food Service Program (SFSP) to cover the summer meal gap by providing nutritious meals to students when school is not in session. Free meals that meet Federal nutrition guidelines are provided to all children 18 years old and younger at approved SFSP sites in areas of significant concentrations of low-income children. Most sites provide one or two meals each day, while places serving migrant children may serve up to three meals per child, each day.

State approve SFSP meal sites as open, enrolled, or camp sites:

• Open – These sites are operated in low-income areas where at least half of the children come from families with incomes at or below 185% of the federal poverty level, making them eligible for free and reduced-cost school meals. Meals are served free to any child. 
• Enrollment – Enrollment sites provide free meals to children enrolled in an activity program at the site. At least half of the children enrolled at the site must eligible for free and reduced-cost meals. 
• Camp – These sites receive payments only for meals served to children who are eligible for free and reduced-price meals. 

Though this program is intended to help the majority of children that receive free or reduced-cost school lunches, only 16 percent of eligible kids are participating. Want to learn more about how kids in your community can benefit from SFSP? As part of their webinar series, the USDA will be hosting a webinar, Make your Summer Meals Site the Talk of the Town, to learn how to get more involved. The webinar will be hosted on Wednesday, April 9, 2014 at 2:00 PM EST. To register for the webinar, click here. 

Funding Announcement: Service Area Competition for Health Center Program

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced funding for the Health Center Program. Health centers are located in underserved communities to provide quality health care services to vulnerable populations. Health Center Program grants support community-based and patient-directed public and private nonprofit organizations. Currently, the Health Center Program funds approximately 1,200 health centers operating in nearly 9,000 service delivery sites across the country. In 2012, over 21 million medically underserved and uninsured patients received high-quality health care services through the program.

A variety of health centers are funded by this grant, including Community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care. Funding amounts and the specific health centers vary by location. For a list of service areas, maximum amounts of funding, and the specific health centers that will be funded, click here. HRSA will fund only one grant for each listed service area. Approximately $468 million is expected to be available in FY 2014 to fund an estimated 310 grants.

Funding beyond the first year is dependent on Congressional appropriation. Eligible applicants are public or private nonprofit agencies and can be a competing continuation, new or supplemental grant.

Due dates for applications vary by type of grantee and start at July 24 and extend into January 2014. For a list of due dates and technical assistance resources, click here.

Early Childhood Comprehensive Systems Grants Announced

The U.S. Department of Health and Human Services (HHS) has announced the 2013 Early Childhood Comprehensive Systems: Building Health Through Integration grant opportunity.

As outlined by HHS, the purpose of this grant program is to improve the healthy physical, social, and emotional development of children during infancy and early childhood by improving the quality and availability of services in communities throughout the nation. Specifically, this opportunity will fund strategies focused on creating a seamless system of early childhood services for children and their families by engaging in systems development and integration activities.

The Early Childhood Comprehensive Systems grant opportunity will allow grantees the option to plan, if necessary, and implement one of three strategies:

1. Mitigation of toxic stress and trauma in infancy and early childhood across two or more early childhood systems (e.g., health, child care, home visiting, parenting education, etc.); 
2. Coordination of the expansion of developmental screening activities in early care and education settings statewide;
3. Improvement of state infant/toddler child care quality initiatives (e.g., State licensing standards) by incorporating 10 or more Caring for Our Children 3rd edition standards focused specially on the infant/toddler age group. 

Typically, Early Childhood Comprehensive Systems grantees are active members, and in some cases hold a leadership role, in their early childhood multi-agency state teams. These teams have developed plans that guide the development, implementation, governance, and financing of their state early childhood service systems. Traditional recipients of these funds have been State Title V Departments and/or State Maternal and Child Health Agencies and/or departments, and/or their contractors.

Strengthening Families - a framework developed by the Center for the Study of Social Policy (CSSP) - has partners at the federal, state and local levels working together to prevent child abuse and neglect.  The Early Childhood Comprehensive Systems grant notice highlights the importance of partnering with early childhood state teams, including Strengthening Families.  To learn more about how Strengthening Families and the Early Childhood Comprehensive Systems grant priorities are aligned, check out a recent brief written by the Strengthening Families team.

