By Bailey McCann

We live in uncertain times. Between a shifting climate, a volatile economy and a rapidly changing political landscape, community building is more important and more challenging than ever. Effective strategies look beyond purely economic concerns to include climate, nature, belonging, and community participation in the vision for success. Across rural regions, communities rich in local knowledge, social cohesion, and cultural heritage are increasingly shaping their own economic futures.

From the Soil Up: How McDowell County is Turning Its Land Into Economic Revival

McDowell County, West Virginia is situated in the former coalfields of the Appalachian Mountains and lived through the uneven heights of the coal boom, before hitting the bottom hard when that industry collapsed and left. The local demographics are mixed, coal country is predominantly white, but McDowell has a significant African American population as well. The area continues to be generationally impoverished due to failed policies and a decades-long fight for basic infrastructure like potable water. As recently as March 2026, the West Virginia state government killed a $250 million bill to clean the tap water that comes out light brown on a good day and black on a bad one.

The message from political leaders at the state and national level, businesses, and many national nonprofits to residents amounts to the suggestion, “have you considered moving?” A proposition that isn’t feasible for most people in the area. Even if they could, uprooting would mean residents abandoning the only support systems they have with no guarantees of rebuilding elsewhere.

That question is a big part of why Jason Tartt moved back after leaving the military. Tartt runs T&T Organics, a company he founded as an African-American veteran. In partnership with a local non-profit EDGE AgForce, the two run a DRT Environment — a 350-acre demonstration, training and research farm in Berwind, West Virginia. The effort allows young farmers and agripreneurs to train in a farm setting, receive mentorship, and develop products and projects that build on the unique type of mountain agriculture that is native to the area.

Prior to the coal industry’s dominance of the region, many locals made their living from agriculture. Mountain agriculture is different from the kind of large land mass and feedlot driven agriculture common in the middle of the country. Mountain agriculture is more specialized and runs on smaller pieces of land. Tartt says bringing it back is important not just because McDowell is a food desert, but also because it restores the livelihoods and practices of people native to the area.

Projects like the DRT Environment offer the county a different path, rooted in wellbeing economy development and focused on sustainability rather than extraction.

As a living classroom, the DRT Environment (The Environment) provides localized workforce development and entrepreneurship training, generating small business development within agriculture, tourism, conservation and housing. The Environment has also developed partnerships with local businesses and faith based organizations which puts locally grown products in shopping carts, kitchens and on restaurant plates throughout the region. The project’s impact is growing but Tartt says it could be doing even more if it had more support.

“The people that should be focused on this area simply aren’t. They’re in the statehouse talking to energy companies trying to court deals that are basically extraction 2.0,” he says. “But those days are over and we need to turn the page.”

Based on current environmental projections, McDowell County is located in the greenbelt of the future — one of the few areas of the country that is more resilient to climate change in part because of its being surrounded by mountains. They act as a natural barrier for the extreme weather we are likely to face as the earth continues to warm. That barrier means it will be one of the places where agriculture will be easier to do. Internal migration projections from climate researchers also expect that more people will start moving to central Appalachia driven by natural disasters and extreme weather events elsewhere.

Projects like the DRT Environment offer the county a different path, rooted in wellbeing economy development and focused on sustainability rather than extraction. The DRT Environment centers on native forms of agriculture which work in concert with the land and require fewer resources and yield high quality and cost efficient food. This matters in a county long classified as a low-access food area where residents often rely on lower quality produce and processed foods from big box stores and fast food restaurants.

Those facts are not lost on Tartt. “If you look at McDowell right now, we have some of the worst health statistics in the country,” he says, “ If we could start building out the value chain around the land that’s here we could start feeding people healthy food now and be in a position to continue to do that as more people come here, but no one wants to talk about that”.

For Tartt, it’s important that the focus remains on people who are already in the area and who could be making a living off the land beneath their feet.

DRT Environment has turned that conviction into action, converting the remnants of extraction into infrastructure for a different kind of economy. Old logging roads, for example, are being used as passageways for workers taking soil samples and moving materials across the land. The site also serves as a de facto workforce training center. People who learn about the site can get a piece of the 350 acres to continue their projects. That’s important, Tartt says, because it helps to build a long-term pipeline.

Building that pipeline is also a marketing effort. Tartt works hard to heavily publicize every success, every project, not only to the landholder but also to the surrounding area. That attention brings partnership and local support and creates positive counter programming to the deficit-driven stories that so often features McDowell and the neighboring counties. In Tartt’s view this contributes to the idea that locals should just move somewhere else or that the state should just sell it off to corporate interests.

“There are a lot of chronic health issues in the population. People have been incarcerated. These aren’t circumstances that are likely to change if they move. But we are willing to find ways to work through them here.”

Getting that marketing just right is a skill unto itself. Amelia Bandy, co-founder at EDGE knows that policy priorities change constantly — especially at the national level forcing people on the ground competing for grants or other support opportunities to strike the right balance between highlighting the right facets of their work and carefully avoiding any language or topics that might disqualify them from consideration out of the gate.

“You know, unfortunately the need is so great in this area that if you’re going to tell me that one year the priority is X and the next year it is Y, we’re just going to reshuffle our list a bit in terms of what we’re working on first,” she says. “The mission doesn’t change, the overall vision doesn’t change. But we do have to spend time on alignment.”

Bandy’s public health background informs her view of resource exchange and gives her a window into the local population that underlines why it might not be easy for everyone to “just move.” EDGE is building workforce training and infrastructure, but Bandy notes that they often run up against challenges that would follow people even if they left the area.

“Many people don’t have reliable transportation,” she says. “There are a lot of chronic health issues in the population. People have been incarcerated. These aren’t circumstances that are likely to change if they move. But we are willing to find ways to work through them here. Being able to show that work to our funders and to our policymakers has been something that has worked in our favor.”

Building a track record is also likely to help projects maintain relevancy and funding over the long haul.

“When I look at the next ten years it just further underlines that point because the level of need is not going to change,” Bandy says.“We are already seeing more people move here because the cost of living is much lower. That adds pressure to the infrastructure that isn’t really there yet. But if we can build it, if we can keep doing what we are doing, we have the opportunity to become an agriculture and tourism hub. This is a beautiful place with a lot to offer if we put in the work and don’t give up on it.”

When the Floods Come: Building Economic Strength and Flood Preparedness in Floyd County, Kentucky

Weather patterns are shifting, and for Floyd County, Kentucky — that’s not a good thing. Based on current projections, 56% of all property in the county is at risk for extreme flooding. The area is already feeling it. Over the past handful of years extreme floods have happened in rapid succession giving the county little time to recover — a problem that has been compounded by other factors like the Covid pandemic and an already tight county budget.

FEMA buyouts have compensated some residents whose homes were destroyed by extreme flooding, but if they can’t or don’t want to leave the surrounding area, affordable replacement housing is limited. The housing supply crisis predates the floods. Low population density and limited economic growth have made it difficult to build out that supply anywhere, not just flood-prone areas of the county.

“The flood we had in 2021 was devastating and that, of course, was on the heels of Covid. Then there was another one in 2022. We had three in 2025,” she explains. “So we’re trying to rebuild our economy but it’s like spinning plates on sticks.”

Kentucky manages much of its economic and municipal needs through a fiscal court structure. Fiscal courts are unique to the state and basically take on many of the roles people would expect to see from city councils or city managers but at the county level.

That means for Floyd County, any projects that help local residents go through the fiscal court are led by Judge-Executive Robbie Williams. Missy Allen, Administrative Assistant/Special Projects Director at the Floyd County Fiscal Court manages the details of those efforts.

“The flood we had in 2021 was devastating and that, of course, was on the heels of Covid. Then there was another one in 2022. We had three in 2025,” she explains. “So we’re trying to rebuild our economy but it’s like spinning plates on sticks.”

A lot of the work right now is going into an area called Thunder Ridge. Thunder Ridge used to be a horse racing and dirt track. It’s a large tract of land outside of the floodplain and Judge Williams, along with Allen and other local stakeholders are trying to make it a local hub for industry, housing, and small business. It’s a long term development project that they hope to link up to nearby areas that could be supportive to local infrastructure. Many of the large land areas outside of the floodplain are abandoned coal fields and mines. Allen is working on getting land access to these areas.

“There is one near us that has rail infrastructure, which if we could rehabilitate and repurpose would be critical to bringing products into the area and making it easier for local businesses to operate,” she explains. “That’s why I say it’s like plates on sticks. We have to work on all of these things simultaneously. We can’t get builders in here to build homes if there aren’t businesses and we need the businesses to support people who are already here.”

Allen says the rebuild has been grueling, not only because new floods keep happening, erasing progress, but also because funding and programs are inconsistent year to year. FEMA buyouts of residents who have lost their homes get held up with repeated government shutdowns. Policy priorities change on the fly, as do the lists of allowed words and projects that impact what can be applied for.

In response, Judge Williams, Allen and other stakeholders created a resilience strategy that would bring in grant writers and other specialists who could respond to these shifting policy needs, understand the impacts of climate change, and still help the community reach its recovery goals. The plan is for community redevelopment and recovery to be a resilient, long-term effort that creates a stable housing situation, economy and sense of community for residents.

To do this, they formed the Floyd County Disaster Recovery group. It’s a 501c3 organization that has enabled them to bring on a team of grant writers and others with the background to support their long term recovery plan. The county is also working with the National Association of Counties through their federally funded Building Resilient Economies In Coal Communities, (BRIC) program, designed to help areas like Floyd County diversify and bring in new industries.

“Hopefully, that helps us get the support we need so that a decade from now we’ve brought the businesses in. We are building housing. We’re getting tourism from people who like the mountains. We can do all of that here if we keep putting in the work.”

For Allen, the most important part of all this work is creating tangible change on the ground. “A lot of people ask us why we talk in terms of resilience and recovery and not economic development. I can take you to the part of the file room where we have economic development plans lining the shelves — policy people make them all the time. They don’t result in much,” she says.

With the combination of the disaster recovery team and the BRIC plan, they’ve been able to create a set of living documents that track projects, funding and goals. These can be adjusted when another flood happens. In practice, one recent application involved creating fridge magnets printed with QR codes that link residents directly to flood resources in a flood emergency. On the larger scale, the county is bringing in specialists in flood protection and resilience. Workforce training programs are also being developed for the Thunder Ridge area and elsewhere in the county.

“The magnets are probably a $2,500 dollar project and people ask me why we’re spending time on applying for grants on that, but it’s one way to get information directly to people and it pushes us forward. It builds a connection between residents and the county. That’s important,” Allen says.

Like the projects in McDowell County, the approach in Floyd County was first built on the ground through an informal leadership network with local residents and groups and then started building up and out. Every win is heavily and intentionally publicized to state level policymakers, local groups and companies that could provide further support. It’s been challenging but it’s starting to pay off.

“What we have been able to do with Thunder Ridge is provide proof we can build things here. Now we’re getting buy-in at the state level. But it’s been a bit of a game of divide and conquer,” Allen says.

That buy-in has translated into state funding and support for flood mapping, a step toward long-term risk models based on current data.

“Things like the flood mapping are important,” Allen says. “It doesn’t get us to our end game, but it helps us get the data together that we need to see where the risks are. From there we can go to the state or to agencies like FEMA and say ‘ok here is the reality and here is what we are doing.’ Hopefully, that helps us get the support we need so that a decade from now we’ve brought the businesses in. We are building housing. We’re getting tourism from people who like the mountains. We can do all of that here if we keep putting in the work.”

Pride of Place: Built From Within in Rural Vermont

Building community from the ground up is also central to the work of Jessica Savage, Director of Programs and Strategic Initiatives at the Vermont Council on Rural Development. Many states have rural development councils, but the Vermont Council operates as a nonpartisan nonprofit, independent from government. This structure has allowed it to act as neutral facilitators and convenor for local communities, creating forums that build and in some cases rebuild trust between local actors.

“It’s been really important for us to be able to show that we’re not coming from the outside or on high in the state government. We’re doing our work at the community level, with people on the inside,” Savage says.

The Vermont Council does what it calls “community visits” and in essence large gatherings where communities can come together, have a meal and talk about their goals. The Council handles logistics; venue, childcare, transportation, food, accessibility support. It brings together stakeholders, facilitates the discussion and helps community members and groups build action plans.

“What we’re trying to do is get as many people in the community as we possibly can to show up,” Savage says.

The goals for each community may vary but the Council uses the action plan process to connect each one and with others across Vermont that have already been successful or are tackling similar projects. “When you get everyone in on the process you might come away with a list that has 20 things on it, so we try to help with prioritization and resources,” Savage explains. “We bring in state agencies so they can hear in real time what a given community needs. When we get that list together, Vermont Council has direct democracy so we bring the issues to the town meeting and people vote on them. We are trying to create tangible action at every step.”

These are not large scale projects. Most of the towns the Vermont Council works with have around 2500 people — but not many more and in some cases, less. With populations that small it is easy to fall below the radar of national initiatives. The community-driven model has helped to get resources into these towns and communities and helped them solve their issues locally. That embeds a pride of place, Savage says. Ultimately that pride gives projects longevity because local residents are actively engaged in the outcomes.

“There are economic interests but there are also real local needs. When you have an empowered community and you combine that with direct democracy, what we have seen is that the people on the ground have a better sense of what the needs are and what the community wants.”

Those outcomes are also created from resources on the ground. “These are not often places where there’s some magical formula and you can apply and get a $5 million grant,” Savage says. “Which isn’t to say that these communities shouldn’t apply — we hope they do. But it’s more about building on what is already here because that’s going to lead to a stronger foundation long-term.”

To that end, the Council also has what it calls the Village Trust Initiative picks up after the initial community visit. The initiative focuses on skill building and skill transference with local leaders spearheading projects to help create a pipeline of people with the knowledge and ability to keep expanding on the projects they started in phase one.

“We try to make it intergenerational and inter-speciality. What I mean by that is you might have residents who have lived in a place for a long time and know the land really well so you can bring them in or maybe you have an environmental group and a faith based group both working on the same thing but they don’t know because they don’t interact otherwise,” Savage explains. “If we can foster that awareness, maybe they can pool resources. There’s a lot of siloing that happens and if we can break those down people tend to find they can get more done.”

Breaking down those silos also strengthens communities when they are dealing with the state or industry. Some communities have been able to put limits on the development of data centers on local land needed for housing or farming. Other communities have been able to find solutions to limit school closures and the loss of other critical infrastructure as a result of changing populations.

“It’s a delicate balance,” she says. “There are economic interests but there are also real local needs. When you have an empowered community and you combine that with direct democracy, what we have seen is that the people on the ground have a better sense of what the needs are and what the community wants. It’s empowering for those people to be able to come together and find solutions that are going to support the residents over the long term.”

For Generations: The Rural Roots of the Wellbeing Economy was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

By: Bailey McCann

In 2017, Dean Dupris and his girlfriend, Kristen Lawrence, started running a cattle ranch on a piece of tribally-leased land 40 minutes outside of Timber Lake, South Dakota. They started with a Farm Service Agency (FSA) loan to get going, but three years into operations their ranch was starting to wane. The herd had decreased in size and margins were incredibly thin. Getting a traditional loan to buy more cattle and keep going was also out of reach since those loans require high up front fees and the loan payment often causes farmers and ranchers to get second jobs to keep the loan in good standing.

Facing the threat of going out of business, Dupris turned to Four Bands Community Fund, a Native American Community Development Financial Institution where he had taken an entrepreneurship class a decade earlier. He worked with them to develop a new business plan and secure an agriculture loan with very low payments, tailored to the financial realities of the local community.

With the loan, Dean purchased 33 head of cattle, his “Four Bands cows,” as he calls them. The cows give him enough flexibility to sell steers annually and make a profit without depleting his stock. By contrast, a traditional loan would force him to sell all his calves plus part of the herd each year just to stay current, leaving him worse off by the end of the loan term than when he started.

Lakota Vogel, executive director of Four Bands Community Fund, says their work gaining a deeper understanding of local community’s financial needs allows them to offer “patient capital” — flexible funding that helps residents maintain control of their businesses and their futures. Serving the Cheyenne River Sioux Reservation and broader South Dakota, Four Bands takes a hands-on approach, using community feedback and locally informed data to design financial products and services accessible even to borrowers with unique circumstances.

Resident Data Driving Resilience

For residents in greater Boston, flooding is becoming a bigger issue as a result of climate change. These areas also have dense, often older housing and aging municipal infrastructure, which can compound the impacts of flooding when it happens. Some of the most vulnerable areas are also home to neighborhoods that are primarily Spanish or Creole speaking which can make it harder for residents to access city services or understand information if it isn’t available in their native language.

