Sameera Fazili
Federal Reserve Bank of Atlanta
Community and Economic Development Department
Discussion Paper 2017-3
December 2017

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The two sectors of community development and health have long worked in the same neighborhoods, but they have not always worked together. This is starting to change, due in part to a growing recognition among health experts of the social, economic, and environmental factors that drive health outcomes. These social determinants of health have become the basis for new collaborations between community development and health professionals. This paper introduces professionals in both sectors to this emerging area of practice through a series of case studies of innovators in the southeastern United States. Case studies look at ways to bring housing and health professionals together, opportunities to leverage community development finance tools, and efforts to use Pay for Success to improve Medicaid spending. This discussion paper reviews early lessons on how to build a successful health and community development partnership, including an examination of the incentives for community developers, health professionals, state and local governments, and philanthropy to participate in these collaborations.

JEL classification: I11, I14, L31, P46, R51, Z18

Key words: social determinants of health, affordable housing, health and housing, community development financial institutions, Medicaid


The author would like to thank Chris Thayer for her diligence in both research and graphics that were essential to supporting this paper, and Tamilore Toyin-Adelaja, Jeanne Zimmermann, and Jen Staley for their editing support. The author would also like to thank the following people for both taking the time to review drafts or shape the author's thinking with their thoughtful and challenging comments: Rachel Bluestein, Lanhee Chen, Kimberlee Cornett, David Erickson, Robin Hacke, Harry Heiman, Doug Jutte, Karen Kopecky, Karen Leone de Nie, Michael McKnight, John Moon, Von Nguyen, Elizabeth Skillen, and David Zuckerman. The views expressed here are the author's and not necessarily those of the Federal Reserve Bank of Atlanta or the Federal Reserve System. Any remaining errors are the author's responsibility.

Comments to the author are welcome at sameera.fazili@atl.frb.org.