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Overview of Public Health Primer

Build Healthy Places Network (BHPN) and National Association of Chronic Disease Directors (NACDD) held a thought leader roundtable gathering national, state, and local leaders to bridge a way for public health and community development sectors to work together advancing health and racial equity through upstream partnerships. This primer shares the recommendations emerging from our roundtable and illustrates opportunities for public health to advance racial equity goals through engagement with those responsible for helping to shape the built environment. Support for 'Public Health Primer: Engaging Community Development for Health Equity' was provided by NACDD and the Robert Wood Johnson Foundation.

A 2023 survey* found that 81% of executives in public health agencies and 72% of state and local government public health employees believed addressing racism as a public health crisis should be part of their work. However, only 39% of those employees reported being highly engaged in such efforts.

This primer seeks both to create a starting point for the work and to challenge our perspectives of where race, health, and place intersect, and who are our partners in addressing the drivers of health.

We employ the vital conditions for health and well-being (see below) as an organizing framework through which we can see the multisector nature of these drivers of health and a role for the community development sector as a partner in influencing health at the community-wide level.

Vital Conditions for Health and Well-Being:
A Framework Supporting Upstream Collaboration to Advance Health and Racial Equity

The thought-leader roundtable hosted by NACDD and BHPN was grounded in the Vital Conditions for Health and Well-Being, a framework by the Rippel Foundation and ReThink Health.

The vital conditions framework invites us to envision a holistic and community-based approach to health. Using this framework, we can reimagine how we invest in social needs, asking instead: What are the community conditions for well-being that can help support the drivers of health? Are we preventing the demand for urgent services and allowing communities to thrive? Belonging and civic muscle are at the center of this framework and are essential to successfully working with residents and other organizations to create equitable communities and shared stewardship.

Vital Conditions for Health and Well-Being

Large graph that resembles a pie chart and has the vital conditions for health and well-being written inside different segments.

The vital conditions framework emphasizes the multifaceted nature of our systems that combine to impact community health. It also helps us think about what levers we can use for community change to improve spatial justice and overall well-being. In addition, it can be used to support the examination of how policies and practices have shaped the distribution of the vital conditions geographically.

In 2023, FrameWorks Institute, a nonprofit think tank, released a report in which the authors suggest that “advancing racial justice in the United States requires the pursuit of spatial justice.” Our aim of making holistic, long-term, and widespread improvements in the country’s health inequities will also require an awareness and pursuit of spatial justice. In doing so, we can shift the paradigm to not conflate a lack of infrastructure investment and the presence of environments that impair health, with a lack of character or judgment of the people making up those communities. In this way, we shed a different light on the persistence of health inequities in communities and point to a way in which public health can partner to influence spatial justice, increase vital conditions, and advance health and racial equity.

Partnerships are a critical foundation for addressing the root causes of health inequities, and coalescing frameworks, such as the vital conditions, are helpful in identifying the new range of partners that will be required as we catalyze multisector action.

We can’t address health equity without addressing racial equity.”

—Roundtable Participant

Video Snapshot

How Public Health Practitioners Can Expand on the Vital Conditions Framework

In this video snapshot, Build Healthy Places Network’s Co-Executive Director Ruth Thomas-Squance speaks with Bobby Milstein, Director of System Strategy from ReThink Health and the Rippel Foundation, who was part of the initiative that developed the vital conditions framework.

Bobby explores the vital conditions and explains how public health practitioners can use the framework to build on the social determinants of health to create a future where all people and places can thrive.

In addition, they discuss the importance of centering belonging and civic muscle to bring more people together to create inclusive and equitable policies.


Organization Reflection Questions

What is your organization’s definition of equity? Health equity? Racial equity?

Which of the vital conditions does your organization work to address?

In what ways does “place” impact the health of the communities you serve?

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Get Acquainted with the Sectors

Many public health practitioners wonder how the community development sector differs from the community development activities that are more familiar and common in the public health field. The community development sector is a multi-billion-dollar sector investing in persistently disinvested communities through the development and financing of affordable housing, schools, grocery stores, health clinics, small businesses, job training programs, and services to support children, youth, and families. Broadly, one can break down the major players into two groups: community development corporations, or CDCs (not to be confused with the Centers for Disease Control and Prevention) and community development financial institutions (CDFIs)

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CDCs are nonprofit organizations, born out of the civil rights movement to build healthier communities in disinvested neighborhoods by improving the social, health, and economic conditions. They often focus on real estate development, such as affordable housing, but also engage in community economic development, creating jobs and building the local tax base.