Robyn Gibson, Founder and Principal at R.E.G Solutions, is piloting work in three of those communities, Everett, Brockton and West Springfield, to get feedback on what happens when flooding occurs to identify the best ways to support flood mitigation and get assistance from the city council for these efforts.

“We created roles, released a job spec and hired directly from within the community. So, it’s not a scenario where it’s another survey and gift cards. The community is interacting with people they already know, and everyone is getting paid to do the work.”

“We are looking at this from an environmental justice perspective,” she explains. “The city is providing the support to do our study in part because they haven’t been successful at bringing these communities to the table yet and getting feedback.”

In Massachusetts, environmental justice is a state level categorization meaning that the state funds an Office of Environmental Justice and Equity (OEJE), and state residents can get support under this categorization. If residents live in an area that is vulnerable to environmental challenges or is suffering the fallout of a past action, (OEJE) will work with them to find solutions. Gibson’s flood mitigation study is part of that work.

Gibson says they started with a variety of data sources to determine where to focus their efforts including census data, the Healthy Neighborhoods Study, as well as information from the Metropolitan Area Planning Council in Boston. From there, she says, the focus was on ensuring equity.

“I think one of the biggest differentiators for us is that people are on the payroll here,” she says. “We created roles, released a job spec and hired directly from within the community. So, it’s not a scenario where it’s another survey and gift cards. The community is interacting with people they already know, and everyone is getting paid to do the work. There is ownership in that.”

The residents that are working with Gibson on the study are mapping potential flooding impact areas, understanding the best ways to deliver information and creating mitigation strategies. This information can then be brought back to the city and incorporated in city level planning through an environmental justice lens. Several of them also work for other community organizations, businesses in the area or in schools and are already taking what they’ve learned back to those places to share information and help spread awareness.

“The residents are the ones that are identifying and ranking which issues are important and how they should be handled so the results that we are getting are really representative of the reality on the ground,” Gibson says.

Once the pilot communities have completed the project, a report will be generated and shared with the city. Gibson says that the pilot will also be analyzed for potential frameworks that could be used by other communities in flood prone areas.

“One of the things about this format is it is so customized to each community. They determine how the project will go for them, so it’s hard to say we’re going to be able to make it a one size fits all response. But that also means there is a lot of opportunity for innovation here because the communities are determining how they are going to use what they learn and what happens next,” Gibson says.

Rethinking Data to Build Trust

Creating space for community and doing so in a highly customized way, is a core focus for D. Rashaan Gilmore through his organization BlaqOut. He founded BlaqOut in 2017 to provide health and wellness care for the LGBTQ+ community in the Kansas City metro area.

BlaqOut provides health screenings, primary care, telehealth, health insurance navigation, and supportive services including emergency food, housing and transportation. Each facility is tailored to the surrounding neighborhood and aims to be a place where residents can visit and find a safe space when needed. Individuals who visit a BlaqOut clinic for services can also contribute to things like the in-house playlist at their location and get information and resources from partner organizations.

“When our members are coming into an appointment they are bringing their whole lives with them,” he says. “You can’t be an anchor for a community if you don’t know what that looks like.”

Gilmore says that when they started setting up BlaqOut, they went through a data gathering process to try and understand the demographics and needs of neighborhoods throughout the KC metro. The process was a formal study of the surrounding area to get as much granular data as possible about what was available and what was missing.

Gilmore says he used a variety of tools including information from Build Healthy Places Network that helped him shape the study. While census tract information can provide a lot of demographic information, he says, it wasn’t enough. “When our members are coming into an appointment they are bringing their whole lives with them,” he says. “You can’t be an anchor for a community if you don’t know what that looks like.”

This process, he says, was only the first step. Gilmore and his team used that data to start crafting their ideal member experience as well as identifying issues that would need further study or potentially further feedback from the community.

“I think a lot of people start from saying ‘these are the services I want to offer’ and just standing something up without really thinking through some of the core issues that can define a neighborhood,” Gilmore says. “We intentionally started from a place of saying ‘ok if we put a facility here what does safety really mean? Do we need to take extra steps? What are the transportation options? Can people get here? What are the accessibility options?”

Gilmore says that all these questions factor into health outcomes and the efficacy of any programs or services BlaqOut offers.

“We want to look at the whole picture and give people the tools to have ownership over their lives, and in turn, ownership over the support they get from us. We want them to play a role in the long-term vision for BlaqOut. That’s how you build trust and stay relevant within a community.”

“We recognize if someone is visiting us and sits down before an appointment that might be the first break they have had all day,” he says. “So, we have snacks and drinks available, we have a TV, we have a patient playlist. Providing a positive experience all the way through helps people feel better. If they know they are going to go somewhere and be treated with respect, in a supportive environment, they are going to take better care of their health and support the organization over the long-term. That’s how you become embedded in a community and become a place where people gather to build on that feeling and extend it outward back into the community.”

Gilmore says that organizations that work within marginalized communities can’t afford to be single-issue organizations if they want to lead and if they want those communities to take them seriously and invest in helping make them a long-term presence.

“Housing, transportation, job security, food security — all of those things are healthcare as well,” Gilmore says. “We can’t just offer someone a vaccine or some other service and say, ‘ok come back if you need anything else.’ That’s a very transactional mindset. We want to look at the whole picture and give people the tools to have ownership over their lives, and in turn, ownership over the support they get from us. We want them to play a role in the long-term vision for BlaqOut. That’s how you build trust and stay relevant within a community.”

Gilmore says there can be a hesitancy on the part of nonprofits and other community organizations to move away from models of service and data gathering that have been used for a long time like intake forms or generic surveys. “When we look at the data for some of those models,” he says, “they don’t work very well. So my question is why keep using them when you can work with the community you are in directly and get their feedback?”

Where Data Meets Healing

For Angie Main building resilience also starts with a focus on community building. Main is the Executive Director for the Native American Community Development Corporation — Financial Services (NACDC-FS) based in Browning, Montana which provides individual and business loans and financial services for Native Americans. NACDC-FS is the financial arm of the Native American Community Development Corporation which also provides access to healthcare services and supports community events and tourism within Native communities.

Established in 2010, NACDC-FS serves Montana, the Dakotas and Wyoming. Main says it took a year for NACDC-FS to begin offering financial services within the Native community in part because almost no data was available about the needs or demographics of Native Americans within NACDC-FS service area.

Fifteen years on, Main has moved NACDC-FS onto Salesforce to track a robust and largely fully custom dataset on the economic activities and needs of the Native American community across four states. Aggregate insights from these data are also being used by other Native American community development financial institutions in other states.

Main says the work has been a labor of love and necessity, but the dataset has matured to a level that NACDC-FS can more rapidly refine its products and services, ultimately allowing it to do more within Native communities. Most recently, NACDC-FS launched a project with Sweetgrass, a local consultancy, to help understand the drivers of financial trauma within Native communities and help individuals break free from problematic financial cycles. The report is a combination of survey findings and insights from financial services users.

“Main says all these factors show up in how Native Americans think about, spend and save money. The survey is designed to pull together responses from residents about how those traumas impact them directly and gain insights on what they want support for most.”

NACDC-FS pairs its financial services with coaching and educational programming for both individuals and businesses. This helps individuals develop financial literacy or additional entrepreneurial skills to keep a business running. In contrast to many traditional banks, their relationship is more hands-on and is designed to keep up with borrowers over the life of their loans.

This close relationship helped NACDC-FS focus on some consistent patterns they were seeing. “An individual borrower, for example, would take out a loan to build credit or consolidate debt. Inevitably, they get to a point where their credit looks good. They have more options and then they go get a new credit card and it starts all over. Or something else happens and they get behind on payments. That indicated to us that what was going on went beyond just low financial literacy,” Main says. These interactions prompted NACDC-FS to focus on trauma and study it.

It goes without saying that Native American communities have faced profound intergenerational trauma. Those traumas continue today at a structural level. Native communities are often significantly lower in income than the surrounding cities and towns. Some reservations struggle with infrastructure like potable water, electricity, and emergency services. Native owned businesses also face hurdles when it comes to securing financing and finding consistent sources of revenue in part because of the underinvestment in their communities.

Main says all these factors show up in how Native Americans think about, spend and save money. The survey is designed to pull together responses from residents about how those traumas impact them directly and gain insights on what they want support for most. The findings from the survey will be used to inform NACDC-FS programming and may also lead to changes in the financial products offered if it becomes clear that there are additional unmet needs within the community.

“We have the opportunity through the programming that we do to get feedback from the community and address these topics in our coaching and in the way we manage our products,” Main explains. “We don’t have to be as formal as a bank. If something happens and someone needs to reduce their payments, we can work with them on it and be a source of support.”

“People use data to make decisions every day. They should be empowered to use their own data to make decisions about their own communities.”

The survey and all the data work done by NACDC-FS are also, indirectly, significant contributions to the Native American population overall. None of this information was being tracked by the states where NACDC-FS provides services which created an opportunity for Main and her colleagues to build it themselves — by Native Americans, for Native Americans. Main plans to present the findings of the survey to other Native CDFIs later this year and hopes that the work of NACDC-FS and Sweetgrass will be a jumping off point for other Native communities to approach financial services and economic development from a trauma-informed perspective.

Four Band’s Vogel says this work, and the work Four Bands does with individuals like Dean Dupris to help his business stay viable are examples of data sovereignty in action.

“A lot of people want to talk about data sovereignty, but I think we should take it a step further and call it data democratization,” she says. “What we are talking about is pulling together the information that builds equity. Everyone thinks that data gathering or making data driven decisions is something for data scientists or managers. But it’s for everyone. People use data to make decisions every day. They should be empowered to use their own data to make decisions about their own communities. We want our frontline people to have as much data as I do as the executive director. We want to be using all the tools we have all the time, so that we can make the best decisions possible.”

Vogel says Native led, Native focused organizations like Four Bands and other Native CDFIs play a unique role in the community because they aren’t exactly like a bank even if many of the services they provide are similar. In this role, Four Bands gets a first hand view of what constitutes the economic and community development of the reservation itself.

“What really moved the needle for us was understanding how we rated character and commitment to the business. Getting that right is as important as looking at a factor like credit score.”

“We’re doing a lot of case management because we work so closely with our borrowers. Whether that is through helping them launch a business or just improve their personal credit,” she explains. “When you say case management people instantly get form and survey fatigue. What we’ve tried to do is make that process more supportive.”

Four Bands has refined its process so that intake is only done once, and people aren’t filling out the same data points over and over again on various forms. They also use what they learn through their classes and educational programming to refine survey questions. If a topic is coming up a lot in a question and answer, that might lead to further study. If coaching clients are showing a pattern of behavior, that might lead to a focus group or other type of study to understand what’s driving the pattern.

Four Bands also uses the feedback to reassess their lending criteria to ensure that the fund is being prudent about its lending, while still reaching as many people as possible. Most recently they took a second look at how they evaluate financial equity in their small business lending and discovered that the original ratings framework they were using wasn’t helping all that much. Like any lender they were looking at the basics — credit score, cash flow, collateral, etc. But there were some gaps.

“What really moved the needle for us was understanding how we rated character and commitment to the business. Getting that right is as important as looking at a factor like credit score,” she says. “So we’re refining our criteria and making it so that if someone is just starting out they aren’t getting dinged for having a smaller balance sheet or other limiting factors if they can demonstrate commitment to the business.”

By rethinking their underwriting criteria Four Bands was able to offer access to financing to more businesses earlier on in their journey and make it easier for them to grow into mature companies that will be able to serve the local community over the long-term.

“That’s how we leverage our data for maximum impact. We see our work as advocacy in addition to providing financial support. We’re always looking for ways to expand and improve access to services.”

Those Who Hold the Data Shape the Future was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

Disinvested neighborhoods around the country are already experiencing some of the worst effects of climate change. New federal funding targeted to sustainability and resilience is offering a giant opportunity for community development organizations and healthcare groups to improve some of those outcomes through collaboration.

By Amanda Abrams

It’s a fact that New Orleans experiences legendary levels of flooding from time to time. What’s less well known is that the city has also seen an increase in regular, nuisance flooding. Nowhere is that more of a problem than in the city’s low-lying, lower-income neighborhoods.

That’s a phenomenon Angela Chalk is very familiar with. For over a decade, she’s been the director of Healthy Community Services (HCS), a nonprofit organization focused on helping residents of the city’s 7th Ward live healthier, more fruitful lives. HCS offers resources, skills and job training so neighbors can better help themselves amid climate change’s pernicious effects.

“We work on climate mitigation, stormwater management, and urban agriculture — driving community choices to live resiliently, because we can’t wait for the government to do it,” said Chalk. “This is all community-driven and community-led.”

Around the country, neighborhoods impacted by divestment like Chalk’s are struggling with the devastating effects of climate change. While increased storms, heat and other extreme weather have hit the entire country in different ways, the results are felt more strongly in low-income regions, particularly communities of color, that have for years lacked resources and investment. Crucial upgrades to stormwater systems, roads, buildings and other community infrastructure may not have been made in years or even decades. As a consequence of that disinvestment, the neighborhoods are now far less resilient in the face of new weather patterns.

For example, many disinvested neighborhoods act as heat islands: asphalt and non reflective buildings soak up sunlight without the mitigating effect of shade trees or other vegetation, then radiate heat during already-hot summers. Stormwater systems may be patchy or have significant leaks, leading to greater flooding after intense downpours. And after a deluge, homes in poor neighborhoods are often repaired more slowly, due to politics, limited city resources, or landlord disinterest.

“If you did a heat map on health-related issues that affect people, certain neighborhoods would light up. What we’ve known is that there are similar maps for overcrowding or for people in poverty — they’re the same neighborhoods.”

Even schools, which are usually funded by local property taxes and therefore tend to be less equipped in less-wealthy communities, can be affected. “We know that if the ventilation isn’t up to standards, that can affect learning because of increased carbon monoxide levels,” said Elizabeth Beardsley, senior policy counsel at US Green Building Council.

Because of these outcomes, climate change can exacerbate already-stark social inequities. Extreme weather can lead to increased housing vulnerability for many families, and some may even become homeless. They may also experience health problems as a result, making mitigation of climate change essentially another vital condition for health.

“If you did a heat map on health-related issues that affect people, certain neighborhoods would light up. What we’ve known is that there are similar maps for overcrowding or for people in poverty — they’re the same neighborhoods. What we didn’t know was that the propensity to flood, the quality of air, the likelihood of something being a Superfund site — it’s also the same neighborhoods,” said David Erickson, senior vice president at the Federal Reserve Bank of New York.

Like the 7th Ward, many communities are trying to help themselves. For example, West Street Recovery is a nonprofit working in a largely Black and Hispanic part of Houston that is low-income and has long been the target of industrial pollution. Flooding from hurricanes like Harvey and Imelda spread toxins and mold to families’ homes, worsening already-bad health outcomes. West Street Recovery helps households fix their homes, while also trying to make them more resilient for the next disaster.

And in another part of New Orleans, Sankofa Community Development Corporation preserved 40 acres of wetlands, creating a park that protects the Lower 9th Ward from flooding, while also providing greenspace and a nature trail.

However, for community-based organizations, going it alone can be slow and difficult.

New funding, and new partnership opportunities

The good news is that many communities stand to benefit from a massive injection of new federal funding dedicated to addressing climate change in poor and working-class communities.

The 2022 passage of the Biden Administration’s Inflation Reduction Act — called “the single largest investment in climate and energy in American history” — as well as other recent legislation like the bipartisan 2021 Infrastructure Investment and Jobs Act, is resulting in an unprecedented amount of federal funding earmarked for climate change-related initiatives. To boot, much of it is specifically targeted to low-income areas earmarked as “Justice 40” communities.

Large sums of money designed for resiliency and sustainability-related initiatives may soon be available around the country for community infrastructure projects that make an area safer and healthier for its residents.

“When you think about what housing investment looked like 10 years ago — it took a while for it to materialize. Lesser-known social determinants like climate are on that trajectory.”

Projects that benefit from the funding are designed to be community-driven and community-led, to achieve actual climate justice. One good example is the new Tribal Community Vision Fund, which the Biden Administration announced in March. The fund — which was created in partnership with Native groups — will focus on expanding capital access to Tribal communities in order to promote their self-determination and sustainable economic development. Some of the fund’s investments will include large-scale renewable energy, climate mitigation, and environmental sustainability projects.

Critically, all of the recent federal funding establishes an opportunity for a wide range of cross-sector partnerships. Already many groups, including community development financial institutions, are poised to receive money from the federal government and distribute it in the form of low-interest loans and grants to coalitions, partnerships and organizations.

