Leveraging Partnerships and Data to Improve Rural Health and Well-Being: A Guidebook for Rural Practitioners

Rural communities face many health challenges, often related to structural barriers such as limited access to health care. Targeted services and programs can improve rural health and well-being but require strong partnerships and committed funding. Additionally, good data is necessary to identify problems and track how well new programs are working. This guidebook provides ideas and examples for rural stakeholders and communities who want to improve rural health and well-being by building partnerships, implementing innovative service models, and leveraging data.This guidebook may be useful to three groups:Rural community and economic development specialists who work on improving local economies and social well-being. They may finance or build housing or support systems delivering water, sewer, or broadband internet services to communities. They may also finance and assist local businesses and community spaces like schools and libraries and may want to learn how to focus more on health.Rural health services professionals who help prevent health problems and address urgent health needs. These medical experts may be looking for different partners and models to work closely with other community stakeholder groups and actors to address health needs.Funders focused on improving rural health who may be interested in learning about promising health models and partnerships that they could potentially invest in to help meet their funding goals.The guidebook covers the following topics:making a general case about rural health needs to policymakers and funders, including the challenges and opportunities in meeting these needsidentifying potential local partners for improving rural health and well-beingconsidering service models for rural programs or communitiesmeasuring progress to understand if programs are achieving desired goalsfinding and using the best data to identify problems and track outcomesThis guidebook also includes recommended resources for more in-depth information on these topics

Mutual Accountability Is the Key to Equity-Oriented Systems Change: How Initiatives Can Create Durable Shifts in Policies and Practices

The COVID-19 pandemic and protests arising from police killings of Black Americans have drawn national attention to long-existent and worsening racialized gaps in health, wealth, and well-being that decades of investment and problem solving have been unable to close. Responding to amplified calls from communities and advocates for meaningful change, some philanthropic organizations are reexamining what and how they fund. We present findings from one such effort by the Robert Wood Johnson Foundation (RWJF) in partnership with the Urban Institute to assess the funder's health-promoting portfolio of investments in community development organizations and activities.This brief presents a framework for grantmakers seeking to understand why some past efforts have fallen short and how future investments might produce more equity-oriented, power-shifting systems change. Urban analyzed a portion of RWJF's portfolio consisting of 15 health-promoting programs and investments launched between 2013 and 2019 that aimed to integrate public health, health care, and community development to improve community health, well-being, and equity. As part of the assessment, we developed a guiding framework that proved critical to our inquiry. We were able to road-test the model as we synthesized insights from dozens of interviews with grantees and partners, community development intermediaries, and philanthropic leaders and staff. The mutual accountability framework allowed us to disentangle intended goals, necessary commitments, and actual results to think about the ways these three elements may—or may not be—aligned

Wealth Opportunities Realized Through Homeownership (WORTH): Baseline Report

This report is part of an evaluation of the Wealth Opportunities Realized through Homeownership (WORTH) initiative. Led by the Wells Fargo Foundation, WORTH supports efforts to close persistent disparities in homeownership in Atlanta, Houston, Milwaukee, New York, Philadelphia, Richmond, San Diego, and rural and tribal areas. In each market, we examine housing supply and demand, homebuying activity, homeownership trends, and preservation conditions. We found that in almost every market, white households have higher homeownership rates than every other racial or ethnic group. Moreover, macroeconomic forces driving market conditions, like higher interest rates and moderating house prices, can significantly dampen or thwart market collaboratives' efforts to boost homeownership rates for people of color. Future evaluation will examine the implementation processes used in each market. The larger body of work contributes to understanding the crucial connection between homeownership and wealth-building and the multitude of barriers that households of color face in achieving homeownership. It also supports research-backed strategies for increasing homeownership for households of color and for reducing racial disparities

Linking public housing, employment, and disability benefits for working-age people with disabilities

Since the 1990s, US housing policy has emphasized increasing the economic self-sufficiency of assisted households. However, an estimated 41% of working-age public housing tenants have a disability, and many participate in multiple public benefit programs. We explore this policy dilemma by asking: (1) do levels of employment vary between people with disabilities who are and who are not residing in public housing, and (2) do the types of disabilities vary by those who are and who are not residing in public housing? We also consider whether or not answers vary based on household receipt of public disability benefits. Results from the Current Population Survey suggest that working-age people with disabilities who live in public housing but do not receive disability program benefits are significantly less likely to be employed than disabled non-beneficiaries who do not reside in public housing. No differences in employment levels are noted between Social Security disability program participants who do and do not live in public housing. Some significant differences in types of disabilities were noted among disability program participants who do and do not reside in public housing. We discuss policy implications and suggestions for further research

Democracy in Action?: NIMBY as Impediment to Equitable Affordable Housing Siting

Effective democracy requires participation. However, the history of urban politics, housing policy, and neighborhood revitalization has demonstrated that wealth and power often overshadow participation and community activism. Proponents of equity planning and advocacy planning in the USA have fought to include vulnerable, marginalized populations within planning decisions, yet there have been few examples of this in action. We apply Fainstein’s principles of The Just City (Ithaca: Cornell University Press, 2010) to investigate the extent to which local opposition affects affordable housing development. In doing so, we question the extent to which housing policy and planning in the USA successfully achieve the goals of equity and fairness, or whether not-in-my-backyard forces operating within (and beyond) “democratic” planning processes override those principles in siting decisions. Our results suggest that community opposition is a considerable barrier to the efficient siting of affordable housing, and propose changes to local planning and implementation strategies in order to minimize opposition and produce more equitable outcomes

Democracy in Action?: NIMBY as Impediment to Equitable Affordable Housing Siting

Effective democracy requires participation. However, the history of urban politics, housing policy, and neighborhood revitalization has demonstrated that wealth and power often overshadow participation and community activism. Proponents of equity planning and advocacy planning in the USA have fought to include vulnerable, marginalized populations within planning decisions, yet there have been few examples of this in action. We apply Fainstein’s principles of The Just City (Ithaca: Cornell University Press, 2010) to investigate the extent to which local opposition affects affordable housing development. In doing so, we question the extent to which housing policy and planning in the USA successfully achieve the goals of equity and fairness, or whether not-in-my-backyard forces operating within (and beyond) “democratic” planning processes override those principles in siting decisions. Our results suggest that community opposition is a considerable barrier to the efficient siting of affordable housing, and propose changes to local planning and implementation strategies in order to minimize opposition and produce more equitable outcomes