CDFIs coordinate financing and innovate financial tools to meet the needs of disinvested communities, such as by financing affordable housing, Federally Qualified Health Centers, and other community infrastructure. The CDFI sector has experienced rapid growth, with a report* from the New York Federal Reserve Bank estimating that their assets have tripled since 2018 to over $450 billion. Driven by a mix of public and private resources, federal and state grants, and tax incentives, this sector brings in needed capital for disinvested communities.

One of the greatest drivers of resources into disinvested neighborhoods is the Community Reinvestment Act (CRA) passed in 1977. The CRA requires for-profit banks to invest in low-to-moderate-income neighborhoods where they take deposits. Since 1996, banks have made CRA investments totaling $2.5 trillion.

Community action agencies—networks of private and public nonprofit organizations working locally in most counties across the country—are another ready source of partnership for public health. The federally supported community action agencies target poverty and address social determinants of health by improving conditions that support better health. These include childcare, housing services, weatherization of homes, and food programs, to name a few.

The following are a snapshot of community development activities where emerging partnerships with public health have focused on upstream interventions:

  • Establishing community engagement processes to prioritize the needs and solutions of people most affected by inequities, especially residents of color.
  • Mitigating the range of physical and mental chronic health problems associated with housing instability by partnering to apply trauma-informed design to affordable housing.
  • Developing farmers markets, community gardens, or walking paths to increase food access and healthy lifestyles.
  • Adding integrated pest management strategies into affordable housing buildings to reduce rodents and mold and asthma triggers.

Give power to the communities. Funders should give money to communities without asking about deliverables or indicators. They know what they need and have their own ideas, just give them the resources they need.”

—Roundtable Participant

State health departments are responsible for assessing the needs of local populations and advising local health departments on actions to meet those needs. A state health department is a centralized unit of state government with overarching responsibility for protecting, assuring, and improving the health of the state’s citizens. They typically act as conveners, supporters, and distributors of data, information, funding opportunities, and support for local and county health departments. Local and county health departments are responsible for assessing the needs of local populations and more often provide direct services, resources, and information to citizens in local areas. Health departments traditionally work in concert with other agencies and nongovernmental organizations.

The roles, responsibilities, and scope of public health authority depend on state policy and the governing relationship between state, local, and county health departments. Below are the most common governance structures:

  • Centralized/state: All the local health departments are units of state government.
  • Mixed/hybrid system: Some local health departments are led by state government and some by local government.
  • Local or decentralized: Local health departments are led by local governments, which make most fiscal decisions.
  • Shared system: All local health departments are governed by both state and local authorities.

Since the factors impacting health rest in the social, political, historical, and economical spheres of our country, it is unrealistic to think public health can solve health disparities and inequities in a silo.

Public health can play an essential role in multisector collaborations, as a convener to distribute information, uncover common priorities, and work with a broad range of partners to develop upstream and downstream strategies to protect and promote health. Multisector collaboration between public health departments and diverse community partners is increasingly recognized as important for promoting positive public health outcomes, addressing social determinants of health (or vital conditions for health and well-being), and reducing health inequalities.

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Discover New Partners

Generally, this ecosystem of partners should serve as a way to include all interested individuals, entities, and organizations as it will take all of us to combat the generations of disinvestment, harm, and mistrust done to disinvested communities. More specifically, it is important to identify and name which sectors, government entities, community members, and community-based organizations need to have their voices and perspectives included in the work to advance racial and health equity.

Health Partnership Ecosystem

Large info graphic with icons explaining the Health Partnership Ecosystem

Encourage communities to share their stories. This will help strengthen data and center the human experience.”

—Roundtable Participant

Racial and health equity work is sometimes discussed on a macro level, and that is important when thinking about systems-level change. But there is also a benefit to discussing this work on a local level as it helps to identify which individuals/organizations influence the built environment in a particular community and which folks are important to engage with when discussing the long-term health of a community.

BHPN recently developed a five-step pathway to help facilitate and think about how to:

  • Assess interest, value, and potential impact of multisector partnerships.
  • Identify where you can potentially leverage existing relationships to develop upstream solutions.
  • Determine who should be involved in conversations/work on racial equity in your community.
  • Envision ways to make sure you remain flexible and adapt to the needs of your community/locale.

