Housing: A Social Determinant of Health

Neighborhood & Built Environment (Housing) is one of the five social determinants of health, as identified by the US Department of Health and Human Services.

In DC, 80 percent of residents’ health outcomes are driven by socioeconomic factors, compared to just 20 percent driven by clinical care. Access to safe, quality, affordable housing – and to the supports necessary to maintain that housing -- constitute one of the most basic and powerful social determinants of health.

Research demonstrates that housing and health are inextricably linked:

• Poor health is a major cause of homelessness. Chronic physical and behavioral health conditions can lead to loss of income and contribute to the loss of stable housing and episodes of homelessness.

• Lack of stable housing makes people sick. People experiencing homelessness are at higher risk for infectious diseases, injuries due to accident or violence, the exacerbation of chronic physical conditions like diabetes, mental illness, or addiction, and death due to exposure. Homelessness has been found to “age” people up to 20 years beyond their chronological age.

• Homelessness makes it harder to heal. Homelessness complicates efforts for health professionals to successfully treat chronic conditions, illnesses, and injuries. Discharging a patient from a hospital to a safe and stable environment is critical for proper wound care, compliance with recommended treatments and medication regimes, and access to healthy foods and a place to rest and recuperate.

The Partnership to End Homelessness knows that housing is healthcare and that housing increases economic mobility. Access to quality, affordable, supportive housing can prevent illnesses and help successfully treat health conditions

The Partnership works to increase health equity and improve health outcomes for DC residents through its investments in the development and preservation of housing that is affordable to households with extremely low incomes, including Permanent Supportive Housing (PSH). PSH is an evidence-based practice that combines permanent affordable housing with comprehensive support services for people who have experienced chronic homelessness.

Through its direct grantmaking and impact investing programs, the Partnership supports the creation of housing for extremely low-income households.

One example of this work is a recent project from Jubilee Housing. The EucKal apartments will create a combined 50 units of housing that will be affordable to very low-income individuals and residents of permanent supportive housing. This project was made possible through a $500,000 recoverable grant from The Community Foundation to support Jubilee Housing’s development of PSH and other housing investments. In addition to the EucKal project, this funding was also leveraged to purchase four buildings in Adams Morgan and Columbia Heights to create 120 new units of housing for residents with low incomes. Jubilee plans to further expand its reach by creating housing to serve families, returning citizens, and individuals exiting homelessness. The organization hopes ultimately to provide housing to approximately 317 individuals annually, across 102 permanent units and 18 single room occupancy units.

Learn more about The Community Foundation’s Impact Investing Programs

Enterprise Community Loan Fund Impact Note

In partnership with Enterprise Community Loan Fund, the Partnership offers an Impact Note - an impact investing option for donors seeking to make a difference in the housing space. To date $14.8 million has been invested through this initiative, which has been leveraged to create and preserve 482 homes affordable to low-income households making less than 50% of the area median income. Projects have also included 96 units with supportive services and 192 units serving senior residents. Check out our 2022 Enterprise Community Loan Fund Impact Report to learn more about our investments and impact.

To learn more about how the Partnership’s investments in ending homelessness improves health outcomes for DC residents, contact Jennifer Olney at [email protected] or Silvana Straw [email protected].

Helping Nonprofits Navigate the Guaranteed Income Movement

Last month, the Greater Washington Community Foundation’s Health Equity Fund hosted its first Lunch & Learn Event with nonprofit partners from its inaugural $9.2 million grant round, and other organizations interested in launching and sustaining guaranteed income pilots. The event was hosted at the offices of Capital Area Asset Builders (CAAB) and featured a virtual panel of national experts who shared insights about executing successful and sustainable pilots.

“The Health Equity Fund team believes in the inextricable link between health and wealth,” Dr. Marla M. Dean, Senior Director of the Health Equity Fund explained. “That is why we are using an economic mobility frame to address the social determinants of health – in alignment with The Community Foundation’s broader vision to closing the racial health and wealth gap.”

“We believe that guaranteed income pilots are one of the best ways to achieve that.”

Launched in 2017, the Guaranteed Income Movement was designed to provide unrestricted cash transfers to help individuals and families improve their economic stability. Deemed a “quiet revolution in social policymaking”, the Guaranteed Income Movement has quickly taken center-stage in the economic mobility arena. As of September 2022, there were 100 such pilots announced across the United States – including several in the Greater Washington region.

That figure has increased since October, when several Health Equity Fund partners from the inaugural grant round announced they were using their funding to launch their own Guaranteed Income Pilots (also known as Cash Transfer Programs).

