A shift in strategy leads to a new focus on community investment for health equity for the health agenda

In cities across the country, institutions such as health systems, health plans, and universities have substantial resources, including purchasing power, job opportunities, land, and cash, which they can contribute to help solve local problems. Since 2017, the Kresge Foundation Health Program has worked to encourage these institutions to utilize these resources and invest meaningfully in the communities they serve through our Community Health Institutional Investment Strategy.

Over the past three years, we have been pleased to see a growing number of health systems and other organizations changing their investment and procurement practices and policies to meet local priorities – especially those that benefit Black people. , Indigenous, and Low-Income People of Color (BIPOC). Leading health systems like Kaiser Permanente and CommonSpirit, along with health plans like UnitedHealthcare, have collectively invested hundreds of millions of dollars in affordable housing and other community assets.

What started as a small group of innovators has grown into a larger movement of institutions embracing their anchor mission and directing more of their investments to their surrounding communities. Key partners like the Center for Community Investment, the Healthcare Anchor Network and others have been instrumental in facilitating this movement.

As the field matured, we realized we needed to refine our strategy. Four main considerations drove our recalibration:

Apply a racial justice lens

Reading our previous institutional investment strategy for community health, one would think that having a major health care system invest hundreds of millions of dollars in the preservation and development of affordable housing was our ultimate goal rather than an important step on the road to health. equity. We realized we needed to be much more explicit about applying a racial justice lens to this scope of work, as well as the need to close the racial wealth gap to help achieve health equity.

Community capacity building

We also realized that we needed to rebalance our grantmaking portfolio in ways that build community capacity to attract, absorb, and deploy affordable capital from mission-driven investors. We are always interested in influencing institutional policy and practice, but our portfolio going forward will place greater emphasis on community intermediaries who can create effective community investment ecosystems to fund priority project pipelines for BIPOC communities at low wealth.

Support innovative models of community ownership

We’ve seen growing momentum for new models of community ownership — like community investment trusts and neighborhood investment trusts — emerging in recent years. Such models provide the opportunity for BIPOC residents who have historically been excluded from traditional opportunities for wealth creation to both exercise some degree of control over development and to benefit financially when neighborhood conditions begin to change.

Charting the course for a just recovery

The pandemic has disproportionately harmed BIPOC communities, both in terms of COVID-19 infection rates and economic consequences. As our nation begins to emerge from the wreckage, we cannot afford a repeat of the financial crisis of 2008-09, which devastated black wealth for years afterwards. We must create the conditions for a fair recovery.

These considerations, along with many conversations with our partners in the field, led us to define what is now our Community Investment for Health Equity Area of ​​interest.

Going forward, we will seek to foster and learn from emerging models of community ownership while encouraging more mission-driven institutions to enter the field. We will prioritize BIPOC’s leadership in creating equitable community investment ecosystems that help close the racial wealth gap as a pathway to health equity.

We are also interested in pursuing these learning questions:

  • What would it take for mission-driven investors to move beyond traditional asset classes like housing to invest in community ownership models?
  • What type of local and state policy environment can best support community ownership and asset creation?
  • How can mission stewards center racial and health equity at every stage of development, especially in financially and legally complex investment structures?
  • How can community power and asset building contribute to health equity?

We look forward to sharing what we learn along this journey, and we welcome your thoughts and questions along the way.

Jill E. Washington