Using this pathway can help you generate a list of sectors, people, and organizations that need to be involved in this work as you address the vital conditions for health and well-being.

As you engage with the five-step pathway and review the ecosystem of health partners diagram, consider using these reflection questions, and remember to check for anyone you might be missing and those whose voices are rarely heard.

Factors Addressing Racial Equity in Upstream Cross-Sector Investments

Enabling Constraining
Truth and reconciliation Lack of psychological safety
People-focused models, community-led planning, data creation etc. Top-down approaches leading to marginalization of community members
Flexible + braided funding Restricted funding
Coordinate community-based resident services Reluctance to shift power dynamics
Public health role as central, trusted conveners Status quo
Intergenerational visions reflecting community values Lack of questioning the legacy of race-based policies
shared stewardship and building long-term relationships Short-term transactional relationships and projects
Equitably shifting power and incorporating community voice into decisions around funding and investments Unrealistic (short) funding and project time frames

The system itself is so hard to work within because it takes more than 3 years to change the health outcomes of a whole nation.”

—Roundtable Participant

Organization Reflection Questions

In your own region, is your organization similar in mission, practice, or approach to organizations operating in other sectors but within the same communities?

What are some initial steps your organization can take to establish partnerships with the community development sector?

What would your commitment to equity look like to ensure it is applied as an intentional design decision and practiced across the partnership process? How are you centering the community in your partnerships?

Partner Finder

Ready to find a community development or public health partner? BHPN’s Partner Finder is a collection of directories to help you find the community development or public health organization nearest to you. Below are some examples of national organizations working across the fields of public health and community development.

Public Health

ASTHO: The Association of State and Territorial Health Officials

ASTHO is the national nonprofit organization representing public health agencies in the United States, the U.S. Territories, and the District of Columbia, and over 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, formulate and influence sound public health policy and ensure excellence in state-based public health practice.

ASTHO membership includes public health agencies serving rural areas and small cities. The organization’s website also features blogs covering public health topics relevant to rural communities.


NACDD: National Association of Chronic Disease Directors

There are 58 chronic disease directors representing states and territories of the US. In addressing chronic diseases which is long-term by nature, NACDD employs a broad focal view on disease prevention and promotion of health, making them excellent partners for projects addressing social determinants of health. Their mission is to protect the health of the public through primary and secondary prevention efforts and work “upstream” on root causes of chronic conditions.


NACCHO: Directory of Local Health Departments

The National Association of County and City Health Official’s (NACCHO) tool to search for local health departments in your area.

Learn more about NACCHO’s Rural Health Section, composed of NACCHO members and partners working together on specific rural public health issues across multidisciplinary and programmatic expertise in support of NACCHO’s mission.


NNPHI: Network Engagement Directory

The National Network of Public Health Institute’s (NNPHI) directory of member institutes. Public health institutes are nonprofit public health organizations dedicated to advancing public health practice and making systematic improvements to population health.

Community Development

Enterprise Community Partners

Enterprise Community Partners is a national nonprofit that exists to make a good home possible for the millions of families without one.


The National Alliance of Community Economic Development Associations (NACEDA)

The National Alliance of Community Economic Development Associations (NACEDA) is an alliance of state and regional community development associations who are champions, stewards and thought leaders for community development.


Neighborworks America

NeighborWork’s members are community development organizations building strong and resilient communities, providing people with opportunities to live in safe, healthy and affordable housing.

Learn about NeighborWorks America’s Rural Initiative. An initiative dedicated to creating vibrant rural communities by delivering a range of essential services, including capital, training, and peer learning.



The Local Initiatives Support Corporation (LISC), a national Community Development Financial Institution (CDFI), has urban offices around the country that work to equip struggling neighborhoods with the capital, strategy and know-how to become places where people can thrive.

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Step Into Action

During our roundtable discussion, we found that the term “racial equity” did not necessarily hold common meaning within sectors or across sectors. Practitioners need to expand the way they talk about equity, to build trust and continue deepening work that ultimately aims to center community voices. We must build adaptive change that is receptive to the values, the experiences, and the leadership within the communities we seek to serve.