Eligible applicants include state and/or local governments and nonprofit organizations. HHS anticipates making 57 awards of no more than $140,000 per year for three years. It should be noted that awards will be subject to the availability of appropriated funds.  Applications are due April 26, 2013.  To learn more about the application process, please click here.

Healthy Communities/Healthy America Grants

The American Medical Association (AMA) Foundation has announced the 2013 Healthy Communities/Healthy America Grant Program. The AMA Foundation recognizes that access to quality health care is essential to helping communities thrive. In an effort to meet the needs of children and families that are uninsured, many communities have started free clinics that offer free or low-cost health care. According to the AMA Foundation, a recent AmeriCares survey found that 89 percent of the nation's free clinics have seen a steady rise in patient visits within the past three years, and that increased demand and resource constraints have forced 56 percent of these clinics to turn away eligible patients.

The AMA Foundation has responded to the increasing need for resources by creating the Healthy Communities/Healthy America Grant Program and, to date, has awarded over $1 million to 56 free clinics across the country. This year, the Healthy Communities/Healthy America Grant Program will support clinics that are developing a diabetes management or education project – a critical need in several communities throughout the nation.

Grant applications are due March 15th. Awards will range from $10,000-$25,000. For more information about the Healthy Communities/Healthy America program, including information about past recipients, please click here.

The Affordable Care Act and Place-Based Community Work

On June 28, 2012, the Supreme Court upheld the Patient Protection and Affordable Care Act (ACA) as constitutional, meaning the law is legal and will mostly be implemented as originally written. Many experts predict that the ACA will have a concrete impact on every American individual, but what about communities and community work? As states strive to meet upcoming ACA implementation deadlines, how will place-based initiatives and their constituents be affected?

Going beyond Coverage to Improve Community Health is the first in a series of CSSP Issue Briefs that examine how place-based initiatives can harness ACA resources and programs to maximize community health. Some of the new or enhanced programs, initiatives and funding streams authorized by the ACA and highlighted in CSSP’s Issue Brief are described below: 

• Community Transformation Grants (CTG) are intended to combat health disparities and chronic illness by empowering local communities to recognize and address social determinants of health outcomes. Grantees will focus on reducing health disparities and chronic disease rates through targeted disease prevention and health promotion initiatives. CTG is also dedicated to supporting and expanding evidence-based strategies. Roughly $103 million CTG funds have been awarded thus far. Grantees for the small communities program will be announced in September 2012. See here for more information about CTG.

• The National Prevention, Health Promotion and Public Health Council, an inter-agency coalition of 17 federal departments, models the cross-sector collaboration that many place-based initiatives also operationalize. The Council’s first report, National Prevention Strategy: America’s Plan for Better Health and Wellness, highlights four strategic directions for prevention-oriented work, listed below, and serves as a guide for how communities can implement prevention strategies.

Strategic Directions for Prevention-Oriented Work:

1. Healthy and safe community environment
2. Clinical and community preventive services
3. Empowered people
4. Elimination of health disparities

The National Prevention Strategy has also defined seven priorities:

1. Tobacco Free Living
2. Preventing Drug Abuse and Excessive Alcohol Use
3. Health Eating
4. Active Living
5. Injury and Violence Free Living
6. Reproductive and Sexual Health
7. Mental and Emotional Well-Being

• In order to maintain their tax-exempt status, non-profit hospitals will now be required to conduct a periodic community health needs assessment and demonstrate concrete action to address identified needs. The needs assessment process must be public knowledge and will provide opportunities for place-based initiatives and community organizations to partner with local hospitals.

• The ACA enhances the evidence-based, two-generation Maternal, Infant and Child Home Visiting Program. ACA funding to states and native tribes will be partially categorical and partially competitive. As part of the application process, states must conduct a needs assessment, identify at-risk communities and assess home visiting programs already operating in the state. While this year’s funds have already been allocated, stay tuned for the $400 million that will be available through this program in FY 2013. 