For healthcare institutions, health insurance companies, public health agencies and others, this represents an extraordinary opportunity. Most health-related groups now recognize the powerful role that the vital conditions for health play in an individual’s and a community’s health. Whether a person has safe and secure housing, access to good food, or the ability to get around is often far more important than the medicine they take. With the incredible impact that climate change can have on health, both individually and collectively, it should be viewed as another vital condition and invested in accordingly.

“If we could incorporate climate change [as a vital condition], that would allow us to prioritize it better,” said Kendra Smith, vice president for community health at Bon Secours Mercy Health. For now, she said, she sees health institutions beginning to include climate change in their deliberations, but it’s not yet front and center. “When you think about what housing investment looked like 10 years ago — it took a while for it to materialize. Lesser-known social determinants like climate are on that trajectory.”

There has been an increased focus, both internationally and nationally, on how healthcare institutions can become more climate resilient and sustainable. And research has shown that US healthcare workers really do want their employers to begin addressing climate change.

One key way they can do so is by partnering with community development groups to support infrastructure projects. Together, the two sectors could potentially leverage climate change-related funding in ways that could make low-income neighborhoods healthier and more resilient in the face of climate change by bolstering valuable upstream community infrastructure.

“There is a wealth of room for these sectors to work together,” said Anthony Nicome, an environmental justice fellow with the Association of American Medical Colleges, Center for Health Justice. “Right now, the sides don’t know each other. There’s a lot of opportunities missed for collaborations.”

Erickson, from the Federal Reserve Bank of New York, agreed. “If you want to tackle health, poverty, or climate stuff, you need to work in these communities. And we’d all be better off if we all worked together.”

The benefits and challenges of decarbonizing affordable housing

One goal a variety of groups around the country have begun focusing on is electrifying low-income housing, much of which is fueled by natural gas. Though it may sound dry, the work offers a giant win from a climate perspective. Additionally, rewiring an aging apartment complex presents a major opportunity to address historic disinvestment and poor health outcomes in marginalized communities.

The correlation between older appliances like gas stoves or fuel oil furnaces with poor indoor air quality and negative health outcomes such as asthma and low birth weights has been well established by research. Ruth Ann Norton, executive director of Green and Healthy Homes, a group that has been focused on this longer than most, says that her group has noted reductions in hospitalizations and improvements in school attendance following upgrades to homes. Plus, the work can be easily paired with other health-related improvements, such as clearing out mold and moisture within the walls.

“You can’t have a leaky roof and walls and upgrade the electrical system,” said Norton. “If you pull out old appliances, you’re going to disturb lead-based paint. Same with ventilation, and also regarding pest management. They all fit hand in glove.”

So far, healthcare groups have been only marginally engaged, but advocates say they seriously stand to benefit and should take note. However, recruiting them as investors and quantifying the potential savings has been challenging for many groups interested in decarbonization.

“It’s a hard sell,” said Ravi Malhotra, president of the Triple Bottom Line Foundation, a CDFI that performs green upgrades in affordable multifamily developments. The company has received a $1 million investment from Utah-based Intermountain Health, an integrated, nonprofit health system, but that was due to an existing relationship; it has otherwise struggled to enlist healthcare groups. Many require decades’ worth of data documenting reduced emergency room visits and other savings, which can be very difficult to acquire — especially when the subjects are low-income renters who frequently move.

In the meantime, however, a promising climate-centered collaboration between a local hospital and a housing group has sprung up in Washington, DC. National Housing Trust (NHT), an affordable housing organization headquartered in the capital city, has prioritized decarbonizing low-income housing complexes and making them healthier places to live. In response, Children’s National Medical Center created a map of multifamily buildings in DC that are home to a high concentration of children with asthma, and shared that anonymized data with NHT. That gave the organization a clear roadmap of which properties to target.

NHT’s plan is to not only electrify the buildings, but also improve ventilation and address other asthma triggers like mold and pest infestations. “That’s the model we’re trying to prove out,” said Todd Nedwick, NHT’s senior director of sustainability policy. “You can go into the buildings and address them holistically,” and see significant change.

One of the nonprofit landlords involved is Mission First Housing Group. The organization had been planning on renovating and expanding one of its properties when NHT got in touch. “We were dismayed to learn that one of our buildings was on that list,” said Elizabeth Everhart, senior development manager with Mission First. “But obviously, we want to do everything we can to improve the health outcomes of the kids in our building.”

The group has pivoted and is now planning to perform a massive electrical upgrade. It’s a huge expense that likely wouldn’t even be covered by low-interest loans. But Mission First has applied for $10 million in grant funding from a new HUD initiative, the Green and Resilient Retrofit Program, that could cover all of the costs. As of July 2024, NHT and DC Children’s Law Center will receive an additional $20 million from the EPA’s Community Change Grants Program for the project.

Everhart said this collaboration between a hospital and a housing group is inspiring. “I’ve heard for a long time about the fact that local health systems and hospitals have these funds set aside that are supposed to be used for programs like this, but have never been able to identify those funds or partner with those groups,” she said. “So this is really exciting.”

Just as important, it’s a collaboration with room to grow.

They’re more than just solar panels

Decarbonizing affordable housing complexes is not the only way healthcare groups can work with community development organizations to create meaningful upstream change that begins to reverse longtime inequities.

“There is a wealth of room for these sectors to work together. Right now, the sides don’t know each other. There’s a lot of opportunities missed for collaborations.”

After all, the healthcare sector is responsible for 8.5 percent of greenhouse gas emissions. And as a recent op-ed in The Hill outlined, hospitals account for a significant portion of that. Yet, “In 2023, just 37 — substantially less than 1 percent — were Energy Star certified by the Environmental Protection Agency,” read the op-ed. Given that the effects of climate change overwhelmingly affect lower-income communities and will continue to do so, simply finding ways to operate more sustainably can be a significant step for hospitals and other healthcare institutions.

But some are going further. Boston Medical Center (BMC), for example, recently utilized federal funding to install a solar array on the roof of its administrative building. All of the energy that’s generated through the panels will be allocated to low-income patients in the form of credits.

“We’re giving all of the power away,” said Anna Goldman, a primary care doctor and BMC’s medical director of climate and sustainability, who founded the program. Ultimately, 80–100 families should receive roughly $600 in credits over the course of a year, lowering their utility bills and acting much like an income transfer.

BMC’s initiative doesn’t rope in community development groups, but it’s brand new; other healthcare groups could do something similar in ways that partner with local organizations.

Some healthcare institutions are already using solar panels to build community resilience. In the rural Southeast, many Federally Qualified Health Centers (FQHCs) are on their way to becoming self-standing microgrids, thanks to the installation of solar panels on their roofs and the addition of accompanying battery storage systems.

FQHCs, also known as community health centers, provide comprehensive primary care for low-income people. The presence of reliable, independent solar power in clinics serving them offers several important advantages. First, it means that even when power outages to the traditional electrical grid occur during and potentially for weeks after disasters, key medications and vaccines can remain refrigerated, essential medical equipment can be used, and medical records can be accessed. For low-income populations, that could literally be lifesaving.

Solar power paired with battery storage can also allow a health center to serve as a community resilience hub during and after a catastrophe. It can become a place where key community and health leaders can charge their phones, or act as a cooling station for vulnerable community members. Eventually, in coordination with local service providers, it might become a center for food distribution and other vital services.

Finally, a solar installation saves the center money, allowing leaders to spend funds on services and other critical needs rather than on energy.

“You’re fixing your energy costs. And you have a resiliency that you otherwise wouldn’t have: you’re not dependent on fossil fuel being delivered,” explained Becky Regan.

She’s the CEO of Capital Link, an organization that works closely with community health centers and runs an affiliated CDFI, Community Health Center Capital Fund. Together with Collective Energy, a company that designs solar solutions, and the National Association of Community Health Centers, Capital Link is helping to establish these microgrids; the program is called the Community Health Access to Resilient Green Energy (CHARGE) Partnership.

Using funding from the Department of Energy, CHARGE will also strengthen communities by partnering with community colleges and other local entities to provide job training and bring other economic opportunities to residents. “We’re making sure we’re not just doing our thing and then leaving,” said Regan. “We’re developing the social fabric and the infrastructure.”

For the community, it sounds like a win-win-win.

Building a Sustainable Future: How Healthcare and Community Development Can Unite for Climate… was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

The relationship between Tribal nations and the U.S. government is marred by land theft, countless efforts to erase Native culture and even genocide. But these and other injustices have only strengthened the commitment to self-determination that is driving Tribal members to spearhead multi-sector partnerships aimed at improving the health, safety and well-being of Tribal nations.

Partnerships, such as the one between the Sogorea Te’ Land Trust, which is focused on restoring the land in San Francisco’s East Bay to Indigenous stewardship, and the ecological justice non-profit Movement Generation have taken shape in the last decade. However, there are Tribal governments that have been at the forefront of Native-led partnerships for decades. One is the Blackfeet Nation.

The Blackfeet Reservation in northwestern Montana is home to 7,000 people, or roughly half of the nation’s enrolled Tribal members. Yet, even among this relatively small population, stable, quality, affordable housing and many of the amenities that people outside of the Tribe take for granted — such as adequate heating and plumbing — are not always available.

“Everybody has water issues where we go,” said John Castillo, executive director at Walking Shield, a California-based organization that partners with Tribal governments, urban Indian service organizations, state and federal government funding agencies and other groups to serve Native American communities.

“Housing, water, roads, health; those all come up no matter where we go,” Castillo, who is of Apache heritage, added.

The Blackfeet Nation, together with Walking Shield, has prioritized several projects to help address these needs including the development of 30 units of veterans’ housing specifically geared to home ownership; water delivery and sewage infrastructure for those homes; preventative healthcare programs for adults and children; and expanding access to trauma-informed care on the reservation to reduce domestic violence, substance abuse and teen suicide.

These projects, set to be completed in 2024, are part of a five-year infrastructure development plan. The power of this jointly-developed plan, Castillo said, is to serve as an “organizing principle” that allows both the Blackfeet Nation and Walking Shield to focus on the services most needed on Tribal lands, identified by the communities themselves and subsequently to measure their efficacy in delivering them. Another key partner is the U.S. military which, through its Innovative Readiness Training program, provides armed forces personnel with military training while addressing the needs of communities across the country, according to the Department of Defense.

“We’ve been developing these five-year plans because we don’t want to talk about this in another five or six years: We want to get stuff done.”

Castillo said the five-year plan is an outgrowth of having worked with small Tribes, many of which don’t have the staff or expertise on the reservation to compete for available resources that would bring money for infrastructure or programming. Having a plan in place enables the Tribe to map projects out and ensure that projects are constructed on time and within budget. Moreover, the five-year plans address multiple social determinants including health, housing and education.

“With the plan that we develop, Tribes can match their assets to their needs over the five-year period so they know that this unit in 2024 needs to produce infrastructure, or this unit in 2025 needs to go to health care,” Castillo said. “We’ve been developing these five-year plans because we don’t want to talk about this in another five or six years: We want to get stuff done.”

Nations Within A Nation

There are 574 Native Tribes in the U.S., representing a population of about 6.8 million people, according to the most recent census. Under the Constitution, each Tribe is recognized as a sovereign nation. Historically, however, the ties between Tribal nations and the U.S government have been strong but largely inequitable.

Government departments such as the Bureau of Indian Affairs (BIA), which was established in 1824, are legally responsible for supporting Tribal government as well as Native self-determination, reservation roads programs, law enforcement, and detention facilities on Native lands. The bureau also oversees all activities associated with management and protection of trust and restricted lands, natural resources, and real estate service.

As a result, self-determination, or Tribal Nations’ ability to manage their own resources and determine their own funding priorities rather than the BIA has been a major point of conflict between them and the U.S. government.

The BIA has an annual budget of around $2 billion a year, of which 68% is used for Tribal support in the form of contracts, grants or compacts for social services, job training, schools and home improvement. A portion of the remaining 32% goes to operate the Office of Indian Services. These funds are used across a wide range of needs including: disaster relief; child welfare; education; Tribal government; reservation roads; general assistance and Indian Self-Determination; law enforcement; Tribal courts; and detention facilities on Tribal lands.

But the budget doesn’t meet the needs of the Tribal communities. Data from the National American Indian Housing Council shows that 40% of on-reservation housing is inadequate and around 90,000 Native families are either homeless or under-housed. Moreover, as many as 24% of Native people live in poverty, according to data from the 2020 census.

There have been some attempts at a legislative fix for on-reservation housing. At the start of 2023, South Dakota Sen. John Thune introduced the Tribal Trust Land Homeownership Act in the U.S. Senate. The bill, which was passed unanimously, establishes a deadline for the BIA to process and complete all residential and business mortgages on Native land, effectively expediting the mortgage approval process. However, that bill has languished in the House of Representatives.

But getting a mortgage approved isn’t the only hurdle. Tonya Plummer, Native American Housing Programs Director at Enterprise Community Partners and an enrolled Tribal member of Assiniboine, Sioux and Cree heritage with roots in the Sisseton Wahpeton Sioux Tribe of South Dakota and the Fort Belknap Indian Community in Montana, said that paying back the loan can be just as difficult, in her April testimony before the House Appropriations Committee’s Subcommittee on Transportation, Housing and Urban Development, and Related Agencies.

Plummer noted that foreclosures can also occur because loans provided through the Department of Agriculture’s 502 program which are used for housing on Tribal lands, can potentially leave homeowners underwater. She added that, as a result, properties with delinquent mortgages become vacant, reducing the amount of affordable housing in rural communities and ultimately making areas more dangerous.

The federal government is also required by treaty to provide critical health care services to Native Americans and Alaska Natives, which it currently does through the Indian Health Service (IHS), which was created in 1955, to fulfill those obligations. Members of federally-recognized Tribes are able to receive services through IHS for everything from regular physical health care to mental health care, dental and vision. However, there’s a discrepancy between what Tribal health experts and the federal government say IHS needs to provide and what Native communities are entitled to.

“It’s critical to remember that, in exchange for ceding huge portions of land, many Tribes received a promise from the federal government that carries a duty to protect Native Tribes through departments including BIA, IHS and the Bureau of Indian Education, and while protecting Native Tribes’ relationships with the federal government is critical, it is not enough to replace the equity lost in the ceded lands and years of disparity in resources. There’s a lot of room for private capital investment.”

Last year, the Biden administration commissioned a report from the Department of Health and Human Services that showed IHS’s funding is roughly around 50% of where it should be in order to provide services promised by treaties signed more than a century ago. The Tribal Budget Formulation Work Group, a group of Native health experts that advise the federal government, have asked that the federal government provide IHS with $51.4 billion in funding, amounting to a 700% increase above its current budget.

In January, IHS received $7 billion through advanced appropriations as part of a $1.7 trillion omnibus budget signed by President Joe Biden. Plummer said that federal funding has not kept pace with population growth and inflation. As a result, the disparities are even greater and potentially more difficult to address without additional capital.

“Instead of seeing the good things that tribes have been doing in Tribal industry, we often see the pain point first,” she said. “It’s critical to remember that, in exchange for ceding huge portions of land, many Tribes received a promise from the federal government that carries a duty to protect Native Tribes through departments including BIA, IHS and the Bureau of Indian Education, and while protecting Native Tribes’ relationships with the federal government is critical, it is not enough to replace the equity lost in the ceded lands and years of disparity in resources. There’s a lot of room for private capital investment.”

However, much of that private capital has yet to materialize. David Castillo, CEO of a Tempe, Ariz.-based CDFI, Native Community Capital (NCC), who is of Nahua Indian descent, said that financial institutions and private-sector capital sources continue to redline Tribal communities, making private-sector partnerships with Native communities harder to establish.

“Someone from the Office of Management and Budget once asked me ‘Why do you feel it’s important for Native people to have homeownership options on reservations?’ That’s the wrong question,” he said. “It’s enough that Native families desire to have a home of their own, that they can purchase on their own but for which the financial system denies them. At NCC, We don’t ask ‘Why should someone be able to buy a home?’ We ask ‘Why aren’t they able to and how can we change that?’”

Opportunities such as Community Reinvestment Act reform and proposed new regulations could potentially spur investment by allowing banks to use Tribal areas as part of their assessments, according to Castillo, but that has yet to happen.

Pete Upton, CEO of the Native CDFI Network and a member of the Ponca Tribe of Nebraska, said that, generally, the partnerships currently seen in Native communities are government oriented and — in most cases — rarely used. He added that a wide range of issues around how property is seen in Native communities have, to date, made collaboration between the private sector and Native communities relatively rare.

“In regard to the private sector and Native communities, the collaboration just isn’t quite there yet,” Upton said. “The land is held in trust, and it’s not that complex to figure out, but put it this way: I think there’s easier lower hanging fruit for those investors. They can go elsewhere and not have to deal with some of the challenges and hurdles and hoops that you might have to [face] in Indian country.”