Holding value-based conversations requires spaces where participants feel safe to take interpersonal risks and disagree, openly, in order to surface concerns without fear of negative repercussions. As public health and community development build solidarity together, providing space to learn best practices and develop shared language, it is imperative for sectors to build relationships with each other and the community. Many communities and institutions are leading the way with innovative approaches to expand how we talk and think about equity.

Recent work done by the Othering & Belonging Institute at UC Berkeley highlights the ways that targeted universalism can simultaneously respond to the needs of particular groups of people, while also reiterating and reminding us that we are all part of the same social fabric. This is done by working across socioeconomic, political, and racial lines to co-create universal goals and creating space to assess the general population’s performance in relation to those universal goals. The framework leads us to assess and understand the structures in place that act to either support or hinder any specific group from achieving that universal goal.

Another important component of value-based conversations is taking an asset-based approach to build on community strengths and resources that public health and community development can leverage. Storytellers for Change notes that this only works if we have an equity-centered storytelling approach emphasizing things like hope, healing, and radical imagination.

What has gotten us here will not get us to where we want to be.”

—Roundtable Participant

“Stewardship is more imperative than the power of leadership. When people and organizations become stewards, they recognize the value of working together in coalitions, taking collective responsibility to create conditions where everyone can thrive.” –theme from thought leader roundtable

Purpose Built Communities and FrameWorks Institute developed guidance to help shift cultural mindsets and expand conversations about equity and inclusion, grounded in mutual values of fairness and shared prosperity.

Value-based conversations also take center stage in communication with the communities we seek to serve. We acknowledge that residents know what they need for their communities to thrive, but communities are not routinely invited to lead projects to revitalize their own neighborhoods, and this exclusion creates mistrust. The community development, public health, and multisector collaboratives have a responsibility to recognize the history and work to develop their own trustworthiness by working with communities to value their knowledge and realize their assets.

There is an opportunity for multisector coalitions to open up generative conversations centering community voices through trust-building, creating shared goals and language. It is vital to establish residents as experts in defining their own challenges as well as crafting solutions.

Values drive policy. It’s not a science, it’s about understanding what people value in their communities that begin to shape hearts and minds.”

—Roundtable Participant

Organization Reflection Questions

How do you and your organization recognize historical and persistent harms of structural racism and build trust toward healing?

How can you co-create an inclusive community process that centers community voice?

How can communities play a central role in analysis and use of data, to reflect their unique lived experiences, historical context and inform needs through a community-rooted vision?

Jargon Buster Terms

Community Development Corporation (CDC)

The CDC is an operating agency of the Department of Health and Human Services that serves as the nation’s leading public health institution. The CDC’s primary mission is to protect public health and safety through the control and prevention of diseases, injury, and disability. Through its Community Transformation Grant (CTG) program, the CDC has invested more than $200 million annually in programs to promote safe and healthy neighborhood environments since 2011. As of 2015, the CTG program has been reorganized and reassigned to the Prevention and Public Health Fund, established through the Affordable Care Act. This program continues to be the primary funding source for local initiatives that address social determinants of health.

Community Development

Community development is a multi-billion-dollar sector of the American economy that invests in low- and moderate-income communities through the development and financing of affordable housing, businesses, community centers, health clinics, job training programs, and services to support children, youth, and families. The sector has its roots in the urban revitalization efforts of the late 19th century but expanded as a result of the War on Poverty programs of the 1960s. Today, the community development sector invests more than $200 billion annually in low-income communities.

While community development is not a discrete academic discipline or an accredited field like public health, it is more than an activity. It is best viewed as a self-defined sector involving organizations from multiple fields that share a common focus on improving low-income communities. These organizations come from fields including real estate, city planning, law, social work, public policy, public health, affordable housing, and finance, and generally identify themselves as being part of the community development industry. Neighborhood-level Community Development Corporations (CDCs) and Community Development Financial Institutions (CDFIs), working at both local and national levels, provide leadership in the sector, often working alongside neighborhood residents, real estate developers, philanthropic organizations, city agencies, investors, and social-service providers.

By improving well-being in disadvantaged neighborhoods, community development affects the “upstream” causes of poor health, like poverty, unstable housing, and limited access to fresh food markets and other services. At its best, community development achieves health equity by addressing many of the factors, or social determinants, that affect public health.