“We are delighted to watch the incredible work you all are doing in DC,” Natalie Foster, President and Co-Founder of the Economic Security Project shared with the group. “You all are pioneers in how we think about the social contract in America – one that centers dignity and humanity and freedom and agency for people.”

As part of the event, nonprofit partners had a chance to share their questions with the virtual panel – which included some of the founding funders and organizers of the movement. Questions ranged from how to build the right narrative to how to ensure the financial sustainability of the work.

“We believe that our families know better than anybody else what they need,” Sarah Stripp, Managing Director of Springboard to Opportunities shared in response to a question about program design. Sarah Stripp was the manager behind The Magnolia Mother’s Trust – one of the first Guaranteed Income Pilots founded in Mississippi in 2018.

“We’ve found that the most successful ideas come from an intentional design process where we’re creating something with individuals, instead of just for them; a process where, we’re proactive in engaging those we serve to figure out what works.”

“How we frame our initiatives – the narrative we use – is really key to helping them become sustainable,” shared Halah Ahmad, a Vice President at Jain Family Institute (JFI) shared. In addition to funding some of the Guaranteed Income Pilots, JFI has also conducted research about public perceptions of cash transfer programs.

“We’ve seen a direct correlation between the way a cash transfer program is framed and the amount of support they receive. Is it framed as a poverty-fighting program? Is it framed as a community empowerment mechanism? The language you use to frame your initiative really matters.”

Nick Salazar of the Fund for Guaranteed Income and Katherine Cagat of Mayors for Guaranteed Income added that it’s important to engage and empower the individuals they serve in creating the narrative, rather than building a narrative around them.

“When you have people speak about their own experiences, rather than being presented, you allow them to tell their story in their own way,” Katherine explained. “This is critical to preserving their dignity and humanity, while at the same time giving them a platform to tear down negative stigmas that our society has about people in their situation.”

Panelists also talked about the importance of being purposeful in identifying and connecting with their target audience.

“Beliefs about poverty and those living in poverty run deep in this country,” Nick added. “We can’t fully wait for everybody to change their mind before we begin.”

“We need be bold and intentional in this work, staying focused and being true to the communities we’ve committed to serve; the people we’re striving to serve.”

“As long as you’re doing that, I don’t think you can go wrong.”

The Community Foundation is committed to promoting economic justice throughout the Greater Washington region through strategies like Guaranteed Income Pilots, Children’s Trust Accounts, and Community Wealth Building. For more information, visit https://www.thecommunityfoundation.org/strategic-plan

Health Equity Fund Celebrates Inaugural Cohort of Nonprofit Partners

From Left to Right: Lucinda Babers (Deputy Mayor for Operations & Infrastructure), Lester Davis, (VP & Chief of Staff, CareFirst), George Jones (CEO, Bread for the City), Tonia Wellons (President & CEO, The Community Foundation), Commissioner Karima Woods, (DC Department of Insurance, Securities & Banking), Dr. Marla Dean (Senior Director, Health Equity Fund).

Just days after the historic announcement of its inaugural $9.2 million grant round, the Greater Washington Community Foundation, partners from CareFirst and DISB, and members of the Health Equity Committee hosted a special breakfast to celebrate and network with Health Equity Fund nonprofit partners.

“You all here today, are a part of history,” Dr. Nnemdi Elias, Chair of the Health Equity Committee shared with the audience of nonprofit and community partners. “Thinking about health as it relates to socio-economic mobility is something that’s been talked about for at least 50 years. However, now – at this place, in this time, with all of you – now is the time to bring this idea to life.”

In addition to networking, the event also reinforced the fund’s commitment to a transformative vision for economic mobility in the region.

“We’re laser focused on increasing economic mobility and closing our region’s glaring racial wealth gap,” Tonia Wellons, President & CEO of The Community Foundation added. “I’m so proud of our Health Equity Committee for taking the bold decision to make the strategic link between health and wealth.”

Given that 80 percent of DC’s health outcomes are driven by social, economic, and other factors, compared to just 20 percent by clinical care, the Health Equity Fund has adopted an economic mobility frame to address the root causes of our region’s glaring racial health and wealth gap.

Grantees such as Bread for the City’s CEO George Jones echoed their commitment to the Health Equity Fund’s vision.

“If we don’t deal with the racial wealth gap on a systemic level, organizations like ours will be around forever – doing great work, but not able to solve the larger problems that continue to plague our communities,” George observed. “We are excited to be a part of this bold approach to transform our community.”

Click here to see pictures from the event! For more information about the Health Equity Fund, including the complete list of nonprofit partners from the inaugural HEF grant round, visit our website!