• The ACA requires every state to launch a culturally competent and linguistically diverse Navigator program to assist individuals/ families enrolling in health insurance through their state Health Insurance Exchange (“a new ‘health insurance marketplace’ created by the ACA that is designed to offer a range of affordable, quality insurance coverage options to individuals and families”). Navigators are tasked with encouraging health insurance enrollment and ensuring that consumers have full and accurate information about their options.  

• Through the new Community Health Center Trust Fund, the ACA will support federally qualified health centers (FQHCs) in an effort to bring them to greater scale and to encourage the development of new FQHCs in medically underserved communities. FQHCs already have a measurable impact, currently serving roughly 20 million uninsured patients. The first round of Community Health Center Trust Fund grantees was announced in May 2012.

• The School-based Health Center Capital Program will fund capital improvements to school-based health centers (SBHCs), prioritizing schools with high Medicaid- and CHIP-eligible student bodies. SBHCs often serve students’ families and neighbors in addition to the students themselves and present an opportunity to link clinical health to other community or school initiatives.

• New networks known as Accountable Care Organizations (ACOs) will provide targeted, coordinated, continuous care, including primary and specialty medicine. ACOs will structure payment based on outcomes, rather than the amount of services provided and will be closely linked to the communities served.

For more information and a full list of ACA opportunities applicable to place-based initiatives, see CSSP’s Issue Brief: Going beyond Coverage to Improve Community Health.

HRSA Healthy Tomorrow Partnership for Children Program Grant Now Open

The Health Resources and Services Administration (HRSA) announced the availability of $377,021 in grants for the Healthy Tomorrows Partnership for Children Program (HTPCP), an initiative aimed to increase the number of community programs that promote access to health care for children, youth and their families nationwide, as well as implement preventive health strategies.

According to HRSA’s call for applications, grant proposals should show how the project will focus on four areas:

1. Development of cost-effective initiatives that increase quality of and access to health services, particularly for vulnerable children;
2. Foster/promote collaboration among community organizations, individuals, agencies, businesses, and families;
3. Involve pediatricians and other pediatric health professionals in community-based service programs; and
4. Build community and statewide partnerships among professionals in health, education, social services, government, and business to achieve self-sustaining programs.

HTPCP is especially interested in technology as a means to increase access to more community members and encourages applicants to integrate technology into their plans.

In FY 2010, funding from this grant served infants, children and youth, including children and youth with special needs, and pregnant and non-pregnant women. The majority of those assisted in 2010 were Hispanic. In FY 2011, funds were used for direct health care services, enabling services, population-based services and infrastructure building services.

Projects are expected to last five years and grantees are required to obtain a matching award of $100,000 from non-federal sources in years two through five of the grant.

Eligible applicants include any public or private entity, including an Indian tribe or tribal organization, which has both direct fiduciary and administrative responsibility over the proposal. It is estimated that eight awards are available (approximately $47,000 per grant, per year); funding is to be used for direct service projects, not research. Applications are due September 21, 2012.

For more information, please click here.

Forum on Child and Family Statistics Releases Annual Report on National Indicators of Child Well-Being

The Federal Interagency Forum on Child and Family Statistics has released their new report on the well-being of children and families; this report has been published annually since 1997. The agency strives to make federal data available and works with 22 other federal agencies to coordinate collection and use of the data. Each report looks at 41 indicators in seven domains: Family and Social Environment, Economic Circumstances, Health Care, Physical Environment and Safety, Behavior, Education, and Health.