For more read Demystifying Community Development

Community Development Financial Institution (CDFI)

CDFIs are “private financial institutions dedicated to delivering responsible, affordable lending to help low-income, low-wealth and other disadvantaged people and communities join the economic mainstream” (see the Opportunity Finance Network). CDFIs include both for-profit and nonprofit institutions like community development banks, credit unions, loan funds, and venture capital funds. These institutions invest in communities by financing small businesses, microenterprises, nonprofit organizations, and commercial real estate and affordable housing. As of 2018, there were more than 1,100 CDFIs serving cities, rural areas, and Native American reservations.

CDFIs also serve as intermediaries that help commercial banks invest in low-income communities to meet their Community Reinvestment Act (CRA) requirements. Some Community Development Corporations and affordable housing developers operate CDFIs as part of their work (for example, the affordable housing developer Mercy Housing has an associated CDFI, Mercy Loan Fund).

Leading CDFI resources include the Opportunity Finance Network, the nation’s leading CDFI trade association, and the United States Treasury’s CDFI Fund, the federal government’s designated funding source for CDFIs. Established in 1994, the CDFI Fund provides financial and technical-assistance grants to certified CDFIs, and manages the New Markets Tax Credit program, among others. CDFIs must be certified through the CDFI Fund to access these programs. In 2013, the CDFI Fund distributed $172.6 million to CDFIs nationwide.

For more information on CDFI’s, check out this great video from the Opportunity Finance Network:

Vital Conditions for Health and Well-Being

Vital conditions are properties of places and institutions that all people need for health and well-being. They include a thriving natural world, basic needs for health and safety, humane housing, meaningful work and wealth, lifelong learning, reliable transportation, and, central to all of these, belonging and civic muscle.

Investments in these conditions are necessary to create an equitable, thriving future for ourselves and for generations to come.

Source: ReThink Health

Upstream Services

Upstream services focus on macro level factors such as structures that impact health whereas downstream services focus on providing equitable access to care. For example, addressing income from an upstream initiative is to advocate for living wage policies, wage capping, and progressive taxation whereas a downstream imitative would be to address income to ensure that chronic disease prevention programs are accessible to people who have low income.

Resource: Loma Linda University Health

Equity (Health)

The Network adopts the Department of Health and Human Services definition of health equity: “The attainment of the highest level of health for all people.” Others describe health equity as the “the absence of systematic disparities in health or in the major social determinants of health.” Community development provides a pathway to achieving health equity by serving as a mechanism to address many of the root causes of poor health.

Equity (Racial)

The Network adopts the Center for Assessment and Policy Development definition of racial equity as “the condition that would be achieved if one’s racial identity no longer predicted, in a statistical sense, how one fares. When we use the term, we are thinking about racial equity as one part of racial justice, and thus we also include work to address root causes of inequities, not just their manifestation. This includes elimination of policies, practices, attitudes and cultural messages that reinforce differential outcomes by race or fail to eliminate them.”

Spatial Justice

The distribution of power and resources within and between places needed to establish racial equity.

Read more about spatial justice in the Frameworks Institute’s new report: Navigating Cultural Mindsets of Race and Place in the United States

Participatory Action Research

A framework for conducting research and generating knowledge centered on the belief that those who are most impacted by research should be the ones taking the lead in framing the questions, the design, methods, and the modes of analysis of such research projects. The framework is rooted in the belief that there is value in both traditionally recognized knowledge, such as scholarship generated by university-based researchers, and historically de-legitimized knowledge, such as knowledge generated within marginalized communities.

For more read from the Participatory Action Research website as part of a university-community participatory action research (PAR) collaboration between Carleton College and community members and institutions in Faribault, MN.

Trauma Informed Design

Design that is trauma-informed centers healing as an integral part of the design process and prioritizes it as an observable outcome in the built environment. It is good for everyone because spaces are purpose built and empower individuals and communities to steward the design of homes, schools, neighborhoods, etc. It goes beyond tactical interventions when a trauma-informed design process offers an opportunity to disrupt the structural systems that perpetuate trauma.

Resource: Trauma-Informed Housing

Much of the capacity for collaboration across sectors is local and context-specific. While there are many common barriers faced by practitioners collaborating across sectors at the neighborhood level or farther upstream, they vary across social, geographical, and political context. Successfully navigating these barriers requires aligning strategy, financial resources, leadership, and community power to your context. There are no one-size-fits-all approaches.