It will take intentional efforts by private investors to listen to and work alongside communities to find better ways to realize the government’s duty towards Tribes.

A Measure of Success

Although multi sector partnerships are still nascent on Tribal lands, there are a number of projects where Native governments have spearheaded the successful development of infrastructure for the Tribal community. One such project is Nesika Illahee in Portland Oregon.

The 59-unit affordable housing development was constructed in 2020 through a collaboration between the Confederated Tribes of Siletz Indians, the Native American Youth and Family Center (NAYA) and the Native American Rehabilitation Association of the Midwest. It was financed in part by the Siletz Tribe’s Indian Housing Block Grant, which has historically been used for affordable housing activities on Native lands.

“The Siletz Tribe had done an assessment with its citizens and knew one priority was to create housing outside of the reservation setting,” NAYA’s Interim Chief Executive Officer Oscar Arana said, adding that the Tribe was particularly interested in creating housing in the city of Portland that Tribal members could afford.

According to the city government’s 2022 assessment, the median home sales price rose 17% from 2016 to 2021 to $525,000. Meanwhile, Native Americans’ median annual income was $ 55,172 as of that year.

Arana said that the block grant funding was one of the last resources in the capital stack which, when combined with tax credits and philanthropic resources, allowed the partnership co-owners and co-developers to create a leasing preference for Siletz Tribe members first, followed by anyone from a federally-recognized Tribe.

In addition to creating a subsidy enabling applicants to afford housing, Arana said that the collaboration also enabled the partnership to bring in different approaches to design.

“It was important for us that the building visually looked like it was for the Native community,” he said. “We spent time, effort and funding to include art by Native artists, to ensure that the colors and signage were visually appealing and trauma informed, and that it was designed and built in a way that was welcoming for residents and the Native community.”

Arana acknowledged that while it’s possible to leverage tax credits and block grants to develop projects for Tribal nations, it’s difficult since they are intended to be separate. But he added that support from Home Forward, the city’s housing authority, helped to make a difference.

Nesika Illahee, Mamook Tokatee and Hayu Tilixam provide a model for partnerships with Tribal Nations, but it’s only one. In 2013, Sioux Falls, SD-based Avera Health — a regional healthcare system serving communities throughout the midwestern U.S. — launched the Avera American Indian Health Initiative, which provides “high-quality, sustainable healthcare solutions to benefit Native Americans throughout the Upper Midwest.”

J.R. LaPlante, the former director of Tribal relations for Avera and a member of the Cheyenne River Sioux Tribe, said that, prior to the initiative, many of the Tribal communities’ needs were not being met by the federal government. However, a partnership between Avera, Urban Indian Health, and the government-run Indian Health Service (IHS), has established public-private partnerships to provide for specialty clinical services in Native communities.

“We had Tribes come to us and say ‘We need help with specialty clinical services. We need help with public health research. We need help with infrastructure,’” LaPlante said. He added that, while healthcare has been nothing short of a debacle for Tribal lands historically, it enabled Avera, Tribal communities and their partners to identify gaps in the health care system that IHS doesn’t provide, such as specialty clinical services, underlining the importance of community leadership for success.

“There is scarcity, there is necessity and there’s unmet need, but what I’m saying is that there has to be kind of an identification of what the need is, an agreement on what the need is. And identification of the need has to be done by the local community,” he said. “That’s step number one.”

The second step according to La Plante is relationship building. He noted that, while a given need or crisis may bring people together to seek solutions, there’s a history of mistrust that would-be partners have to contend with when seeking to develop partnerships with Tribal Nations.

“For over 100 years, well intentioned organizations, private sector, nonprofit organizations, religious faith based organizations, states, corporations and individual people with expertise have come to these Tribal Nations and said ‘We promise we’re going to do this and we’re going to help you with your problems’ and then they come out and they do their research or they create their idea, or they create the nonprofit and nothing ever comes out of it,” he said. “So there’s a history of broken promises.”

According to La Plante, the most effective partners are the ones that have been fostering relationships with the community, governmental actors and community actors alike. That takes time and a degree of patience since there may be no immediate result. But, La Plante also noted that even though Avera, which recorded $1.4 billion in revenue for 2022, helped develop specialty clinics alongside Tribal Nations, self-determination was always one of the goals associated with the development.

“We were just the provider of record. The bricks and mortar belong to the Tribe, the land obviously belongs to the Tribe and, and we actually just leased the clinic from them,” La Plante said, adding that self-determination lay at the heart of the initiative.

“We really wanted to promote self determination and local autonomy, [understanding that] it’s going to be better if it’s an indigenous clinic, if it’s run by the Tribe.”

Mariano Diaz, a senior fellow at Walking Shield, said that public health has increasingly become a factor in infrastructure development on Native lands.

“Twenty-five years ago, nobody talked about the intersection between housing and health,” he said. “When I look at it in my framework of comprehensive community development, if you’re working across any of those sectors, and you’re doing it well, it’s leading to better health outcomes.”

But, while the newfound focus on health is encouraging, it’s still relatively nascent. Lanalle Smith, senior programs officer, capacity building, at Longmont, Colo.-based Oweesta Corporation and a member of the Navajo Tribe, of the Dibelzhini (Black Sheep) clan, born for the Naaneesht’ezhi tachii’nii (The Charcoal-Streaked Division of the Red Running Into the Water) clan, said that while partnerships for housing and financial security on Native lands have been successful, tying those to healthcare services has not generally been done to the same degree.

“If you’re offering homeownership, the tendency is that you have a stable household. Your children are healthier, you’re healthier, and there are a lot of health benefits to that versus living in flux or in public housing within the Tribal communities. I feel like that piece is missing,” she said.

Smith also noted that not every Tribal community has a clinic or a hospital, so access to those services can be impacted because of the rural nature and lack of transportation. But it’s possible for CDFIs to help Tribes create what she calls a “holistic addition” to the services that are being offered and provided.

“CDFIs can partner with Tribes and create enterprises,” she said. “I’ve seen organizations create senior homes, daycares and really look at the business aspect too because, when you look at rural Tribal communities, there are a lot of gaps in services.”

There are, however, some hurdles to creating these enterprises.

“People looking at multi-sector partners have to ask what their missions and values are. If those partners’ values and missions are far apart, the partnership is not going to work when it comes to prioritization or operations.”

A recurring issue for Diaz is how to work within the federal government’s parameters in order to make healthcare more accessible for Native people living on Tribal lands. He said that, while Walking Shield works with Native Tribes to help them determine what their needs are and how best to pursue them, for the most part, infrastructure projects don’t align with the federal definition of a health program.

“Nobody would argue that having clean water and wastewater management on the reservation is a determinant of health but a health funder doesn’t necessarily want to provide us with resources to build a new well,” he said, adding that the organization is willing to work with any partner in order to deliver the health outcomes most important to the Tribe.

One challenge that can arise when working with partners is making sure that their priorities are the same as those of Tribal Nations.

“People looking at multi-sector partners have to ask what their missions and values are,” Arena said. “If those partners’ values and missions are far apart, the partnership is not going to work when it comes to prioritization or operations.”

A Delicate Balancing Act

According to the Government Accountability Office, one of the main barriers to Tribal groups’ obtaining credit is the U.S. government.

In a 2022 Tribal economic development report, the office said that programs supporting Tribal governments’ economic growth are fragmented across seven agencies, including the Departments of Agriculture, Commerce, Energy, Housing and Urban Development and the Interior. While the Secretary of Commerce is responsible for helping Tribal governments determine what opportunities are best for them, Native governments generally have to do the work themselves since the department doesn’t keep records on federal programs specifically geared to economic development on Tribal lands.

The only drawback is that many Tribal governments lack the resources to do the work required to access those programs.

The complexities of finding capital partners, managing relationships with the federal government are hard enough but leveraging community power can be one of the most difficult challenges in getting any project over the line.

NCC’s Castillo noted that, while Tribal leaders are key to the process, many are not professional politicians. Instead they have either been elected to the position or had it thrust upon them by the Tribe, and often have to prioritize addressing the social distress of the Tribe.

The consequence of centuries long structural racism built in across various systems has a broad impact.

“Writing about the African American community, Casey Gerald, in his masterful essay entitled ‘The Black Art of Escape,’ writes that it is not enough to be woke, we must ‘commit to be well.’ That in and of itself is also a huge challenge for Tribal communities also,” he said.

Castillo went on to say that Ta-Nehisi Coates references a concept coined as “relative deprivation” in his writings that describes community-based trauma, and added that “when communities are scattered, when our leaders are having to work on so many different historic and complex issues — many of which affect their own families as well — it’s overwhelming.”

“For tribes it’s the Indian Child Welfare Act, water rights, gaming, voting rights, it’s all the social trauma,” Castillo said. “The pressure of it all, including the high level of incarceration, joblessness, drug addiction, homelessness, single parent headed households, it’s just crushing.”

Castillo noted that, for Tribal leaders, garnering support for programs can be extremely difficult in the face of all the societal pressures faced by the Tribe as a whole.

“If an individual or group of Tribal citizens is interested in developing a homeownership program but the Tribal council doesn’t support them [that’s problematic]. “From a Tribal leaders’ perspective, the myriad and urgent social and governance issues a citizen governance body must look after is daunting, so much so that their time in Tribal leadership may be very short-lived because they may be voted out at the next Tribal election.”

Castillo also said that the contemporary Tribal government system is also a minefield since the dependence on federal resources affects their ability to rally community power. But he added that Native CDFIs have the ability to influence development.

“Whereas Tribal governments have significant federal funds flowing through them, and are really the only focus of power because there is a very limited if any private- and non-profit sector operating on Tribal lands, now you have Native CDFIs that are leveraging outside dollars and new sources of capital, not to compete with the tribe, but to augment and provide resources to Tribal members who may not able to get access to those resources through the Tribal government or who are forced to use more predatory providers.”

A Bright Future

Self-determination has been critical to Tribal Nations’ survival, and it is also key to helping them thrive.

Plummer said that, even though legislation enacted by the U.S. government, such as the Native American Housing Assistance and Self Determination Act of 1996 and the Helping Expedite and Advance Responsible Tribal Homeownership Act of 2012, have put pressure on Tribal communities by increasing the need for housing, Native people have responded by learning business and industry and establishing strong Tribal enterprises.

As sovereign nations, Tribes have the ability and the opportunity to leverage community power in transforming Native lands. Partnerships provide a framework for addressing decades of inequity, and Tribal members are defining what those needs are and partners have to let them lead, in order for any collaboration to be successful.

For Us, By Us: Self-Determination and Community Power at the Forefront of Tribal Land Development was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

Around the country, housing and community development groups are increasingly stepping up to partner with residents to improve community well-being by proactively strengthening residents’ emotional and mental health.

By Amanda Abrams

If there were any upsides to the Covid-19 pandemic, one would have to be the increased public awareness of mental health issues that it brought. With so many people simultaneously facing isolation, anxiety, grief and other overwhelming emotions, it became impossible to sweep them under the rug.

It has been recognized that those with means are often able to obtain the care they need to address their emotional struggles. But lower income communities, particularly those that have been historically marginalized, have fewer resources to support their mental health needs. They have less free time and money, reduced access to natural settings, and organizations that assist them have traditionally focused on meeting more tangible needs like food and housing. To further complicate the situation, for some BIPOC communities, acknowledgement of mental health struggles has often been taboo. And importantly, many of those communities are already bearing a disproportionate burden of generational trauma that stems from historic and systemic inequities directed by race and ethnicity.

The leaders of Codman Square Neighborhood Development Corporation, in Dorchester, Massachusetts, are intimately familiar with those challenges. “There have always been mental health issues in our community, but the pandemic certainly exacerbated them,” said Gail Latimore, Codman Square’s executive director. “It’s become more acceptable to acknowledge them, but there are stigma issues that still remain.”

During Covid, the organization partnered with the University of Massachusetts, Boston to offer a regular Zoom meeting focused on mental health and relaxation techniques. The initiative was surprisingly successful, with around 50 people participating, mostly from the surrounding neighborhood.

When the meetings ended in 2022, Latimore and her colleagues realized they needed to find a way to continue to meet residents’ emotional needs. The neighborhood was experiencing increased gun violence that the staff attribute in part to anger and pent-up frustration. The result is the creation of what they’re calling their Anti-Racism Equity Army. The program is composed of two parts: residents learn about the history and context of racism in the U.S., while they are simultaneously provided with strategies and advocacy opportunities to address it.

Cultivating a sense of agency and empowerment can offset some of the harmful impacts of racism, said Marilyn Forman, director of community organizing and resident engagement at Codman Square. “We want them to understand their power and how to use it.”

Environmental factors can deeply impact mental health, too

Around the country, community development groups like Codman Square have been dipping their toes into programs that address residents’ mental health. Some began that work prior to 2020, already noticing an increased need among the populations they worked with. “Before the pandemic, mental health challenges in low-income communities were becoming a recurrent theme,” said Laura Choi, senior vice president of public engagement at the Federal Reserve Bank of San Francisco.

Part of that was a by-product of the increased focus that arose a decade ago among professionals and practitioners on the impact that housing, food, transportation and other needs can have on a person’s health. Those necessities were originally deemed “social determinants of health,” but the list of key needs has since expanded. The Vital Conditions for Well-Being and Justice include not only concrete needs like food and shelter, but also less tangible requirements like meaningful work and a sense of belonging. The widely accepted statistic that 80 percent of a person’s health comes from these non-clinical, environmental factors has led community development professionals to think much more broadly about health and how to improve it.

Mental health is similarly impacted by environmental factors, if not more so. Studies have repeatedly demonstrated a clear causal link in both adults and children between housing affordability struggles, food insecurity, other indicators of poverty, and mental health. A lack of those vital conditions often leads to stress, which can manifest in physical symptoms but also causes problems in itself.

In addition, mental health professionals emphasize that racism itself is a mental health issue. “There are things that many Black people have to contend with that can contribute to mental health conditions or exacerbate them,” said Nicole Cammack, a licensed clinical psychologist and the CEO of the organization Black Mental Wellness. From daily microaggressions to large-scale historic trauma like segregation, as well as ongoing systemic racism, Black communities may experience heightened mental health challenges simply by existing.

Even watching the news can be traumatic, Cammack emphasized. “Witnessing the murders of Black people on television — that can be triggering, leading to nightmares and hypervigilance. If you’re already having a hard time, that can contribute.”

For many working in the housing and community development field, Covid-19 and the racial justice protests following George Floyd’s murder in 2020 made the issues difficult to ignore. Many more groups have incorporated approaches to mental health work in some way. “There’s a lot of interest in how to do this well,” said Choi, who regularly communicates with the communities her institution works with.

It is exciting to see that most of the new approaches use upstream interventions that aim to reduce mental health challenges before they become unmanageable. And many are collaborating with a range of partners — including, importantly, residents themselves.

Romi Hall, director of Healthy Homes and Communities at NeighborWorks America, agreed. Her organization recently surveyed a wide range of housing and community development groups to hear about their post-Covid status. “Mental health is really big on the frontier,” Hall found. But simultaneously, many community development practitioners are wondering, “Where do we go next with this?”

So far, the new approaches fall into a few categories. Some organizations are creating physical spaces or programs that allow people to feel a sense of belonging and safety, two important domains on the Vital Conditions for Well-Being and Justice framework. Others are boosting residents’ services in order to proactively provide more support and contact. And some are overhauling their entire approach to ensure that a focus on mental health pervades everything they do.

Aerika Loyd, a professor of psychology at the University of California at Riverside who focuses on health and development among young people of color, said that community-based approaches like these have some significant strengths. “I think they’re particularly relevant for groups with collectivistic cultures. They can be very powerful.” She pointed out that community groups often have an intimate understanding of residents’ culture, needs, and viewpoints that can complement or even supplant outside interventions. “And people may be more open to it.”

While there are groups that provide clinical options such as counseling, it is exciting to see that most of the new approaches use upstream interventions that aim to reduce mental health challenges before they become unmanageable. And many are collaborating with a range of partners — including, importantly, residents themselves. After all, one thing that has become clear over the past few years is that the best way to meet the needs of people in a community, particularly less tangible needs, is to work directly with them to find solutions.

Creating safe gathering spaces for cultural connection

San Diego’s City Heights neighborhood is home to one of the country’s largest communities of East African refugees. Residents arrived fleeing war, famine and other catastrophes, but many struggled in their new country. In addition to the significant trauma they brought with them, they now lived in an individualistic culture where economic survival was a real challenge.

The community organization United Women of East Africa Support Team (UWEAST) came together specifically to assist fellow residents in navigating services that could meet their health, economic, and educational needs.