This year’s report shows there have been some improvements in particular indicators:

• Preterm births declined for the fourth straight year, from 12.2 percent (2009) to 12 percent (2010)
• Death of children before first birthday decreased from 6.4 per 1,000 births (2009) to 6.1 per 1,000 births (2010)
• The adolescent birth rate declined, from 20 per 1,000 girls ages 15 to 17 (2009) to 17 per 1,000 (2010)
• The violent crime victimization rate among youth decreased from 11 per 1,000 12-17 year olds (2009) to 7 per 1,000 (2010)
• Children living in food insecure households decreased from 23 percent (2009) to 22 percent (2010)
• Average mathematics scores for 4th- and 8th-grade students increased by one point from 2009 to 2011

However, the report also found that:

• The percentage of children living in poverty increased from 21 percent (2009) to 22 percent (2010)
• The percentage of children with at least one parent employed full time, year round decreased from 72 percent (2009) to 71 percent (2010)
• The percent of households with children that had physically inadequate housing, crowded housing, and/or a housing cost burden of more than 30 percent of household income increased. Such conditions can pose serious problems for children’s physical, psychological and material well-being.

Similar research has yielded the same results: a different report released in March 2012 found that between 1996 and 2011, the number of households living in extreme poverty, defined as those with $2 or less per person, per day in total household income in a given month, rose by 130% during this time period, increasing from approximately 636,000 in 1996 to an estimated 1.46 million households in early 2011. The estimated 1.46 million households in extreme poverty at the start of 2011 includes 2.8 million children, or about 16% of all children living in poverty.

For more information and to see further details of the report, please click here.

Convergence Innovation Fund: Promoting Health and Equity through Built Environment and Healthy Food Access Policy

Earlier this month, the Convergence Partnership announced a new funding opportunity to promote equity and improve the health of low-income communities and communities of color. Entitled the "Convergence Innovation Fund: Promoting Health and Equity through Built Environment and Healthy Food Access Policy,"this program will provide funds to help local and regional philanthropic organizations to develop grant opportunities that would support cross-sector efforts to improve the built environment and increase access to healthy foods in these communities. The Innovation Fund will provide a 50% match over a three year period, not to exceed a total of $200,000.

The Convergence Partnership strongly recommends that interested parties participate in one of two upcoming webinars describing this opportunity in greater detail. The two webinars will be held on Thursday, June 28 at 12:00pm (PT) and Tuesday, July 10 at 12:30pm (PT).

Proposals are due on August 9, 2012 by 5:00pm (PT). For more information about this funding opportunity, including the full RFP, an RFP cover sheet and budget template, and links to register for the informational webinars, please click here.

Interested in learning more about past and future grant opportunities and strategies for improving the health of your community? If so, please check out the 'Health and Wellness' and 'Healthy Food Access' sections of our blog for past posts related to these areas.

KaBOOM! Let’s Play Community Construction Grants Announced

The Dr Pepper Snapple Group and KaBOOM! are now offering grants for organizations to purchase playground equipment in accordance with the KaBOOM! community-build model.

Grantees will receive $15,000 to help acquire the playground equipment, as well as access to planning tools on the Our Dream Playground website, one-on-one planning support from KaBOOM! and post-build support from KaBOOM! alumni. Grantees are expected to share best practices and challenges through the Our Dream Playground website.

Applications are open to U.S. based municipalities, neighborhood associations, schools, day care center, and nonprofit organizations without a playground or with unsafe play equipment. Applicants must own the land or possess a long-term lease and have permission from the land owner to build a playground.

KaBOOM! is specifically looking for communities with a demonstrated need for a playground, as well as the project’s impact on the area and its capacity to engage the community.

Applications are due July 20. For more information and to apply, please click here.

Sodexo Foundation School Engagement Grant Announced

Youth Service America and Sodexo Foundation are now accepting applications for the Sodexo Foundation School Engagement Grant Initiative. K-12 educators are invited to apply for the grant, which funds service-learning programs that educate and engage students in the fight against childhood hunger in communities.

Service-learning is a teaching and learning strategy that combines meaningful service to the community with acquisition of academic learning and skills. Schools and organizations use service-learning as a strategy to support student learning, academic achievement and workplace readiness, as youth address real problems and improve communities. The Sodexo School Engagement Grants program incorporates service-learning into a Semester of Service framework that engages students in a minimum of 70 hours of service and learning over a period of at least 10 -14 weeks.

Successful grantees will receive a $5,000 grant award to support the design and implementation of their program, as well as documenting and sharing outcomes.