Greater Washington Community Foundation Announces $9.2 Million in Health Equity Fund Grants

The Greater Washington Community Foundation today announced $9.2 million in grants funded by the historic Health Equity Fund (HEF). Grants will support 32 DC nonprofit organizations (see full list of partners below) engaged in economic mobility to help close the glaring and intolerable racial health and wealth gap.

The $95 million Health Equity Fund has the potential to reshape the way DC addresses its long-standing health inequities. Given that 80 percent of DC’s health outcomes are driven by social, economic, and other factors, compared to just 20 percent by clinical care, the strategy for this fund is to use an economic mobility frame to address the root causes that are causing these challenges in the first place.

“Mindful that health and wealth are inextricably linked, the HEF’s first round of grants is boldly investing in economic mobility and wealth building in DC’s historically underinvested communities,” said Greater Washington Community Foundation President and CEO Tonia Wellons. “Achieving this vision puts our city on a trajectory to improve and achieve optimal health outcomes for all DC residents.”

“The Health Equity Fund represents an important opportunity to advance DC HOPE—health, opportunity, prosperity, and equity,” said DC Mayor Muriel Bowser. “We know that by addressing the social determinants of health, we can attack disparities in health outcomes, empower families, and transform communities.”

“At CareFirst, we recognize that social and environmental factors have a greater impact on health outcomes than factors within our healthcare system,” said Brian D. Pieninck, President and CEO of CareFirst BlueCross BlueShield (CareFirst). “By supporting community-based efforts to improve the economic mobility of District residents, this first round of funding aligns with our mission to advance accessible, affordable, equitable, and quality healthcare for people and communities in the District.”

Nonprofit Partners

A committee composed of Community Foundation staff, community members, and representatives of local foundations and think tanks reviewed proposals from 101 eligible applicants. The 32 selected grant recipients include diverse organizations and projects, including:

• Bread for the City will pilot their CashRx program, a direct cash assistance program that focuses on the social determinants of health to reach those most impacted by poverty.

• Capital Area Asset Builders will address the social determinants of health by providing BIPOC individuals living in DC’s lowest-income neighborhoods emergency savings and access to mainstream financial resources.

• First Shift Justice Project will support working mothers and Latinx and BIPOC people in low-wage jobs to assert their rights to reasonable workplace accommodations and accessing paid leave benefits leading to job retention and stability that increases economic mobility.

• The National Reentry Network for Returning Citizens will support the creation of a new holistic wellness and wealth creation program for women of color returning from incarceration. The program will also feature an innovative matched savings accounts program to enable financial security and wealth creation, and access to housing and job readiness training.

• Mothers Outreach Network will pilot Mother Up, a guaranteed income cash transfer initiative for low-income mothers who are at risk of involvement with the child welfare system. The goal of the pilot is to provide evidence of whether additional money reduces the likelihood of involvement with the child welfare system.

• Tzedek DC will support advocacy to change the way medical debt is collected, educate the community, and litigate high-impact and individual medical debt cases.

• Yachad will support its Healthy Housing Remediation Program to preserve and rehabilitate existing homes for low-income Black and Brown multi-generational households in Wards 7 and 8, so that families can remain in their homes and benefit from increased property value.

About the Health Equity Fund

The Health Equity Fund was created to improve the health outcomes and health equity of DC residents. One of the largest funds of any kind focused on community-based nonprofits that serve District residents, the Health Equity Fund is also the largest in The Community Foundation’s nearly 50-year history. Over five years, the fund will support and advance a sustainable network of people, organizations, and projects that will ensure equitable health outcomes for Black, Brown, Indigenous, People of Color and other marginalized populations in Washington, DC.

The Community Foundation was independently selected to manage the Health Equity Fund because of its track record of working with individual donors, businesses, and local government to manage effective community investments and create tangible, lasting change in the region. Health Equity Fund goals align with The Community Foundation’s ongoing work and 10-year strategic vision to close the racial wealth gap by eliminating the historic, racialized disparities in our region.

The Community Foundation is working in partnership with a Health Equity Committee mandated by the Memorandum of Understanding between the Government of the District of Columbia and GHMSI. The seven-member committee includes Nnemdi Elias, MD, MPH; Dr. Tollie Elliott; Wendell L. Johns; Lori Kaplan; Juan M. Jara; Dr. Djinge Lindsay, MD, MPH; and Courtney R. Snowden. Together, The Community Foundation and Health Equity Committee are ensuring the Health Equity Fund is managed according to guidelines outlined in the Memorandum. 