The following snapshots of multisector collaborations begin to increase visibility of “bright spots” of collaborations centering resident voices in place-based decisions to advance racial equity and community health.

Collectively, as we share we can learn from each other, establish psychological safety to be innovative and creative, and lift our aspirations.

Enterprise Health Action Plan and the Role of Public Health

Enterprise’s Health Action Plan fosters the relationship between affordable housing developers and public health practitioners to analyze health data, engage with residents, and co-develop a plan that prioritizes community health and well-being in affordable housing. The Health Action Plan offers seven steps that guide affordable housing developers to embed evidence-based public health practices that align with residents’ and community members’ health needs into the design of their construction projects. This upstream multisector collaboration approach has led to the adoption of over 42 health-promoting strategies that center belonging and civic muscle by connecting residents with resources, creating community murals, and enhancing community gathering areas.

Forging Lasting Bonds: Creating Healthy Housing through the Health Action Plan

Joining Forces with Community Development to Advance Racial Equity

In this video snapshot, Build Healthy Places Network’s Alexis Sims speaks with two leaders from East Bay Asian Local Development Corporation (EBALDC) Annie Ledbury, the Associate Director of Creative Community Development, and Ener Chiu, the Executive Vice President of Community Building.

During this interview, Annie and Ener dive deeper into the Healthy Neighborhoods Approach to community development and how the research on the social determinants of health from the Alameda County Public Health Department led their organization to expand on the nonmedical factors that directly influenced residents’ health. This approach fosters multisector partnerships within EBALDC’s priority neighborhoods, where residents are at the heart of their work. Annie and Ener discuss how the collective impact model is used within community development to advance racial healing and foster a sense of belonging to improve the community spaces. Trusted partnerships between public health agencies and community organizations are essential for public health practitioners who are looking to collaborate further upstream to advance health and racial equity efforts and should be nurtured not only during urgent situations but also in nonemergent times.

Hennepin County Community Health Improvement Partnership

Hennepin County Public Health Department in Minnesota was one of ten grantees as part of a cross-sector innovative initiative in 2020-2022 to advance health equity through multisector partnerships and improve population health by responding to community needs. The public health department shared that nearly 12% of the population lived below the poverty level in the past 12 months at the beginning of the project. In addition, according to a health survey conducted in 2018, BIPOC residents experienced a higher rate of mental distress compared with White Americans. The department recognized the need to address complex issues, such as racism, as a public health crisis.

The Community Health Improvement Partnership (CHIP) of Hennepin County focused on community mental well-being and housing stability through partnerships with communities of color and Indigenous populations. The coalition included partners from public, private, and nonprofit sectors along with representation from public health and healthcare leaders. Subject matter experts in mental health, housing, and education also partnered with these communities to address historical trauma and racial disparities through equitable policies and practices. Equitable screening criteria were implemented to help vulnerable populations with housing options, and spiritual, faith, and cultural leaders and healers worked with residents to increase social connectedness practices in rental housing and reduce barriers.

CHIP partners used a collaborative financial approach that directed funding to community organizations that would allow them to create meaningful change in their communities. This approach increased community-led solutions to address the unique challenges that BIPOC communities often face. Health and racial equity were prioritized by the community, and partners ensured the community’s voice was heard throughout the program. Furthermore, this approach heightened the importance of community engagement and involvement when planning and implementing programs to advance health and racial equity efforts. Learn more

United Way – Healthier Together Pierce and St. Croix Counties, Wisconsin

Healthier Together is a community coalition formed across Pierce and St. Croix counties in Wisconsin to address the unique socioeconomic challenges faced by residents of these predominantly rural communities. The coalition, spearheaded by United Way of St. Croix and the public health departments of Pierce and St. Croix counties in collaboration with numerous local community development corporations, secured funding through the Wisconsin Department of Health Services’ Mobilizing Communities for a Just Response program to support a bi-county housing assessment and policy scan. This work explores the unique and evolving housing needs of their communities, and develops holistic policy recommendations to advance community-led efforts to build healthy, opportunity-promoting environments.

The coalition centers affordable housing as a key focus of their policy and advocacy goals, and the assessment addresses four priority areas related to housing: senior housing, workforce housing, wraparound services, and community engagement. Through a partnership with Build Healthy Places Network, Healthier Together produced a report providing a framework for designing inclusive and holistic policies that center community voice and set forth innovative policy recommendations aimed at improving access to affordable and healthy housing for individuals and families.