For more details and to apply, click here. Applications are due July 15.

"Roadmaps to Health" Community Grants Announced

The Robert Wood Johnson Foundation has announced the Roadmaps to Health Community Grants program – an initiative that will help communities address the policies and/or local systems that influence health outcomes in their community. Using County Health Rankings as a guide, the Roadmaps to Heath grant encourages communities to address the social and economic factors that impact health. Unemployment, education, community safety and access to health clinics, for example, can influence the health and well-being of a community and its residents. As a result, policies or practices that influence these factors can be shaped to ensure that residents have access to healthcare services and that communities are healthy places to both live and work.

Recognizing that improving public health requires broad community support, eligible applicants must be part of coalitions and networks that have broad representation from various sectors of the community, including representatives from business, education, public health, community safety and policy advocates. In addition, the Roadmaps to Health grant recognizes the critical role that residents play in improving their community and requires that residents are part of the planning and implementation of projects.

A series of conference calls has been scheduled to provide more information for interested applicants. The first call will take place on March 20 from 12:00-1:30pm and the second will take place on April 10 from 12:00-1:30pm. Registration is required and can be found here.

Up to 20 Roadmaps to Health grants will be awarded with grantees receiving awards of up to $200,000 for up to 24 months. Applicants must secure a 100% match for awarded funds, including a 50% cash match. Eligible applicants include nonprofit organizations and state/local government agencies that are part of local coalitions or networks and have expertise in improving the health of the public. For more information about eligibility and the application process, please click here.  Applications are due May 2.

National Competition to Support School-based Programs Promoting Physical Activity

ChildObesity180 and the Partnership for a Healthier America have announced the launch of the Active Schools Acceleration Project (ASAP), a national competition to support school-based programs and technological innovations that promote physical activity for children.  The ASAP competition will award a total of $500,000 to schools with the most "innovative, impactful, and cost-effective" physical activity programs, and to technology developers who create new ways of using technology to promote increased physical activity among youth. Grantees will also participate in funded pilot studies aimed at expanding their programs' reach and impact.

The school-based programs category is focused on those programs already active (programs not yet implemented will not be considered) targeting children ages 5-12. Programs in public, private, charter, and parochial schools are invited to apply. Specifically, a school's physical activity program may be "any curriculum, activity, environmental modification, event, or other initiative that promotes quality school-time physical activity among the target population." The competition will award prizes of $25,000 to up to ten regional school program winners, and prizes of $100,000 to up to two national school program winners.

For more information, visit the ASAP website.

Drug Free Communities Grants Announced

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced the availability of $3.75 million in grants for the Drug Free Communities Support Program (DFC).  Recognizing that local problems require local solutions, this program funds efforts to strengthen community coalitions working to combat substance use among youth.  A community-focused initiative, the DFC encourages participation from community groups, nonprofits, local government, schools and residents invested in the reduction of substance use among youth.  By helping communities identify the unique factors that may increase the risk of substance abuse in the community, the DFC program intends promote factors that minimize the risk of substance abuse among youth and adults.  At a time when youth substance use is of concern, recent evaluation data suggests that DFC-funded communities have decreased rates of youth substance use.

Eligible DFC applicants include community-based coalitions focused on addressing youth substance use.  These coalitions must represent a broad spectrum of residents and include representatives from the following categories: youth, the business sector, law enforcement, schools and healthcare.  For a complete list of required coalition members, as well as detailed information about the application process, please click here.

SAMHSA expects to award up to 30 grants in the amount of $125,000.  Awards may be renewed for up to 5 years and coalitions must provide a one-to-one grant match.  Applications are due March 22, 2012.

Funders and Policymakers Increasingly Support Innovative Models to Address Housing and Health

Where we live, work, learn and play has a significant effect on our health and well-being. Recently, in a commentary from Spotlight on Poverty and Opportunity, Department of Housing and Urban Development Secretary Shaun Donovan and Department of Health and Human Services Secretary Kathleen Sebelius discussed how the Obama Administration is working to address these interconnected needs.