About the Greater Washington Community Foundation

The Greater Washington Community Foundation ignites the power of philanthropy, catalyzes community impact, and responds to critical needs. For five decades, The Community Foundation has connected caring donors with nonprofits creating lasting change in DC, Montgomery County, Northern Virginia, and Prince George’s County. As the region’s largest local funder, we have invested more than $1.4 billion since 1973 to build racially equitable, just, and thriving communities where everyone prospers. Today, our strategic focus is to close our region’s racial wealth gap so that people of all races, places, and identities reach their full potential. For more information, visit thecommunityfoundation.org.

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2022 Health Equity Fund Partners

Asylum Seeker Assistance Project

Beloved Community Incubator

Bread for the City

Calvary Women’s Services

Capital Area Asset Builders

Capital Youth Empowerment Program

Communities in Schools of the Nation's Capital

Community Family Life Services

Council for Court Excellence

DC Affordable Law Firm

DC Central Kitchen

Dreaming Out Loud

Equality Chamber Foundation

First Shift Justice Project

Free Minds Book Club and Writing Workshop

Generation Hope

Healthy Babies Project

Honoring Individual Power and Strengths (formerly Helping Individual Prostitutes Survive)

Latin American Youth Center

Mamatoto Village

Martha's Table

Mothers Outreach Network

My Sister's Place

The National Reentry Network for Returning Citizens

Organizing Neighborhood Equity

Rebuilding Together DC Alexandria

Rising for Justice

Shaw Community Center

So Others Might Eat

Tzedek DC

Yachad Incorporated

The Young Women’s Project

Greater Washington Community Foundation Seeks Proposals For $10 Million Health Equity Fund Grants

Transformative Health Equity Fund is Largest in Foundation’s History

The Greater Washington Community Foundation today issued its first competitive Request for Proposals for grants funded by the historic Health Equity Fund. Mindful that health and wealth are inextricably connected, this first round of grants will boldly invest in economic mobility and wealth building in DC’s historically underinvested communities. Future funding will be devoted to policy advocacy, community and multi-sector anchor partnerships with hospitals and health systems, and behavioral health and trauma-informed systems of care. Over the next five years, the fund will support innovative systems-changing strategies as well as existing approaches that improve prospects for Black, Latinx, Indigenous, people of color, and other marginalized populations.

The $95 million fund was created to improve the health outcomes and health equity of DC residents. One of the largest funds of any kind focused on community-based nonprofits that serve District residents, the Health Equity Fund is also the largest in The Community Foundation’s nearly 50-year history.

“The past two years have reminded us that DC’s economic, social, and health systems favor people who already have access to wealth and good healthcare,” said Greater Washington Community Foundation President and CEO Tonia Wellons. “Given that 80 percent of DC’s health outcomes are driven by social, economic and other factors, and only 20 percent by clinical care, we plan to deploy the full resources of the Health Equity Fund to projects that disrupt more traditional approaches to social change with the goal of addressing our city’s persistent health inequities and helping to close the glaring and intolerable racial health and wealth gap.”

“Improving health outcomes and health equity in our communities is critical,” said DC Mayor Muriel Bowser. “Health Equity Fund grants represent significant investments in the well-being of our residents, and continues to promote DC HOPE—health, opportunity, prosperity, and equity. This is an important next step in providing necessary resources and addressing residents’ whole health.”

The Health Equity Fund was established last year as a result of the resolution of litigation among the District of Columbia Department of Insurance, Securities and Banking (DISB); Group Hospitalization and Medical Services, Inc. (GHMSI) – a CareFirst BlueCross BlueShield (CareFirst) affiliate – and DC Appleseed Center for Law & Justice. In establishing the fund, the parties created an innovative and impactful way of addressing DC’s racial health gap.

“The Health Equity Fund builds upon CareFirst’s longstanding mission to improve health outcomes through affordable, accessible, and equitable care,” said Stacia Cohen, CareFirst’s Executive Vice President of Health Services. “Under the leadership of the Greater Washington Community Foundation and the jointly appointed Health Equity Committee, the funds will be distributed to organizations that share our commitment to transforming healthcare and impacting DC community health.”

Request for Proposals

Two-year general operating grants totaling $10 million will be awarded to 40 organizations implementing economic mobility models that increase income and build wealth or that are implementing innovative enterprise development and ownership models. Applications are due by 4 p.m. on July 25. Awardees will be notified in September. A webinar for potential applicants will be held on June 21. Organizations with operating budgets of $750,000 and below are eligible for grants ranging from $50,000 to $100,000 per year and organizations with operating budgets above $750,000 are eligible for grants ranging from $150,000 to $200,000 per year. Click here to view the RFP or see here for additional information or to read Frequently Asked Questions

Fund Oversight

The Community Foundation was independently selected to manage the Health Equity Fund because of its track record of working with individual donors, businesses, and local government to manage effective community investments and create tangible, lasting change in the region. Health Equity Fund goals align with The Community Foundation’s ongoing work and 10-year strategic vision to close the racial wealth gap by eliminating the historic, racialized disparities in our region. The Community Foundation believes that changing the prospects for how Black and Brown people generate, share, and sustain wealth will ultimately improve the quality of life for all of our neighbors.