Over time, the group’s leaders noticed that young men in the community were hurting. A spate of suicides — rare in their home countries — had occurred, and substance abuse and justice system involvement had become more common. “We were seeing young men in their early 20s using drugs, not going to college, ending up in prison,” Jama Mohamed, a Somalian refugee and UWEAST program coordinator, has said. “We kept having this conversation: what do we need to do?”

In response, UWEAST joined with several other organizations, including Prevention Institute, a national group focused on finding upstream solutions to health-related problems. Prevention Institute’s typical approach to community-level issues is to probe deeply into potential causes. In this case, said Ruben Cantu, an associate program director at the institute, “We coached them through the process of doing a community assessment. We asked, ‘What are the biggest needs? Where is this coming from? What’s driving these needs?’”

The answers revealed that gentrification-related displacement was one of the issues causing real turmoil in the East African community. Spaces that had once served as sanctuaries — mosques, churches, culturally-specific stores and restaurants — were disappearing. Young men in particular had lost their sense of belonging, as well as the physical places where they could connect.

In response, UWEAST, with support from Prevention Institute and other partners, created a local community center. “It’s a place where they can come together to hang out,” said Cantu. There, they can be themselves, learn about behavioral health services, and receive job and leadership training.

“Our long term evaluation is still going on, but in the short term, they’ve been able to build an internal resilience to weather the changes in the community,” said Cantu.

Across the country, another group has come to a similar conclusion about its community’s needs. Virginia Community Voice (VCV), a participant in Build Healthy Places Network’s Community Innovations for Racial Equity Initiative, is an organization focused on Richmond’s traditionally Black neighborhood of Southside. During Covid, VCV was able to provide some funding for families struggling financially, and its leaders gained a glimpse into the deeper trauma many residents were experiencing.

“We really saw how much people were feeling pain,” said Lea Whitehurst-Gibson, VCV’s Executive Director. “It was already there, but it was exacerbated by the pandemic.”

In listening to residents, responding to their needs, and advocating for them, the organization has always inherently promoted community healing. But in the wake of Covid, Whitehurst-Gibson and her staff realized it was time to more explicitly focus on those underlying issues. Through surveys and interviews, Virginia Community Voice staff learned that residents, and particularly seniors, wanted a safe space where they could engage with neighbors.

VCV heard them and is now developing a “healing hub”: a renovated school where residents of all ages can come together and be supported by wellness practitioners. “Our vision is for this to be a community center on steroids,” said Whitehurst-Gibson. She and her staff are envisioning a wide range of therapeutic services provided by partners, including the city’s health department, as well as broader offerings like a community farm.

“Healing-centered transformation means equipping neighbors in historically marginalized communities with the tools to realize their vision for themselves, their children, families and communities.”

The organization is explicitly designing the hub to prioritize racial healing for community residents. “We need a shift from trauma-informed care to healing-centered transformation. This is especially critical in communities of color that need space to heal — not just from the stress of the Covid-19 pandemic, but from centuries of unhealed trauma resulting from racism and oppression,” VCV has written about the project. “Healing-centered transformation means equipping neighbors in historically marginalized communities with the tools to realize their vision for themselves, their children, families and communities.”

Above all, this innovative approach to community health will be a place where residents can connect with one another. “We don’t always want to think about [mental health], but it’s easier if someone’s validating it with you,” said Whitehurst-Gibson.

Residents’ services can meet people where they are

Some community development organizations are taking a more individualized approach to boosting residents’ mental health.

In southwest Ohio, St. Mary Development Corporation is a nonprofit providing affordable housing and services to people over age 55. While the organization has for years prioritized and invested in the Vital Conditions for Well-Being and Justice, even just a decade ago its leaders considered it primarily just an affordable housing developer.

But gradually, in parallel with increased awareness in the broader society, mental health has become an important topic for residents. Today, Executive Director Tim Bete says that 20–25 percent of residents report having mental health or substance abuse issues. In response, St. Mary has increased and refocused the services it provides.

“When residents feel stable and healthy, they’re happier and more successful.” Covid bore that out: despite the major stressors during the pandemic, she said, tenants in buildings with strong residents’ services tended to have better outcomes.

For instance, realizing that isolation was a real danger for many residents, St. Mary’s leaders installed free Wi-Fi throughout most of their communities and taught residents to use hands-free Amazon Echo devices. For those who had formerly been intimidated by computers, the training was revolutionary, particularly during Covid. Residents began asking Alexa to remind them to take their medication at a certain hour, to play their favorite music, to tell them a joke. “They got a big kick out of it,” said Bete. And because they were all learning something new at the same time, he added, “we found that it built personal relationships between residents.”

In 2021, the organization hired a full-time employee to run a wellness program for older adults. The focus is on both physical and mental health, with the understanding that the two deeply affect each other. For example, assistance with their physical mobility allows residents to do more of the activities they enjoy, which directly impacts their mental health. The initiative also offers educational services on stress management, substance abuse, depression, and grief.

And St. Mary provides service coordination to assist residents with general issues that arise, from figuring out how to buy groceries or get to appointments to adapting treasured possessions so that they remain usable. “The service coordinator plays a role that families are used to. It keeps people independent,” said Bete. “It all impacts mental health in one way or another. Otherwise, residents give up.”

While directly quantifying the mental health benefits of service coordination for seniors can be difficult, programs like St. Mary’s have been found to significantly reduce general healthcare costs — in part because of the activities, outings, and overall social support they make possible.

St. Mary is one of 53 affordable housing groups around the country that’s certified by CORES, a rating system indicating the effectiveness of resident services programs that’s administered by the coalition Stewards of Affordable Housing for the Future (SAHF).

Alexandra Nassau-Brownstone, vice president of resident outcomes at SAHF, is in charge of the CORES program. She says she’s seen a growing interest in service coordination among affordable housing providers, both for- and non-profit, as well as in mental health issues more broadly. “I’m hearing about a lot more organizations thinking about how to better support housing stability, and a big piece of that is resident wellness,” she said.

It’s not all altruistic; for-profit housing providers have realized that better services lead to fewer evictions, which ultimately results in cost savings. Regardless of the motive, recipients benefit.

“The pressures of not being able to pay rent, the impact on people’s well-being: that is mental health,” Nassau-Brownstone explained. “When residents feel stable and healthy, they’re happier and more successful.” Covid bore that out: despite the major stressors during the pandemic, she said, tenants in buildings with strong residents’ services tended to have better outcomes.

Resident services are expensive, and organizations often struggle to afford them. Implicitly acknowledging that constraint, Fannie Mae announced its new Healthy Housing Rewards program in 2018. The initiative offers a loan rate discount to developers who incorporate CORES-certified resident services and engagement, or physical amenities deemed health promoting.

While the certification processes can be complicated, participation in the program has grown quickly, demonstrating community development groups’ strong commitment to doing more for residents.

Overhauling the entire approach to put people first

“We had to make a shift. We were losing staff,” said Katsi Miranda-Lozada, director of community engagement at New Kensington Community Development Corporation (NKCDC). She was explaining why the Philadelphia organization decided to make a wholesale change and reorganize itself around a trauma-informed approach.

The phrase “trauma informed” has become popular of late in the community development field. Practitioners say it’s largely because the concept has already been used in healthcare and education for several years and has accrued a body of evidence. Some groups use it and descriptors like “person-centered design” or “resiliency” interchangeably; ultimately, they are all about an outlook that puts people and their experiences first.

Kensington, where NKCDC is based, is a low-income community experiencing very high rates of drug use and violent crime. Several years ago, the group’s leaders realized they needed to do more to acknowledge both the trauma that residents were experiencing, as well as the mental health struggles affecting staff as a result of their work in the neighborhood.

Today, that awareness pervades everything the organization does. “It’s how we deliver services and talk to people about it,” said Miranda-Lozada. When the group works with partners, it often trains them first in its trauma-informed approach. Community health workers take it into account in their interactions with residents. And the organization’s leaders have revamped their hiring policies to give greater weight to people with relevant lived experience.

NKCDC began its shift in 2017, but gradually other organizations have followed suit. Preservation of Affordable Housing (POAH) is a national nonprofit working in 12 states. Over the past few years, the group’s leaders became increasingly interested in identifying obstacles to residents’ success — particularly those caused by the housing group itself.

“We were also learning a lot about trauma-informed care,” explained Julianna Stuart, POAH’s vice president of community impact. “We began to think about how this applied to our organization as a whole: to how we manage, to rules and policies, to building design. What would it mean to reimagine affordable housing through that lens?”

How we feel about ourselves and our future is reflected in our physical health and our ability to build a satisfying life for ourselves and our family.

In 2020, the organization won a $2.5 million award through the Housing Affordability Breakthrough Challenge competition, sponsored by Enterprise Community Partners, to do just that.

Over the course of two years, POAH created a deliberate, collaborative process to examine its operations and how they could be more people-centered. Four teams of residents and staff, each located in areas where the organization has housing developments, met regularly, together with professional facilitators and architects. Team members interviewed those living and working in POAH’s communities, then presented the results for the groups to unpack. Eventually, they devised solutions that could greatly reduce the stress experienced by residents.

For example, why did moving into many of POAH’s properties come with a dense set of requirements implicitly accompanied by the threat of eviction, which invariably increased residents’ anxiety? In response, group members created an orientation video and a process that introduced new residents in a much more welcoming manner.

Or lease violations: “It’s an overutilized tool to manage behavior or respond to challenges at a property,” said Stuart. In the past, residents had been given 10 days to respond to a potential violation. “We said, let’s change it to at least 30 days, and also make it so we don’t give those out so easily.”

The teams took on similar challenges in the physical environment. They identified and upgraded dark corridors, and management offices with walls so thin that no conversation could remain confidential. “How can we improve and promote a sense of safety in those spaces?” Stuart asked rhetorically.

Now POAH is incorporating those results in its properties around the country. The organization recently made all its findings available on its website so that other community development groups can make their properties — and the experience of living in them — safer, healthier, and more equitable. Above all, the group’s goal is to ensure that it isn’t adding more stress to residents who may already be struggling with a significant mental load.

In the end, residents and property owners aren’t the only ones who benefit. It’s a healthcare issue as well. Researchers have known for years that people with unaddressed trauma are at a higher risk for cancer, heart disease, asthma and diabetes. Similarly, having a sense of control over one’s life, and changes in one’s community, is directly correlated with better health outcomes.

In the end, of course, it’s all connected. How we feel about ourselves and our future is reflected in our physical health and our ability to build a satisfying life for ourselves and our family. When we’re left to languish, the costs are borne by a range of actors, including landlords, healthcare institutions, and taxpayers. Organizations’ ability to partner with communities and collaboratively design programs that can address issues before they have snowballed can make a world of difference.

It’s Not Just About the Buildings: How Community Development Organizations are Promoting Residents’… was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

The Biden administration’s “once-in-a-generation” push to revamp U.S. infrastructure keeps people’s well-being at its heart.

Inflation has made it harder for working people to get ahead, and most economists don’t think the pain is going to end anytime soon. The impact has been especially hard on underinvested communities shaped by the impact of systemic racism and historically exclusionary policies. But hope persists, particularly with the bi-partisan Infrastructure Investment and Jobs Act (IIJA), which passed in Nov. 2021.

The law promises to grow the economy “sustainably and equitably,” as well as create 1.5 million jobs on average each year for a decade. However, just how the legislation will address other social determinants of health, such as the built environment, safe housing or transportation, remains an open question.

“Transportation is still a problem for many people, especially younger people,” Lisa Savage, a nurse at The Bridge, a Philadelphia-based nonprofit behavioral health treatment and youth opportunity program for adolescents and their families seeking to overcome substance abuse, mental health issues and other challenges, said. “In the beginning [of the pandemic], the city was giving shuttles to doctors and stuff, and after a while that stuff just stopped. You had politicians saying we gave cities and states billions of dollars but where is the money? What are you doing with the money? What is happening?”

Savage said that the students she cares for at the school have issues which tend to take precedence over health concerns. As a result, some don’t even have the most basic vaccinations they need to attend school, including measles, mumps and rubella. Worse yet, she said, is the sense of hopelessness that many of the students experience.

“You see it with the younger kids: They don’t believe things are worth it or that things can be fixed,” she said. “And the system can only do so much.”

Access to reliable transportation is one of Seven Vital Conditions for Well-Being a project of the Well Being Trust, coordinated with Community Initiatives and ReThink Health, with support by the CDC Foundation. The others include: basic needs for health and safety; humane housing; belonging and civic muscle; meaningful work and wealth; lifelong learning; and creating a thriving natural world.

By using the framework, organizations can begin conceptualizing the conditions needed to ensure that people are healthy. At the same time they can also help in developing a collaborative, multi-sector approach to improving community health by highlighting areas where investment can have the greatest impact and what kinds of investments are needed.

Redressing Historical Transportation Inequity

The Infrastructure Investment and Jobs Act, aims to provide all U.S. residents with access to education, safe transportation options and potable drinking water while simultaneously addressing the effects of climate change and promoting investment in historically underserved communities. Although not stated in the law itself, all of these elements can be expected to have positive impacts on community health outcomes.

One of its signature components is $89.9 billion in guaranteed funding for public transit over the next five years. The money is slated to expand public transit options in all 50 states, improve accessibility for seniors and people with disabilities and replace existing gas-powered vehicles with zero emission options.

The boost in public transit accessibility could be a boon to Savage’s students and their ability to access behavioral health treatment and support their mental health they seek. And, for community leaders such as Leah Shahum, executive director for the Vision Zero Network, the law represents an opportunity to redress years of community divestment and reduce traffic fatalities at the same time.

“I’m really thrilled to see this bill’s focus on recognizing the lack of investment or disinvestment in communities of color and low-income communities,” Shahum said. “This new funding and new direction around policy at the federal level recognizes many past wrongs when it comes to disinvestment. What we’re seeing is the government sending funds to communities that need it most.”

The Vision Zero Network is a collaborative, nonprofit campaign helping communities set and attain the goal of eliminating traffic fatalities and severe injuries among all road users while increasing safe, healthy, equitable mobility.

Shahum added that she is especially encouraged by the $5 billion Safe Streets and Roads for All discretionary program which will provide grants for regional, local, and Tribal initiatives to prevent roadway deaths and serious injuries for five years.

“What we’ve seen is lots of freeways, and a lack of sidewalks and transportation infrastructure that is literally built into our systems,” she said, noting that the concentration of high-speed traffic infrastructure in communities of color and low-income communities leads to more traffic and auto-related fatalities. “For a long time transportation and mobility wasn’t understood as clearly as an important social determinant of health. There’s a very clear one: let’s avoid being hit and killed by cars.”

Shahum added that while Vision Zero can’t apply for funding, it’s possible that it could work with cities or tribal groups in a training capacity in the future. But, for now, the organization is thinking about how it’s using data to support communities that need more funds than others.

“There’s a difference between spreading money equally and equitably and data’s part of the way to get there,” she said. The other part, she added, is through multi-sector collaborations which encourage people to get out of their respective silos. “We’ve got to think of all of this as ‘healthy living’ and I think this bill does.”

Electrifying Central California Communities

Through the IIJA, the federal government will make $7.5 billion available to build a network of 500,000 EV chargers. That infrastructure will accelerate the adoption of EVs, reduce emissions, improve air quality, and ostensibly create manufacturing jobs.

The legislation will also provide funding for deployment of EV chargers along highway corridors to make chagrin more convenient. For Kevin D. Hamilton, co-executive director and co-founder of the Central California Asthma Collaborative (CCAC), EVs are only the first step in advancing equity.

“The infrastructure piece is critical to take worry and stress out of people’s lives but you have to be in communities and available to them in order for them to harness the health benefits,” he said.

The Fresno, Calif.-based community benefit organization (CBO) interprets social determinants of health as “something that brings everything together,” Hamilton added.

There are a multitude of interrelated social and environmental factors that together influence a community’s health outcomes. Hence the importance of cross-sector partners and multi-sector collaborations that can address multiple factors rather than a siloed approach to improving overall community health. With this in mind, CCAC operates multiple programs to improve the lives of residents in low income communities across the San Joaquin Valley including the Clean Vehicle Empowerment Collaborative (CVEC) in partnership with other community-based organizations in the area.

As part of CCAC’s EV Equity Program, the organizations that make up the CVEC — including CBOs such as the Central California Environmental Justice Network (CCJEN), which works to eliminate negative environmental impacts in low income and communities of color in the Central Valley, and the Latino Environmental Advancement and Policy Institute (LEAP) which builds partnerships to promote sustainable development, clean energy alternatives, green jobs and the reduction of pollution and GHGs in concentrated clusters of poverty — collaborate to educate residents about EVs and help them bridge financial gaps to ownership.