As more funding and policy opportunities are developed to address the relationship between housing access and health outcomes, communities can use the growing wealth of research and best practices to both take full advantage of, and influence, these opportunities. Here are some of the ways that housing and health are connected:

1. Where you live affects your ability to access health-promoting resources, such as nutritious food, medical care, a safe environment and public transit.

“An apple a day may help keep the doctor away but that assumes you can find an apple in your neighborhood.” --Dr. James Marks in a 2009 Huffington Post article

Neighborhoods of concentrated poverty can fuel and exacerbate poor health and restrict the opportunities and mobility of residents. According to Spotlight on Poverty and Opportunity’s Helping the Doubly Disadvantaged: The Role of Neighborhoods in Health, concentrated poverty and obesity/ diabetes rates have increased over the same time period, suggesting a correlation between deeply impoverished neighborhoods and poor health. Research on the U.S. Department of Housing and Urban Development’s Moving to Opportunity program, which relocated poor families from high-poverty to lower-poverty neighborhoods, found that rates of extreme obesity and diabetes among female participants declined as they moved into more resource-rich communities.

According to a report released by the Joint Center for Political and Economic Studies, Segregated Spaces, Risky Places: The Effects of Racial Segregation on Health Inequalities, “segregation continues to be a predictor of significant health disparities.” For example, Chicago’s Hyde Park neighborhood, where less than 20 percent of residents live in poverty and nearly 70 percent are white, is directly across the street from Washington Park, where 52 percent of residents are poor and approximately 98 percent are African American. Washington Park’s mortality rate is roughly 1.5 times that of Hyde Park.

In the same Huffington Post article quoted above, Dr. Marks writes, “as it relates to health, our zip code may be more important than our genetic code.” The Boston Public Health Commission has appropriately launched the "What's your health code?" campaign. Investments in neighborhood infrastructure, amenities and safety can improve the health of families.

2. Housing instability (often due to the lack of affordable housing) can cause extreme stress, harm child development and result in poor health outcomes for all family members.

Families who spend more than 30 percent of their income on housing often cannot afford other basic necessities, such as healthy and adequate food, safe and developmentally appropriate childcare and healthcare.In Affordable Housing as a Platform for Improving Family Well-Being: Federal Funding and Policy Opportunities, a report by CSSP, we discuss how affordable housing access and well-being outcomes are connected. For cities with high rates of homelessness, this is particularly problematic. According to a new report released by DC Alliance of Youth Advocates, youth homelessness is on the rise in the District of Columbia. Research has shown that homeless children are more likely to develop mental and emotional health issues and developmental delays than children with a stable home. Homeless individuals of all ages access hospital emergency departments more frequently and stay in hospitals longer than housed individuals in similar health.

3. Housing can serve as a platform for cross-sector, place-based services

Linear models of service provision may require a homeless person to combat addiction, secure employment, or otherwise demonstrate “housing readiness” before they are placed in a stable home. In contrast, permanent supportive housing provides individualized and flexible workforce training, job search assistance, medical care, substance abuse treatment and mental health services, while ensuring housing stability. The latter model operates under the belief that housing is a primary need and it is impossible to expect a homeless person to get a job or overcome addiction.

Although permanent supportive housing may require initial investment, long-term pay-off is substantial and often mitigates program costs. A diverse array of studies and programs, analyzed in Ending Chronic Homelessness: Cost-Effective Opportunities for Interagency Collaboration, demonstrate the success of permanent supportive housing. For example, one study found that 88 percent of those enrolled in a New York City Pathways to Housing permanent supportive housing program remained housed after 5 years, as compared to just 47 percent of the individuals in a linear residential treatment program.

The benefits of permanent supportive housing are not limited to homeless populations. In the aforementioned report Affordable Housing as a Platform for Improving Family Well-Being: Federal Funding and Policy Opportunities, CSSP acknowledges the important role of stable housing as a means for connecting people to services and resources, including quality healthcare and grocery stores. PolicyforResults’ section on promoting affordable housing provides policy recommendations and best practices for supporting interagency partnerships and co-location of housing and services.