The Community Foundation is working in partnership with a Health Equity Committee mandated by the Memorandum of Understanding between the Government of the District of Columbia and GHMSI. The seven-member committee includes Shirley Marcus Allen; Nnemdi Kamanu Elias, MD, MPH; Dr. Tollie Elliott; Jeffrey Franco; Lori Kaplan; Dr. Djinge Lindsay, MD, MPH; and Courtney R. Snowden. Together, The Community Foundation and Health Equity Committee are ensuring the Health Equity Fund is managed according to guidelines outlined in the Memorandum.  

Community Foundation to Manage Historic Health Equity Fund in Partnership with Committee appointed by Mayor Bowser and CareFirst

The Greater Washington Community Foundation is pleased to welcome the historic $95 million Health Equity Fund (HEF) to our philanthropic family. The purpose of this transformative fund is to improve the health outcomes and health equity of DC residents. One of the largest funds of any kind focused on community-based nonprofits that serve District residents, the HEF also is the largest in The Community Foundation’s nearly 50-year history.

“The unprecedented $95 million reinvestment in DC neighborhoods and nonprofits is a game changing opportunity,” said Greater Washington Community Foundation President and CEO Tonia Wellons. “As we all know, the COVID-19 pandemic further widened and amplified pre-existing health inequities. The Health Equity Fund offers a once-in-a-lifetime opportunity to catalyze systemic, lasting change to improve health outcomes and social social determinants of health.”

The funds will be dedicated not only to closing gaps in healthcare but addressing social determinants of health including education, employment, income, housing, transportation, food, environment, medical care, outdoor environment, and community safety issues that have a positive impact on healthcare outcomes.

The HEF was established last year as a result of the resolution of litigation among the District of Columbia Department of Insurance, Securities and Banking (DISB); Group Hospitalization and Medical Services, Inc. (GHMSI) – a CareFirst BlueCross BlueShield (CareFirst) affiliate – and DC Appleseed Center for Law & Justice. In establishing the HEF, the parties created an innovative and impactful way of addressing DC’s racial health gap.

The Community Foundation will oversee the administration of all aspects of the giving program including providing fund administration, financial management, investment oversight, data management, human resources administration, and compliance oversight, among other responsibilities.

Health Equity Committee

The Community Foundation looks forward to working with the newly created Health Equity Committee, which will oversee the HEF, as stipulated by the Memorandum of Understanding Between the Government of the District of Columbia and GHMSI. The seven-member committee consists of three members appointed by the Mayor (Lori Kaplan, Dr. Tollie Elliott, and Courtney R. Snowden); three appointed by GHMSI (Dr. Djinge Lindsay, MD, MPH; Shirley Marcus Allen; and Jeffrey Franco); and one selected jointly by GHMSI and the Mayor (Nnemdi Kamanu Elias, MD, MPH). For bios of the seven committee members, click here.

The Health Equity Committee, in partnership with The Community Foundation, will develop a grantmaking strategy, approve a slate of proposed grant recipients, monitor the HEF's investments, ensure compliance with HEF's governing policies, and review all financial and program evaluation reports.

Community Foundation’s Strategic Vision

The Community Foundation was independently selected to manage the fund because of our track record of working with individual donors, businesses, and local government to manage effective community investments and create tangible, lasting change in our community. HEF goals align with our strategic vision of advancing racial equity and economic justice, especially in our region’s historically underinvested neighborhoods. Racial equity is central to our ongoing work and 10-year strategic vision to close the racial wealth gap by eliminating the historic, racialized disparities in our community.

Grantmaking

In the coming months, the Health Equity Committee in partnership with The Community Foundation will gather community and stakeholder input, identify goals and priorities, develop a grantmaking strategy based on input and an analysis of available data on the nonprofit landscape, and prepare the first competitive RFP. According to the Memorandum of Understanding, all funds are to be disbursed within five years.

If you are interested in receiving more information about funding opportunities, please sign up for our newsletter.

We offer a warm welcome to the Health Equity Fund and Health Equity Committee members and look forward to working together to address disparities in health outcomes so that all DC residents can thrive.