The assessment involved meaningful participation of local residents through focus groups and key informant interviews to identify priority areas, as well as strategies to improve alignment between community development and public health through affordable housing initiatives. The report notes that “by bringing together a wide range of individuals with varied backgrounds, specialized knowledge, and lived experience, these interviews allowed the workgroup to better understand the multifaceted challenges and opportunities related to healthy and affordable housing” (p. 4). The assessment also integrated the vital conditions framework, with the perspective that human housing or safe, affordable, stable, and quality places to live are critical to the health of residents. Access the report here.

Organization Reflection Questions

Where do you see opportunities within your work to try strategies similar to the ones highlighted in this primer? And where do you anticipate there being barriers?

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Tools and Resources for a Deeper Dive

The following materials offer frameworks, guidance, and strategies for centering health and racial equity in partnerships across public health and community development.


Racial Healing tool

The REPAIR framework, developed by Build Healthy Places Network, lays the groundwork for how institutions can work with BIPOC communities to implement long-term, sustainable, community-institution solidarity for racial healing. This tool shares actionable steps to heal the impact of systemic racism by building relationships, trust, and collective community power.

Read More


Social Justice Framework for Public Health Professionals

In public health, equity is both a pathway to achieving and an outcome of social justice. In this report, NACDD partnered with Think Equity, LLC, to present a social justice framework for public health professionals at all levels to strengthen public health practice and improve health outcomes among historically disinvested communities in the U.S.

Read More


Equitable Policy Processes for Multisector Health Efforts

This resource, produced by Build Healthy Places Network, provides coalitions working to create healthier communities with strategies to embed equity at every stage of the policymaking process. The tool offers practical steps to support collaborators who are interested in building capacity for equitable and sustainable policy solutions and surfaces key steps that coalitions can take to co-create an inclusive community process.

Read More

Third Space Report

Anti-Racist Community Development

In this document, ThirdSpace Action Lab provides a high-level overview of their research findings on why focusing on racism in community development matters; what dominant narratives are underpinning racism in the sector; how structural racism specifically manifests; and what a more explicit, more affirmative anti-racist approach might look like within the community development sector.

Read More

Purpose Built Communities

Where We Thrive Framework

When working with communities and across sectors, it is important to find what binds different groups together. Purpose Built Communities and FrameWorks Institute developed guidance to help foster value-based conversations and shift cultural mindsets about how we think and talk about fairness, prosperity, and working together across sectors and neighborhoods.

Read More


Moving to Institutional Equity: A Tool to Address Racial Equity in Public Health

NACDD created the Moving to Institutional Equity tool to help users recognize institutional racism by moving through a series of worksheets that give step-by-step directions to identify potentially racist policies and/or procedures and then to explore opportunities to change the outcomes.

Read More


Centering Equity in Collective Impact

“Collective impact is a network of community members, organizations, and institutions that advance equity by learning together, aligning, and integrating their actions to achieve population and systems-level change.” This resource from Stanford Social Innovation Review explores the global field of collective impact, which has blossomed in recent years, and offers a set of actions to lead equity-centered collective impact work to ensure these initiatives’ efforts do not fall short.

Read More

FrameWorks Institute

The Terrain of Spatial Justice

Rooted in an understanding of how racism shapes and is built into places, this report, produced by FrameWorks Institute, maps the existing cultural mindsets of place, race, and their relationship and describes how they can enable or inhibit transformative work for spatial justice.

Read More

Organization Reflection Questions

In what ways does your organization create spaces that allow you to express your emotions and encourage storytelling with your colleagues?

What are some initial steps your organization can take to establish partnerships with the community development sector to further advance health and racial equity?

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Let’s Collaborate

The goal of this primer is to promote collaboration between public health and community development to advance health and racial equity through the vital conditions for health and well-being framework.

There is much alignment in the focus and shared values of these two sectors but still work to do on mutual learning and understanding of each other’s work. Both sectors need to adopt approaches that recognize intergenerational trauma and are grounded in the history of place and communities to advance equity.

Our hope is that practitioners can lift up the ideas highlighted by this primer, to advocate for multisector collaboration to focus on community-driven and anti-racist approaches that advance health equity in communities across the country.

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