For example, in Vermont, the Support and Services at Home (SASH) program, highlighted in a series of case studies compiled for the recent How Housing Matters Conference, supports the health of elderly and disabled residents who are dually eligible for Medicaid and Medicare. Diverse funding streams include Medicaid and Medicare (public) and various private foundations. To expedite implementation and minimize costs, SASH services are integrated into preexisting affordable multifamily housing developments. Due to the pilot’s success, SASH has been fully integrated into Vermont’s statewide healthcare reform plan, Blueprint for Health, where it is expected to save $40 million in Medicare costs by the fifth year of implementation.

Fortunately, policymakers and funders increasingly support the important connections between housing and health:

Through Choice Neighborhoods, Sustainable Communities Regional Planning Grants, Transportation Investment Generating Economic Recovery (TIGER) II and Community Challenge Planning Grants, the Department of Housing and Urban Development under President Obama is funding innovative, cross-sector initiatives to improve neighborhood resources and infrastructure and promote healthy residents. Additionally, the Neighborhood Revitalization Initiative (NRI), piloted by President Obama’s administration, represents a unique commitment from the Departments of Housing and Urban Development, Education, Justice, Health and Human Services and Treasury, as well as the White House Domestic Policy Council and the White House Office of Urban Affairs to revitalize disinvested communities through interdepartmental collaboration and resident engagement.

A number of private foundations also fund and support (through technical assistance and communities of practice) innovative, cross-sector, place-based neighborhood revitalization and health improvement efforts:

• Joint Center for Political and Economic Studies: Place Matters: 16 Place Matters teams throughout the country are working to improve health in their communities by addressing social determinants of health, including education, employment and housing. In recognition of each community’s unique needs and characteristics, the Place Matters projects vary significantly.
• The California Endowment: Building Healthy Communities: Through a generous 10 year grant, 14 sites in California are working to increase school attendance and access to quality healthcare and decrease youth violence and childhood obesity

For more on what policymakers can do to support affordable housing, see PolicyforResults’ coverage of this topic.

For more information, see also PolicyLink Center for Health and Place

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Is your community addressing place-based health disparities?

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Engaging Communities to Improve Resident Health

In recent weeks, reports from the US Census Bureau have highlighted the bleak conditions in many communities. With the national poverty rate at an all-time high of 15.1%, it is not surprising that healthcare coverage has declined to an all-time low. According to the recently released 2010 Current Population Survey, the United States has the highest number and percentage of uninsured citizens ever reported. Minorities face particular hardship when it comes to health coverage. While 15.4% of Whites were left uninsured in 2010, nearly 21% of Black and 31% of Hispanics were left without coverage.

Although a vital aspect of healthcare, insurance coverage is only one aspect of quality healthcare. In addition to a lack of insurance coverage, research suggests residential segregation and poverty rates also contribute to growing health inequalities. A recent report from the Joint Center for Political and Economic Studies suggests that the racial composition and, most notably, poverty levels of neighborhoods ultimately affect the health of individuals. The damaging effects of these disparities are evidenced by high rates of poor health outcomes for people of color or with low incomes. Impoverished communities often face many challenges, including limited access to public transportation, a lack of grocery stories with nutritious food options and little access to good jobs or social services, such as community health centers. Residents without these essential supports are more likely to struggle with obesity, asthma and other forms of chronic health conditions.

Improving the health of individuals and communities is a challenge that requires comprehensive solutions and significant attention to various issues, such as transportation, access to primary health centers, education and policies that may prohibit access to healthy food options. In response to increasing health disparities, many organizations – including the Federal government – have implemented programs and provided resources that communities can use in addressing health disparities. 