At the same time, the organization is working with teams made up of in the central San Joaquin Valley to identify the places where charging infrastructure can be installed and to make sure that communities can use them.

Hamilton said one of the benefits of EVs for communities in the valley and beyond is reliable transportation. He added that the ridesharing model embraced by companies, including Lyft and Uber, don’t work in many rural communities, in part due to the expense. By comparison, an EV is a dependable vehicle with warranties as long as eight years that can sometimes be purchased for less than $30,000 used. This has relevance to health systems seeking to support access to care.

The CCAC operates by empowering local CBOs to operate independently to complement their work. Hamilton said partners can start out as subcontractors on a project and, ultimately, get 30% of the budget for a particular project in order to make sure that they have the capacity to do the work.

“It makes more sense to find out who’s doing work in the community, partner with them and, if capacity is an issue, talk about how to build and help them connect and get more of the good work they’re doing done,” he said.

CCAC is not just focused on transportation infrastructure either.

Hamilton said that, while the IIJA has allocated $50 billion for weatherization and the protection of structures against droughts, heat, floods and wildfires, the lion’s share is focused on commercial buildings. The CCAC, he said, is advocating for the state to put some of the money into home improvements.

Together with the Lawrence Berkeley National Laboratory, CCAC has developed a model and tested a pilot to look at the cost of putting solar on the roofs of houses, service the breaker boxes and weatherize and insulate the structures to make them more energy efficient, Hamilton said.

“We’ve found that if you do all of those things in homes, the cost would be between $40,000 and $45,000, but a family would have no electric bill for most of the year and they’d be healthy inside of the home,” Hamilton said. “It’s not just one piece.” These dynamics could be very advantageous in affordable housing and increasing housing stability, which is one of the vital conditions for well-being.

Hamilton noted that one area CCAC hasn’t been able to get funding for is in community health assessments. He said that the organization is committed to going into communities, talking to families and asking about changes to their health and added that CCAC doesn’t presently have enough data on the actual health benefits that are impacting communities. But, by including members of communities throughout the San Joaquin Valley, it is only a matter of time before CCAC can make good on its goal.

“Change only happens from the bottom up. Not even that: from this space and not this space,” Hamilton said. “It’s got to be from the community for the community to buy in. There has to be a catalyst to help but that doesn’t mean you move in and take over.”

Changing Health Outcomes by Connecting Communities

The digital divide is steep and, in the case of the Covid-19 pandemic, deadly.

In March of this year, University of Chicago researchers published a study in which the lack of internet access was identified as one of factors most consistently associated with a high risk of death from Covid-19 in the US. The researchers estimated that between 2.4 and 6 deaths per 100,000 people in any urban or rural county can be prevented for every 1% of people with internet access.

“Covid was a big demonstration of how having broadband gave you faster access to vaccinations, and testing,” Heather Gate, executive vice president of digital inclusion at the Bowling Green, Ky.-based nonprofit Connected Nation, said. “There’s a core relationship between access to healthcare services, info, how quickly reserve appointments. If you don’t have access you’re already a step behind.” This has implications for health well beyond the Covid-19 pandemic.

Many Black and Brown people in the U.S. are being kept behind. According to data from the National Telecommunications and Information Administration, roughly 77% of Black and Latinx adults report having broadband internet at home in 2021, compared to 82% of white adults. On tribal lands, only 49% of residents have fixed home internet service.

Part of the reason for this is that, generally, private internet service providers only set up broadband internet in markets where there is more demand, such as high-income areas, and where the cost of wiring is offset by profits. As a result, low-income communities and those dominated by Black and Brown people often have fewer, and more expensive, options for broadband access than their wealthier white counterparts.

According to the White House, more than 30 million people in the U.S. lack access to broadband internet. While the IIJA has allocated $65 billion for broadband deployment and for the reduction of internet service fees, Gates maintained that a critical part of the law’s success lies in how state offices engage with communities.

“A signature part of the requirement is for state agencies to collect information from people through listening sessions and engage with community-anchoring institutions,” She said. “If they want to succeed, they have to make sure that the communities in each state are represented.”

Gate said that, in addition to the infrastructure challenges involved in reducing the digital divide, state officials and stakeholders also have to address affordability, training and internet safety challenges. She added that it is crucial to have internet service providers and practitioners at the same table because the goal is to connect the state and local government, law enforcement, education and healthcare providers with the people they serve. Some might point out that this is a great opportunity for the kind of work across sectors that many have been preaching over the last decade, that impacts health outside of clinical walls.

Connected Nation develops and provides states and communities with the tools, resources, and methods necessary to help create and implement solutions to their broadband and digital technology gaps. Gates said that the organization sees itself as a representative for historically disenfranchised stakeholders including children from low-income households, seniors, people of color and rural communities.

Although the organization could potentially work for a city or community by drafting a broadband map, providing a template for community broadband, job and skill training and digital inclusion programming, its primary function is to bring local communities together to speak for themselves, centering that important community voice.

“Our role is to provide support,” Gate said. “We meet people where they are and get them from one place to another where they’re meaningfully adopting technology, because everybody belongs in a connected nation.”

More Support Needed

The Infrastructure and Jobs Act could be a game changer for communities of color but, just because there’s billions in federal funds available doesn’t mean that communities in need necessarily have an easy time accessing them. Structural barriers from decades of disinvestment can derail efforts.

“Part of helping them [communities] get access is not just making sure people know what’s available but having people there to help them get through the process of raising money,” Hamilton said. “You think: ‘How can anyone get through this when English isn’t their first language or they had to drop out of school in the sixth grade to take care of their families?’”

According to data from Enterprise Community Partners, many CBOs are generally undercapitalized, with a mean operating budget of $280,000 per year. Moreover, they tend to be grossly understaffed compared to the private sector, requiring many to rely on volunteers to support critical programming and operational needs.

These factors can make navigating the federal grant application process extremely difficult for CBOs but community development financial institutions (CDFIs) can make a difference in getting projects focused on the social determinants of health over the line.

“In many cases, CDFI funding can serve as a bridge to a large capital provider with whom they may already have a relationship,” Seth Julyan, executive vice president, network services at Opportunity Finance Network said. “It’s important to have as many options available for funding, and CDFIs can play a role in that.”

Julyan noted that, unlike more traditional financing sources such as banks, CDFIs are unique in that they are mindful of how their lending and blends with the needs of communities. One example he highlighted is the Invest Health collaboration between the Reinvestment Fund, a Philadelphia-based CDFI and the Robert Wood Johnson Foundation, which brought leaders from multiple sectors together to address social determinants of health in 50 mid-sized cities from 2016 until 2018.

“That’s a really good example of how a CDFI thinks about the impact it can make on a community level,” Julyan said. “It’s not just based on a set of assumptions: It’s more thoughtful and intentional.”

These kinds of CDFI investments have direct impacts on the factors that influence community health. But, the ability to identify specific areas of inequality depends on the availability of information generated from multiple forms of data, including qualitative data representing the stories and experiences of communities facing inequities.

Healthcare partners in multi-sector partnerships can make their own community-level, de-identified data available to planners, community leaders, and decision-makers. Information, however, generated from multiple forms of data, including qualitative data representing the stories and experiences of communities facing inequities, is critical for identifying specific areas to invest in.

Community residents are key to ensuring the relevance of a data-informed policy. CBOs, who have strong ties to their communities, are well positioned to engage residents in a participatory data collection process that will ensure the data will inform investments that are aligned with community needs and priorities. Involving them in every step, from developing survey questions and analyzing the resulting data, ensures that investments are aligned with community needs and priorities.

Although CDFIs can help CBOs make connections with funding sources and build relationships with organizations in other sectors such as health, locating ones with a particular bent toward the infrastructure projects outlined in the Infrastructure and Jobs Act can be challenging for some.

“How to find CDFIs with a track record of providing financing for infrastructure projects is an area where there is room for improvement. In some ways they’re not being seen or thought about [by CBOs],” Julyan said.

He added that, while CBO’s can reach out to organizations such as LISC or use the OFN’s CDFI Locator to find a CDFI appropriate for a given project, a little elbow grease can also make a difference.

One way to locate them is to “literally try to Google ‘CDFI’ and the location, or a particular project, and see what pops up.”

The Build Healthy Places Network links community development, finance, public health, and healthcare, positioning partnerships between these sectors to reduce poverty, improve health, and advance racial equity. Organizations interested in multi-sector partnerships can start by using our partner finder.

The Infrastructure and Jobs Act has made an unprecedented amount of money available to address the social determinants of health through infrastructure. Community organizations, community development corporations and healthcare partners can seize this moment to funnel that money into communities through partnerships across sectors.

Finding Health in the Infrastructure Law: New Opportunities for Community Investments that Address… was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

The current housing crisis has been decades in the making. The U.S. reportedly has a deficit of 3.8 million homes, with the greatest supply shortages at low-income price points.

Joseph Flahie, an ICU nurse at Jackson Memorial Hospital in Miami-Dade County, Florida had seen food and gas prices ticking up during the pandemic, but inflation literally hit home when his landlord raised the rent on his apartment by nearly 40%, from $1,725 a month to $2,400.

“We heard of some landlords doubling or significantly raising rents, but never thought we would be upended. Until we were,” he wrote in an op-ed published in The Miami-Herald.

Flahie and his wife, who is also a nurse, had no option but to move out of their apartment in downtown Miami with their two children. Now, instead of being five minutes away from the hospital he commutes one hour each way.

“While my family likes having more space, and the affordability is better, the additional time away from them is hard,” Flahie wrote.

Many reports focus on the lack of affordable housing in cities with large populations such as New York, Los Angeles and San Francisco, but it is clear that the housing crisis is also affecting healthcare access in rural communities.

“To provide the care needed by the people in our communities we rely on having a vibrant, regional workforce,” Carolyn Isabelle, director of workforce development at Dartmouth Health said. “In New Hampshire we are experiencing a significant shortage of housing inventory which is driving the price of available housing up to a point that is unaffordable for most.”

Isabelle noted that, over the past few years, Dartmouth Health has seen an increase in the number of people accepting jobs and then withdrawing their acceptance because they couldn’t find affordable housing within a reasonable distance to work. Moreover, many of the system’s employees live up to an hour away from the center, which adds complexity and cost to their daily lives, while reducing the system’s ability to provide medical care for the community.

“Recognizing the workforce barriers that the housing shortage presented, we knew we needed to take action immediately and also be involved in the short and long-term solution at the regional and state levels,” Isabelle said.

Dartmouth Health is one of a growing number of hospital systems working to address the social determinants of health (SDOH) by providing housing for its employees. Together with Citizens Bank, Hanover Co-op, Hypertherm, King Arthur Baking Co. and other local employers, the healthcare system has launched a $10 million fund which will enable developers to build apartment buildings targeted at renters with moderate incomes through low-interest loans.

The Upper Valley Loan Fund will help finance the construction of 260 apartment units in Lebanon, where Dartmouth Health is located, specifically for households that can afford rents between $1,200 and $1,600 per month in an area where rents range between $1,500 and $2,200 per month.

Dartmouth Health and its partners will receive a 1.5% return on capital with a maturity of 15 years, which will lower the cost of development and allow the savings to be passed along to renters in the form of lower rental rates. Evernorth, a Burlington-based nonprofit that facilitates financing for moderate-income housing projects in northern New England, will manage the fund and work with developers.

Gregory Norman, director of community health for Dartmouth Health said that, through the housing fund, the healthcare center can provide first-tier capital for workforce housing, minimizing the risks associated with development. With the capital in place, developers are better able to obtain additional funding from a bank, CDFI or housing development corporation.

Norman added that Dartmouth Health’s investment is a signal to its partners that the health center is creating capacity for different kinds of housing in the area.

The lender, Evernorth, designed and formed the Upper Valley Loan Fund, and will be responsible for implementing it. Deb Flannery, vice president-lending said the firm leveraged its existing relationships with the likes of Dartmouth Health and Dartmouth College and also built new ones in order to create the fund.

“Cross-sector collaborations help address systems fragmentation,” Flannery said, adding that, when programs are developed in silos, they can be less responsive. “By engaging across sectors we draw on the knowledge and perspectives from a broader group of stakeholders and identify opportunities for future collaborations. It creates relationships that can open doors, and the more we engage in these dialogues and cross-sector work, the better we will all be in serving our missions.”

Nancy Owens, co-president, noted that cross-sector collaboration is an exercise in ‘systems thinking,’ or looking at the world in terms of relationships rather than separate parts.

“We have these complex problems we’re dealing with and they require attention from an array of perspectives,” she said. “We need to collaborate to achieve this.”

The Rebirth of Workforce Housing

The term “workforce housing” has long been used to describe programs for households that earn too much to qualify for traditional affordable housing subsidies; usually between 80% and 120% of the median household income in a given area. However, the need for affordable housing has become so great that even giant technology companies such as Facebook, Google, Microsoft, and the Chan-Zuckerburg Initiative have pledged as much as $1 billion in funding to help build more middle-income housing close to their corporate headquarters.

Some public sector leaders have also turned to workforce housing initiatives to address the housing shortage in their jurisdictions as well. Washington, D.C. Mayor Muriel Bowser had, in 2019, proposed the establishment of a $20 million Workforce Housing Fund to help subsidize housing for city employees and working families. However, the city council opted to replace the fund with a $2.8 million tax abatement for private developers, allowing them to set their own affordable housing policies without local government intervention.

In rural communities, lack of access to vast sums of money or the assistance of high-profile political influencers, can contribute to significantly more difficulty providing accessible and affordable rental units for the people who live there. Moreover, the USDA’s Section 515 Rural Rental Housing Loan Program established to finance affordable rental homes in rural areas has been effectively defunded, leaving rural communities without the means to attract private-sector capital and other federal resources.

According to the National Low Income Housing Coalition, no rural rental homes have been built under the Section 515 program since 2012, leaving rural healthcare centers at a loss for attracting workers at all levels.

“The challenge in terms of finding housing runs from CNAs all the way to the CFO,” Marie Barry, director of community economic development at the Rural Wisconsin Health Cooperative, said. “When most medical school students graduate, rural Wisconsin is not the first place they’re looking at, so it’s an uphill battle to recruit clinicians into the community.”

Ninety-six percent of rural hospitals surveyed by the Chartis Group said they were having trouble filling nursing jobs, and more than one-third said they hadn’t been able to admit patients for as many as 60 days due to a lack of nursing staff. But healthcare providers are finding that multi-sector partnerships can make a difference.

The Impact of Collaboration

More than 1,000 miles west of Dartmouth Health, in Dane County, Wisconsin, a consortium of investors including local businesses and UW Health have been working to build 500 low-cost housing units in the county and maintain their affordability for at least 15 years.

Since its establishment in 2020, the Dane Workforce Housing Fund has loaned $2.9 million to two projects in the micropolitan cities of Fitchburg and Middleton and $1.3 million to two projects in Mount Horeb and Waunakee to support $57 million in affordable housing development. Of the 256 housing units developed, 241 are expressly for those making 80% or less of the county’s average income.

The fund, which invests in projects where the developer is unable to secure the necessary cash, equity or debt for subsidized units in a given project, is slated to initiate a second round of funding later this year or in early 2023.

Juli Aulik, community relations director at UW Health said “The value of the multi-sector partnership has been in attracting sufficient investment, creating a shared understanding of issues and ways to address them, attracting professionals with skills to advise on investments, and building relationships that continue into other aspects of community and economic development.”

“Recognizing our limited experience, the biggest challenge would seem to be the leadership to attract, secure, and retain multi-sector participation,” Aulik said. “We have been fortunate to have that leadership which has enabled our local effort to succeed.”

Barry noted that most of the rural housing development work that their cooperative has been a part of has involved local government partners, business leaders, public health departments and local economic development leaders. She added that the keys to the success of such partnerships in rural areas lie in the connections people have to one another and the sense of a shared purpose.

“I think healthcare organizations are more territorial in urban communities. There’s less incentive to collaborate and more capacity in institutions,” she said. “For rural healthcare organizations it’s the opposite: there are fewer resources and players present so collaborations aren’t optional; they’re necessary and part of the fabric of the community.”

Advancing Equity

It’s easy to look at workforce housing from a purely economic perspective but, at its heart, housing affordability is about health, no matter what the geographical location. A large body of research suggests that up to 80% of what is understood as “being healthy” is determined by what people eat, where they live and how much money they make. These social determinants of health are just as important for the people who keep hospitals running as they are for the communities they serve.

“Housing is a major multiplier of stress,” Norman said, noting that entry-level workers and those with front-line jobs experience the highest levels of economic burden and barriers to accessing services. “There’s a direct correlation to the burden of social determinants of health as you move further from where healthcare sits.”

Isabelle said that while Dartmouth Health is trying to address access to inventory and affordability through its housing program, the healthcare provider’s ultimate goal is to try to ease some of the stress that comes with relocation, better understand what is needed by its employees and layer support and services where they can.

She added that Dartmouth Health has made progress over the last 18 months in understanding and addressing its workforce housing needs, but that it has been incremental in the face of a wider problem.

Gretchen West, executive director of Healthy Homes at Nationwide Children’s Hospital in Columbus, Ohio, said that structural racism continues to impact the development of workforce housing in her community and, by extension, the social determinants of health for the people who live there. She noted that her work is focused primarily on the south side of Columbus and Linden, which are both predominantly Black communities.

“When we think about the south side, the reason why the foreclosure crisis hit so hard, a lot of it is based on race,” she said. “After a decade, digging out of 70 years of structural racism isn’t going to happen overnight. It’s been baked in over such a long time that, even though close to $40 million has been invested, I sometimes feel like we’re at the tip of the iceberg.”

“Things are harder a lot of the time, but it’s not insurmountable,” West added. “The work is complicated, nuanced and always changing.”

One such change, shared by Barry, has to do with health departments and coalitions’ newfound willingness to look at the health of the entire community, including social determinants of health such as housing, when drafting health improvement plans. Although she acknowledged the difficulties involved in expanding considerations of community health beyond factors such as behavioral health, drug addiction and obesity, she said that having a multi-sector coalition willing to take on an unfamiliar and challenging issue in the community is encouraging.

“For a local, health-led coalition to say ‘The community has said housing is a health need and we’re going to work on it’ definitely demonstrates an evolution in how communities and healthcare providers think about health,” she said. “It’s different from what they’ve done and shows a growth in understanding the linkages between social determinants and health outcomes. That’s a wonderful sign.”

The Power of Partnerships: Solving a Challenge for Healthcare was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

As an undocumented immigrant growing up on Chicago’s West Side, Jeisson Apolo and his mother were at the mercy of their landlord. “He saw the fear in our eyes and took advantage of it,” Jeisson said. “He raised the rent every month.”

Jeisson, 28, promised himself he’d never live like that again. After graduating from Cornell with a degree in architecture and another in urban planning, he wanted to sink some roots and buy a home. But in Richmond, Va., where he’d moved after college, prices were already beyond reach.

“Even though I did everything to escape poverty I didn’t do it fast enough,” he said of the ever-rising housing prices in the city.

On a lark, his real estate agent discovered the Maggie Walker Community Land Trust. Homes purchased from a land trust come with lower price tags because the land is owned by the Trust while the buyer purchases the building. In this case, roughly 50 percent lower. For Jeisson, that meant he could afford a two-bedroom home in the Randolph area, a historically Black middle-class neighborhood close to downtown. He also agrees to a cap on profits should he choose to sell, which helps keep the home affordable in perpetuity.

“It’s wild how much they helped me to get to the point where I finally had a key in my hand,” he said, including subsidizing the down payment and closing costs and helping secure a property tax freeze. “I’m deeply grateful.” Jeisson has been a homeowner for three years, and sits on the CLT’s board as a resident voice.

The benefits of homeownership go beyond wealth-building. Being both a homeowner and a board member creates a renewed sense of agency and belonging.

The benefits of homeownership go beyond wealth-building. Being both a homeowner and a board member gives Jeisson a renewed sense of agency and belonging, he said. He enjoys seeing others’ dreams come to life as they become homeowners too, and he finds it gratifying to work on large cultural issues, like the systemic barriers to homeownership for African Americans and others. He’s also meeting his neighbors and hosting get-togethers for owners.

He’s even planted three redbud saplings in front of his home, which he now gets to watch grow. “I didn’t think those scrawny trees would impact me this much. It’s great to know I’m making a literal impact on my neighborhood by providing shade for people.”

The future impact doesn’t escape him. “Every single day I’m living in something that is an actual asset to me, that I can pass down to my kids,” he said.

“Every single day I’m living in something that is an actual asset to me, that I can pass down to my kids,”

That kind of social connection and sense of a future — which trickles down to better health and well-being — is one reason, and perhaps the reason, why health systems like Richmond’s Bon Secours are investing in community-owned and managed land trusts.

“That direct sense of personal and collective agency means less stress and more hope,” said Dr. Geoff Gusoff, a research fellow and family physician at UCLA studying community’s impact on health, with well-documented long-term positive impacts on health.

The benefits of land trusts for health systems

Bon Secours was the first investor in the Maggie Walker Community Land Trust in 2016, and has stayed with them ever since. Addressing the social determinants of health that keep their patients healthy meant making sure their homes and neighborhoods were safe and affordable. Becky Clay Christensen, executive director of community health for Bon Secours, said that meant not inadvertently contributing to rising home costs in neighborhoods with every subsequent home rehab and sale they did, as had happened in some of their initial housing projects. That’s not the case with land trusts, she added, which keep homes affordable for the long run by design.

Addressing the social determinants of health that keep Bon Secours’ patients healthy meant making sure their homes and neighborhoods were safe and affordable.

Another benefit for hospitals is that the land trust handles all the transactions and management, a burden the health system didn’t want to undertake, said Clay Christensen. “There was no reason for us to build competency as home builders. We’re in the health business, and we are fortunate to work in a community with several nonprofit developers who deliver quality housing, ” she said.

Bon Secours’ initial $250,000 investment in the land trust was used to spur others to invest, Clay Christensen said. It worked. To date, other donors have committed more than $5 million to the projects, in part because of the reputation and heft of a large institution like Bon Secours throwing in their hat. The land trust had constructed 50 owner-occupied homes as of January 2021, with plans for 50 more in the next two years.

In addition to the Land Trust investment, Bon Secours has contributed $660,000 in grant funds as gap financing for more than 46 homes (not all in the land trust). Its parent health system has created a $250,000 PRI loan fund that has been used in 10 homes, recycling approximately $100,000 per home each time.

Gaining the trust of the community

Because in any land trust purchase, the land beneath the home remains in the hands of the land trust and not the homeowner, many people in lower-income brackets — and African Americans in particular — remain suspicious. For African Americans, the prospect of not owning the land harkens back to the era of contract for deeds, “a predatory agreement that combined all the responsibilities of homeownership with all the disadvantages of renting — while offering the benefits of neither,” as Ta-Nehisi Coates wrote in the Atlantic.

“Distrust is prevalent in African American communities,” said Clay Christensen. “Government has taken houses away from people. That’s real. That happened. So now when others talk about a land trust — having the land belong to someone else — that rightly raises suspicions and doubts.” She added that land trusts present an opportunity to change the narrative to one of wealth building and preserving land ownership opportunities for those previously shut out of traditional financing.

The first land trust helped rural Black farmers secure their land in the face of predatory lending.

Yet land trusts themselves have their roots in the Civil Rights movement, which can be a helpful reminder, said Gusoff. The first land trust helped rural Black farmers secure their land in 1969 in the face of predatory lending. Today, there are approximately 225 community land trusts in the U.S.

Earning trust, regardless of one’s background, is neither quick nor easy, said Clay Christensen. You earn it the hard way, by doing what you say you’ll do and by engaging authentically with community residents with openness and transparency, she said.

“It’s a slower process,” she said of engaging with the community in an authentic way, but worth it. “Finding ways to listen to people you serve is critical and it’s never done, never complete.”

You earn trust the hard way, by doing what you say you’ll do and by engaging authentically with community residents with openness and transparency.

In Columbus, Ohio, Nationwide Children’s Hospital knows how long it can take to build authentic relationships with community members. For more than a decade, Nationwide has used a collaborative model to fuel its Healthy Neighborhoods / Healthy Families initiative, and especially its core housing improvement and construction program, Healthy Homes.

Though not in a land trust arrangement, since 2008 the initiative has built or rehabbed 450 homes, along with numerous neighborhood beautification efforts, wellness programs, work-readiness programs, and more — all through community partnerships.

Key to its success is the strong neighborhood connection they have forged via Community Development for All People, a local nonprofit organization headed by Rev. John Edgar. His organization works as the liaison between community members and the hospital, shuttling information between the two and making sure the lines of communication are kept open.

Listening to the community, he said, is not a one-off deal, and there is no “representative voice” for a group.

“It’s absurd to believe that one person will speak for every Black person in the community or every woman or every transgender person,” Edgar said. “There’s no way that one voice can ever authentically represent a collective of people. So we are never trying to pretend that we know what the community wants, as if that’s a single, monolithic thing.”

“There’s no way that one voice can ever authentically represent a collective of people. So we are never trying to pretend that we know what the community wants, as if that’s a single, monolithic thing.”

It’s important, he said, to just keep listening, and to keep building relationships of trust on both sides — and not in six months, but over years sometimes.

“What we think we do well is listen to lots of voices and dreams and aspirations and then attempt to distill and offer it as the mosaic.”

Edgar also meets weekly with Dr. Kelly Kelleher at Nationwide Children’s Hospital to “talk and dream about where we are and where we want to go next,” he said. Hospital leadership sits on the nonprofit’s housing board, and vice versa, so the work becomes organic to each organization’s mission.

Edgar said it is through these ongoing involvements that shared core values will emerge, and that is where the magic happens. In the hospital’s case, their core values were addressing social determinants of health, and that fits with the neighborhood’s core values of creating more opportunities for their families. And it fits Rev. Edgar’s faith-based mission to“build the front porch of the Kingdom of God,” or the notion that “we can do things right now that get us closer to what it looks like to live in harmony.”

Getting creative in Boise

Across the country in Boise, Idaho, Saint Alphonsus Regional Medical Center is also investing in community-owned land trusts as housing needs skyrocket. Boise has seen double-digit home price increases for the past several years, with median home values topping $550,000 seemingly overnight and rents on the rise as vacancy rates plummet.

Lack of affordable housing is the number one issue in Saint Alphonsus’ health needs assessment and other surveys, said Rebecca Lemmons, regional director of the Community Health and Well-Being division at the health system.

“We can’t be the only investor in these things. You need a lot of folks at the table to make it work.”

Like Bon Secours in Richmond, Saint Alphonsus was the first investor in the LEAP Housing Land Trust, which broke ground on the first of 14 homes in 2020 in the Caritas Commons development. And like Bon Secours, Saint Alphonsus’ $240,000 commitment for six initial sites would jumpstart others, culminating with the Blue Cross Foundation, for a total of $2.1 million, according to LEAP’s website.

That leverage remains important to seeing projects through to the end. “We can’t be the only investor in these things,” said Lemmons. “You need a lot of folks at the table to make it work.”

Saint Alphonsus was drawn to the community land trust for several reasons, first and foremost the connection of housing to health, but also because the trust is working with a local builder, indieDwell, to convert shipping containers into four-bedroom, single-family homes that can be built on smaller parcels as a way to both lower costs and create eco-friendly residences.

The 14 homes in the first development will sell for about $212,000 to households earning 80 percent of area median income or less. All will be laid out in such a way as to foster a sense of community and social connection, said Lemmons.

That social cohesion, said Dr. Gusoff, the UCLA fellow, will likely have a spillover effect on health. Working with other people on shared goals has positive effects, he said, from greater longevity in older people to fewer stress-related conditions stemming from financial hardship.

An affordable future

Both Bon Secours and Saint Alphonsus are excited about prospects for land trusts in making more homes more affordable for more people in their cities. Both agree that the investments spark others to invest, leveraging the initial money into much, much more.

For Jeisson Apolo, homeownership has meant many things, from the freedom to paint a room whatever color he wants to the ability to build equity. He knows he’s lucky that the land trust has supported him, he said, because coming from a poor family, “we don’t know how anything like that works.” The ins and outs of homeownership, he said, are “a giant invisibility for people like us.”

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Community-Owned Land Trusts Catch Hospitals’ Eye was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

For many of us, the global lockdowns stemming from the COVID-19 pandemic have made our homes places of respite, healing, and renewal. But for many others, including the unhoused, “home” is not always healing and can in fact be just the opposite.

Shari Stratton knows that all too well. For her, “home” meant a constant threat of domestic violence. When she eventually left, she had nowhere to turn until she found Arroyo Village, a supportive housing complex in Denver designed for those with traumatic histories. In a written profile on the Arroyo site, she said Arroyo Village was giving her a chance to heal. Before finding Arroyo Village, she had stayed with friends and had applied for a shelter. When she was told she’d been assigned an apartment in Arroyo Village, she’d worried at first that apartment living would be loud, a trigger for her Traumatic Stress Disorder. But that would not be a problem it turned out.

“The apartments are really soundproof and it’s a secure, safe place to live,” she wrote. The apartments were soundproofed by design in fact, along with other design elements to promote healing. The growing awareness of the impact of the built environment on our health is one reason for the growth of trauma-informed design — design that includes adaptations to support a strengths-based framework based in an understanding of, and responsiveness to, the impact of trauma.

Sandra Serna, vice-president health and housing at Stewards of Affordable Housing for the Future (SAHF), said that the COVID-19 pandemic put a spotlight on the importance of home as a safe and health-protecting haven.

“Substandard housing — places that are overcrowded, dark, confining, poorly ventilated, or without access to social support — really highlight the negative impact poor-quality indoor environments can have on health,” she added.

“Places don’t feel great and you know why: they’re dark, they’re not connected to the environment, and they don’t have a lot of options for living.”

Chad Holtzinger, president of the Denver-based architecture firm Shopworks Architecture, sees this connection of housing to physical and mental health in his daily work. “Places don’t feel great and you know why: they’re dark, they’re not connected to the environment, and they don’t have a lot of options for living. It looks great from the outside, but when you walk in, the space looks gross and you can’t put your finger on what’s wrong. We’re trying to put our finger on it by saying: ‘Here are those spaces that promote feelings of well-being and connection to the environment, that speak to the quality of life.’”

Denver’s Arroyo Village, a 60-bed homeless shelter that also includes 35 units of low-income permanent supportive housing and 95 units of affordable housing for individuals and families, is one of those spaces.

Stephanie Miller, CEO of the Delores Project, which manages Arroyo Village in partnership with Rocky Mountain Communities, said that in Denver, the pandemic has brought seven to eight other shelters together to help open auxiliary shelters. Moreover, the city’s push to incorporate trauma-informed design principles has begun to change how spaces are considered.

“We used to be one of the few shelters in Denver that was trauma-informed, but the pandemic has helped shift the culture, the mindset, and the innovation frameworks to intentional, housing-first, strength-based interventions that give as much choice and autonomy to individuals,’’ Miller said. She added that the city is investing in 13 affordable housing projects in its development pipeline, which will produce 1,021 units of affordable housing, including a 75-bed medical respite community.

Whose Trauma Gets Addressed?

Trauma-informed practices have been, and remain, firmly rooted in design, although Black, Brown, and Indigenous people have not historically benefited from the practice.

The murders of George Floyd and Breonna Taylor, and the health disparities highlighted by the COVID-19 pandemic, have shown the degree to which race-based violence and discrimination underpin U.S. policy. This discrimination has been mirrored in housing policies, including redlining, that continue to have traumatic effects on people of color.

“In so many ways trauma-informed approaches have been for the benefit of a particular class or focus, situated in power,” said Abdul-Qadir Islam, a scholar at Columbia University’s Teachers College. “In the broader scheme, as we think about people learning, and how people engage with the spaces in the world around them, much of it is centered around the white upper class that have access to resources to address their trauma.”

“The systems that are operating in this country now are not listening to trauma-informed practices because they don’t accept that trauma is significant enough to affect their lives, or those of marginalized people.”

Researchers Lillian Comas-Diaz, Gordon Nagayama Hall, and Helen Neville have determined that the symptoms of racial trauma, such as fatigue, lack of focus, hypervigilance, avoidance, suspiciousness, headaches, and heart palpitations, are among those clinically outlined for diagnosing Post-Trauatic Stress Disorder (PTSD). But unlike PTSD, which is linked to a particular experience or series of experiences, racial trauma is marked by continuous direct and indirect exposure to race-based stress, which has a traumatic effect on society as a whole.

Holtzinger, whose firm Shopworks Architecture designed Arroyo Village, said that the organization’s work has been informed by training that shows a link between adverse childhood experiences and brain development. He added that as a result, Shopworks began thinking about ways the built environment can be welcoming, feel safe, and help with the repair and healing of the brain and the prefrontal cortex.

Designing for Trauma

That consideration, according to Miller, was key in creating trauma-informed spaces at Arroyo Village.

One trauma-informed consideration is the stairways. Having substantial lighting, cut-out windows, and corridors that are larger than normal highlight interrelationships that enable people to feel comfortable and safe in a building at any time, Miller said.