The PolicyLink Center for Health and Place, for example, has developed several tools that communities can use in advocating for improved access to nutritious food. These tools provide guidance on how communities can attract quality food retailers or advocate for improvements in the quality of food already in local stores, for example. Similarly, increasing access to community health centers that offer both primary and preventative health services is a critical component of resident health. In response to this need, Department of Health and Human Services (HHS) announced over $10 million in Affordable Care Act grants to support 129 organizations across the nation striving to become community health centers. Many of the awarded organizations are already community-based health centers that plan to use the grant to provide more comprehensive primary care services and/or expand services to the larger community. According Secretary Kathleen Sebelius, these new health centers will provide access to healthcare for millions of individuals while also sparking economic growth by creating a source of local employment in communities. An additional HHS initiative – The Community Transformation Grants – seeks to reduce health disparities by addressing the physical, social and emotional needs of residents, as well as providing quality preventative services in the context of local community needs.

Additional Resources:

PolicyforResults.org, USDA Unveils New Food Desert Locator

PolicyLink, Healthy Food, Healthy Communities

The Department of Health and Human Services, About the Healthy Food Financing Initiative

PolicyLink, Health and Place Tool Group

Center for Disease Control and Prevention, Community Transformation Grants

Center for the Study of Social Policy, The Opportunities for Communities in the Affordable Care Act provides a summary of the existing and upcoming funding provisions from the Patient Protection and Affordable Care Act that can have an impact on local community change efforts

Community Transformation Grant Awards Announced

The Department of Health and Human Services (HHS) has announced grant awards of $103 million to 61 states and communities through the Community Transformation Grants (CTG). Created by the Affordable Care Act, the CTG program provides an opportunity for communities to support intensive approaches to reduce risk factors responsible for the leading causes of death and disability in the nation such as diabetes and heart disease. The purpose of the initiative is to create healthier communities by focusing on capacity building and implementation of broad, evidence-based and practice-based policy, environmental, programmatic, and infrastructure changes in five strategic areas: Tobacco Free Living, Active Living and Healthy Eating, High Impact Quality Clinical and Other Preventive Services, Social and Emotional Wellness and Healthy and Safe Physical Environment. Grantees will also focus on achieving health equity and reducing health disparities; successful applicants had to identify population subgroups experiencing health disparities and identify specific outcomes to narrow the gaps.

Thirty-five grantees received implementation grants ranging from $500,000 to $10 million and 26 grantees received capacity Building grants ranging from $147,000 to $500,000. Awards went to grantees in 36 states, including seven tribal organizations and one territory. Grants are expected to run for five years. A full list of the funded states and communities can be found here.

In addition, HHS announced earlier this month $4.2 million in funding awards to seven national networks of community-based organizations. As part of the National Dissemination and Support Initiative of the Community Transformation Grants (CTG) program, these networks are to engage community members in identifying solutions to improve health with effective community-based prevention strategies that can be modeled in multiple locations. This funding was divided into two categories, dissemination and acceleration. Dissemination grantees will support, disseminate and amplify the evidence-based strategies of the CTG program nationally. Four dissemination awards went to the American Public Health Association; the Asian Pacific Partners for Empowerment, Advocacy and Leadership; the Community Anti-Drug Coalition; and the National Farm to School Network at Occidental College. Acceleration awards are intended to help spread CTG work across the country and in particular to help reach rural areas and areas with health disparities. Three acceleration awards went to the American Lung Association, the National REACH Coalition and the YMCA of the USA.

For more information, see the CDC's CTG page.

Healthy People 2020 Requests Proposals for Community Innovations Projects

Healthy People 2020 is a national initiative that aims to improve the overall health of people in the United States. Recognizing the important role of community-based organizations, Healthy People 2020 released a Request for Proposal (RFP) for community-based projects that utilize the Healthy People 2020 goals in promoting community health. Potential projects must incorporate at least one of the Healthy People topic areas, as well as one of the following priority areas:

- Environmental Justice: Supporting the rights of all people to live in a healthy environment

- Health Equity: Dealing with issues that cause some groups of people to have worse health than others

- Healthy Behaviors Across All Life Stages: Activities to improve the opportunities for people of all ages to make healthy choices

Eligible applicants include nonprofit, community-based organizations with a budget less than $750,000. Up to 170 projects will be funded with awards ranging from $5,000 - $10,000.

Proposals are due on August 5^th, 2011. Please see the RFP for more specific information about project details and the selection process.