“Trauma-informed design for any community would have to look at the space and environment, as well as the structural design and space in terms of landscaping, such as the addition of exterior fences and light fixtures. You can translate that to the community, making sure there’s enough open space and choices in space for residents.”

Serna also noted that the Sanderson Apartments in Denver, which opened in 2017, have provided developers and property managers with a model for implementing trauma-informed practices in affordable housing. For the design, Davis Partnership Architects, in collaboration with the Mental Health Center of Denver, sought to include design principles beneficial to health and well-being, including elements such as green space and natural light, Serna said.

“A lot of work went into making sure there were design elements that facilitated safety and belonging,” she said. “Some residents have said: ‘This is the first space I’ve been in that’s felt safe and welcoming.’”

Serna said that including ​residents’ needs and ideas in the design sends the message that “This is for you: This is your home.” She added that, while such examples are anecdotal, the benefits a thoughtful, well-designed space can have “can’t be underestimated.”

“Some residents have said: ‘This is the first space I’ve been in that’s felt safe and welcoming.’”

Quality of life has become all the more important in the wake of COVID-19. As Black, Brown, and Indigenous people in the U.S. increasingly question and criticize systems that support inequality — including the criminal justice and financial systems — there are some who maintain that the institutionalization of trauma-informed principles is necessary to address rapidly shifting demographics.

“Many corporations, industries, and other stakeholders are now interested in trauma-informed principles and redress for larger swaths of the population, because the majority of that population is now turning racially and culturally diverse in ways that power holders now have to address in order to continue to hold power,” Islam said. “People are saying enough is enough.”

The Way Forward: Residents’ Voice

The key to implementing trauma-informed design practices in community development, and expanding them to heal communities, is talking to residents.

CommonBond Communities, a member of Stewards of Affordable Housing for the Future, hired a behavioral consultant to work with staff and residents to determine where they feel comfortable talking about their experiences and how they continue to be shaped by them. CommonBond did this with the understanding that mental wellness is a priority for residents and staff. Moreover, Holtzinger says, the experiences of people who have not been housed must be paramount in creating spaces that are conducive to healing.

At the same time, Islam noted that such conversations need to be expanded dramatically in order to redress white supremacy.

The key to implementing trauma-informed design practices in community development, and expanding them to heal communities, is talking to residents.

“In the U.S. system, there exist noticeable traumas toward marginalized bodies over generations. If that trauma is to be informed, we have to listen to each other,” Islam said. “The systems that are operating in this country now are not listening to trauma-informed practices because they don’t accept that trauma is significant enough to affect their lives, or those of marginalized people.”

Serna noted that Including residents in the design of the space sends a message that it is a home in which every resident has a stake. She added that, beyond just a roof, the building is also a hub to connect residents to other things that help them to thrive. The effort to connect residents and help form a larger, interrelated community beyond a particular development has led to the exploration of ways in which people can begin to address their trauma collectively and heal.

Islam maintains that it is imperative that Black, Brown, and Indigenous people realize that they have power, and that their agency is connected to power in the community. A welcoming space designed to acknowledge and address ongoing racial trauma, can empower communities and provide a context for newcomers so they can begin to understand the communities they enter.

Spaces that welcome us and affirm our shared experiences are as vital for healing as any medicine.

Having endured the COVID-19 lockdowns, and now, mutating strains of the virus, the principles inherent in trauma-informed design — safety, acceptance, and empathy — have an added resonance. The fear and uncertainty caused by the pandemic is universal, and our collective need to address that, and other traumas, is undeniable. But, if there’s any lesson that can be taken from the events of the last 18 months, it is that spaces that welcome us and affirm our shared experiences, are as vital for healing as any medicine.

Anti-Racism Sparks Movement for Trauma-Informed Design was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.

The impending construction of the Obama Presidential Center in Chicago’s Woodlawn neighborhood comes with the promise of reinvigorating the community. A 2019 community benefits ordinance has mandated that the City and developers build with an awareness that their work benefit the existing community. New thinking on the ability of community benefits agreements (CBA) to leverage residents’ power could make the difference in creating generational wealth, expanding homeownership, and giving people a stake in how their neighborhood grows amid gentrification.

But there’s distrust around the proposed $500 million institution owing to a long history of efforts to push Black people off prime real estate in city centers.

Woodlawn is a two-square-mile neighborhood just west of Lake Michigan on Chicago’s South Side. Adjacent to the University of Chicago, with its long and controversial history of Southside urban renewal, the community of roughly 23,000 is more than 80 percent Black and has been shrinking since 1970.

“Displacement has already happened. There has been a population loss, so the concern is how to retard the decline, how to make it a neighborhood of choice.”

So when President Barack Obama, a former University of Chicago Law School professor who once lived in neighboring Hyde Park, announced in 2016 that his presidential library would be located in Woodlawn, the news captured widespread attention.

Although, for some, it only brought concern of further displacement and cultural loss.

“There are 102 acres of vacant land in Woodlawn, about half of it owned by the City — and over 200 acres of vacant land in the surrounding region,” said Ghian Foreman, CEO of Emerald South, an economic development nonprofit formed in response to the Obama Center to ensure that Woodlawn can grow in a smart, resilient way.

“Displacement has already happened. There has been population loss, so the concern is how to retard the decline, retain the residents who already live there, and make it a neighborhood of choice to attract more residents while making it a great place to live.”

Ahead of the Obama Center breaking ground, community organizations including the Obama Community Benefits Agreement Coalition, along with Alderwomen Leslie Hairston of the 5th Ward and Jeanette Taylor of the 20th Ward, submitted a community benefits agreement to the Chicago City Council that was at least five years in the making.

The ordinance ensures 30 percent of new developments on 52 vacant lots owned by the City be affordable to low-income residents. It provides landlord and homeowner support to preserve affordable rentals. It requires that any building owner wishing to sell give existing residents first dibs to purchase it, and several other features. The City Council passed the ordinance in September 2020.

“I see so many limitations with a CBA; it’s a good tool in the right situation, but I’d rather be in a situation with control. If the community owned the vacant land, then that’s a different story.”

However, some say the CBA doesn’t go far enough to ensure that Woodlawn avoids becoming the latest casualty of gentrification.

“A CBA is fine, but then that’s all you’re going to get: the minimum,” Foreman said. “I see so many limitations with a CBA. It’s a good tool in the right situation, but I’d rather be in a situation with control. If the community owned the vacant land, then that’s a different story. We could say: Here’s our financial objectives, job objectives.”

Pittsburgh and the Penguins

The Hill District CBA in Pittsburgh, has, since 2008, been touted as an example for Black and Brown communities looking to assert some control over their communities amid the kind of rapid gentrification that can lead to displacement.

Pittsburgh United and a coalition of community groups organized as the One Hill Coalition signed an agreement in 2008 with municipal authorities and the developers of the Pittsburgh Penguins’ sports arena. The agreement would ensure that the construction of a new arena in the Hill District would meet several conditions.

“Power comes from a lot of places and, usually the only power we have to get to the table is people power. The other side had money, lawyers and other stuff.”

Those conditions included the establishment of a steering committee composed of representatives appointed by the coalition and the City Council. The committee would draft and realize a master plan for the Hill District with extensive community involvement. Another condition was for the developer and the city to commit $1 million for a full-service grocery store in the neighborhood. Finally, the community wanted a career-development center, for which the city government allocated $300,000.

The group also demanded that the developers and the City conduct targeted outreach to and have pre-bid meetings with local, minority, and disadvantaged businesses in regard to opportunities stemming from the arena.

“The success of the Hill District CBA was a credit to the work that happened in the neighborhood,” Diamonte Walker, deputy executive director for the Urban Redevelopment Center of Pittsburgh, said.

“The corporation and stakeholders did a lot of work to organize, [and] we are demonstrating a governance model to honor agreements and position communities to advocate for themselves.”

However, more than a decade later, community organizations are still fighting for the CBA’s enforcement.

“One thing we didn’t do is secure sufficient resources for monitoring and enforcement of the agreement,” Carl Redwood, formerly of the One Hill Coalition said.

Redwood added that the Penguins have a roughly $750 million subsidy, but noted that there had never been a specific development commitment linked to parking revenue.

“So now the fight is how much will come back to the community, and who will control it,” Redwood said.

The Penguins have disputed the $750 million figure, and maintained that they have fulfilled their obligation to the community under the CBA.

“The Penguins have fully complied with the terms of the 2008 CBA, including our $1 million investment in the Hill District grocery store, investments in the First Source hiring center, and our hiring of hundreds of permanent workers at our arena who were primarily drawn from Hill District residents,” COO Kevin Acklin said.

“Since 2008, there has been a lot of additional work by the Penguins, including the Community Collaboration and Implementation Plan (CCIP) that was signed in 2014, and work toward advancing the Lower Hill redevelopment.”

“One thing we didn’t do is secure sufficient resources for monitoring and enforcement of the agreement.”

The Hill District CBA was a response to an earlier tragedy: the 1956 demolition of the Lower Hill District to make way for a new Civic Center. The plan, which invoked eminent domain, displaced as many as 8,000 people living in the 100-acre area, including 1,240 Black families who received no benefits since they had abandoned the area before the project had been approved.

The neighborhood had been targeted for demolition as early as 1943, when Pittsburgh City Councilman George Evans famously said that there would be “no social loss” if 90 percent of the buildings in the neighborhood were razed.

“My family was displaced from the Lower Hill. It’s my lived experience and my legacy,” Walker said.

The Penguins had occupied the Civic Center since 1967 but, by 2000, the organization maintained that they needed a new, more modern arena, and set their eyes on the remainder of the Hill District.

“My family was displaced from the Lower Hill. It’s my lived experience and my legacy,” Walker said. “I wasn’t here when the deal was structured, and it was shocking to hear that the benefits were given to the Penguins.”

Redwood and other organizers have likened the extraction of community benefits to picking up “crumbs” from developers and city officials.

“The CBA process is not equitable. When the community comes to the table, the community is always a junior partner just fighting to be heard,” Redwood said. “Power comes from a lot of places and, usually the only power we have to get to the table is people power. The other side had money, lawyers, and other stuff. We were able to insert ourselves into their process and extract some crumbs.”

Anchoring Community in Project Development and Decision Making

A CBA may ease the Obama Presidential Center’s integration into Woodlawn. But community organizers have said getting consensus on what will most benefit a community, maintaining engagement, and monitoring are and remain challenging.

Resident engagement, said Devin Culbertson, Director, National Initiatives for Enterprise, is a balancing act of wishes, power imbalances, and different people’s visions. Moving from a vision to an investment-ready project is a journey.

The power imbalance, he said, and the competing interests can lead to wildly different aims that are often working against the realities of the market — aiming for an entirely affordable development instead of mixed-income, for example, or the competing aims of both building wealth but keeping rents low. It’s perhaps one reason the early research shows that outcomes from resident-led development are ambiguous in whether it leads to quicker, larger, or more sustained gains for residents, the Urban Institute’s Brett Theodos recently pointed out.

Another option, Culbertson thinks, is to think of the process as community-responsive development. It’s better to conceive and propose something in partnership with the community than to ask residents to become developers.

“It’s less about having the community define the details of the development project,” he said, “and more about anchoring the project scope in the lived experience and expressed desires of the community partners, and then finding ways for the project to stay true to that,” Culbertson said.

Colleen Flynn, Senior Director, National Programs at Build Healthy Places Network, feels that despite the challenges, community led projects are critical to addressing racial inequities. “We believe that paying particular attention to who has decision-making power for such investments and how decisions are made is critical to ensure Black, Indigenous, People of Color (BIPOC) communities are the beneficiaries of community-level improvements,” she explains. “This is why we encourage and support investments that are in themselves community-level interventions to address historically racist policies.”

Widespread acknowledgement of the need to replace systems of inequality with those focused on equity, diversity, and inclusion have brought attention to other forms of community agreements, such as co-ops, accessory-dwelling units, and community land trusts, the latter of which have become especially popular.

Community land trusts are nonprofit corporations that retain land on behalf of a community, and in doing so keep homes affordable for the long-term. Families own their home but not the land on which it stands. The families build equity, but should they sell, they agree to cap profits, keeping the home affordable for the next family. There are currently over 225 CLTs in the United States and, as stewards of the land, they maintain a long-term relationship with residents and work with them to enhance the community.

“A community land trust could be very effective if you have the political will to fund it — unless you’re very early, before prices take off.”

However, like CBAs, community land trusts come with their own issues, including market pressure.

“It doesn’t take a lot of subsidy to buy the building in a low-income community and put it in trust but, almost universally, community ownership and community land trusts become of interest when the market is so hot that displacement is a problem,” Culbertson said. “By that point, the amount of subsidy you need to buy down from the market price to be affordable gobbles up the subsidy in short order.”

That was the case in Oakland, Calif., in 2018, when the community land bank tried to buy several single-family homes that a real estate developer was unloading. The Oakland Community Land Trust was founded in 2009 as an antidote to waves of speculative buying in Oakland after the housing crisis. In the span of a decade beginning in 2007 there were upwards of 13,000 foreclosures in Oakland, the vast majority of which were in the low-income neighborhoods, according to Steve King, the executive director of the Oakland Community Land Trust. Investors snapped up many of the foreclosures and rented them out while waiting for the market to recover — the bleeding edge of displacement pressure.

“Money — and the right kind of money — is the best tool to fight displacement.”

But by the time the land trust sought to buy a set of homes, the market was already high-priced, and it took a complicated collaboration between the land bank, three nonprofit funders, and the City to buy just a handful of homes — a proverbial finger in the dam.

Culbertson also said that, while there are circumstances where CLTs make sense, their reliance on subsidies can become a barrier, especially in fast-moving markets like was the case in Oakland. The key, he said, is to get ahead of the frenzy and buy land before the speculators arrive.

Beyond Community Land Trusts

Local governments are increasingly taking action with other methods as well to ensure that Black and Brown communities have some protection from the rampant land speculation that has displaced long-term residents. Permanent Real Estate Cooperatives, for example, permanently take land off the speculative market and move it into community stewardship. Community Investment Trusts allow investors an option to buy into a commercial project at low cost and with some protections as a way to build equity and benefit from any new economic prosperity. Neighborhood Investment Trusts are investment partnerships that connect and enable residents to become shared owners of properties in their communities.

The SEC, earlier this year, approved the East Bay Permanent Real Estate Cooperative (EB PREC) in San Francisco as a Land Housing Investment Fund. The designation enables the cooperative to raise up to $50 million, over a three-year period, by selling an unlimited number of $1,000 shares to accredited and non-accredited individuals in California, as well as in a growing number of US states. The organization, which has nearly 400 investors and around 100 community owners, aims to establish affordable co-op housing and mixed-use projects that are not subject to real estate speculation.

And local governments are also using existing tools like inclusionary zoning to help ensure residents can remain in communities as development grows. For example, the Pittsburgh City Council, in July, unanimously approved making a 2019 inclusionary zoning pilot program in the Lawrenceville neighborhood permanent. The ordinance, signed by Mayor Bill Peduto, mandates that developments of 20 units or more must set aside 10% of those units for residents whose income is at or below 50% of the area’s median income level.

According to estimates from developer Action Housing, the legislation will enable single-person households with an annual income of $28,000, and five-person households with a combined yearly income of $43,150 eligible to rent apartments in newly built developments.

Pennsylvania State Representative Edward Gainey, the frontrunner in Pittsburgh’s upcoming mayoral election and a proponent of the ordinance, has said that he supports its expansion throughout the city.

For many projects, however, the bottom line will still mean the need for funding, subsidies, and more investment — aka money.

“If you rush against displacement, you’re fighting against the market, and there’s no way to do that without money,” Culbertson said. “With community infrastructure in place and the right kind of money, that is the best tool to fight displacement,” he said.

A Growing Movement

It goes without saying that not all communities are feeling the heat that Woodlawn and Oakland have felt. For many urban neighborhoods, in fact, investments in persistently disinvested locations is very much needed and on a community’s wish list. The years of disinvestment have left residents without the basic amenities, safety, and services that so many other city dwellers take for granted — with serious consequences to all aspects of health and well-being. Other, smaller or declining cities need investment to jumpstart years of economic decline. The uneven pace of gentrification is evident in the fact that nearly half of all measured gentrification has occurred in just seven cities: Washington, New York, Los Angeles, Philadelphia, Baltimore, San Diego, and Chicago.

But for those experiencing the press of gentrification, an increasing number of communities are mobilizing in support of investments centered on residents and their collective vision for their neighborhoods. Projects like those noted above are showing developers, investors, and local officials that engaging communities and allowing residents to stay and enjoy the benefits of investment is the only way to avoid repeating history.

How to Prevent Gentrification’s Displacement was originally published in Crosswalk Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.