When it Comes to Silo Busting on Health and Housing, This Insurer Is Out Front

Like most sectors, philanthropy can trend towards specialization. Money goes out to fund particular projects. Grantmaking programs set reporting guidelines to make sure grantees fulfill the original intent. Silos develop and careers are honed to focus on making a difference in health, or in housing, or in early childhood development.

Lately, though, it seems like everyone and their brother is out to bust silos. Invoking terms like “ecosystems,” “intersectionality,” and "collective impact," more initiatives are trying to solve problems the same way real people actually encounter them: in a messy jumble, without confining their scope to neatly-arranged categories.

Health and housing are two areas where we're seeing some of the most ambitious silo busting these days. More health funders are looking at people's housing situation as a factor in their health outcomes. Meanwhile, various other funders—in fields like education and workforce development—are focusing more on how a housing affordability crisis is implicated in a lot of other

As we've reported, the Robert Wood Johnson Foundation is one leader in linking health to housing. It channels funds toward affordable housing in New Jersey and has been promoting a holistic concept of a “culture of health” that includes keen attention to the broader patterns of American life. Kresge is another big player with similar priorities. The Boston Foundation’s Health Starts at Home initiative also targets this nexus, as we reported. Locally, funders like the California Endowment, the Colorado Health Foundation, the New York State Health Foundation, and the Blue Cross and Blue Shield of Minnesota Foundation are also looking upstream to change health outcomes, with many spotlighting the role of housing. (See links below.)

Then there is the big-time health insurer, UnitedHealthcare, which is devoting $16.9 million to affordable housing in Michigan. The company has also invested over $240 million since 2011 developing housing in fourteen different states.

What's going on with that? 

The answer isn’t purely altruistic. As an insurance firm, UnitedHealthcare doesn’t want to pay the hospital bills when its low-income clients get sick. It would rather they never get sick at all. It’s in an insurer’s best interests to move past medicine-only care and toward preventative social services. And what can be a more basic ingredient to personal well-being than a roof over your head?

UnitedHealthcare is funding two projects in Michigan: New Parkridge (in Ypsilanti), an 86-unit affordable housing community with onsite support services, and Prestwick Village (in Holt), with 66 units and support services, catering in part to disabled residents and homeless veterans. Implementation partners include the Minnesota Equity Fund and Cinnaire, a community development financial enterprise. Both organizations leverage private investments to fund affordable housing.

Amid valid concerns about urban affordability and gentrification, the ugly reality of homelessness exposes how much society stands to lose (even on purely financial terms) when social services fail the most vulnerable. Think spending on police, ambulances, and emergency room care, all of which might be unnecessary if people didn’t have to live on the streets in the first place.

It’s a positive sign that for-profit firms like UnitedHealthcare are willing to throw money at the housing shortage, even though it is far from clear that the approach will make any real dent in the problem. For cash-strapped affordable housing developers, though, it suggests hidden pockets of funding from nontraditional sources willing to consider the bigger picture.

As we’ve argued before, the affordable housing crunch has been a difficult nut for philanthropy to crack. The sheer resources it would take to build our way out (what UnitedHealthcare is essentially trying to do) are daunting, but funders can still make smart investments. Impact investing is key here, with the potential to move much bigger sums of money. Another strategic move is spending on advocacy to make it easier to develop affordable housing and harder for local interests to block it. Speaking of advocacy, I shouldn’t understate the Affordable Care Act’s role. When insurers are mandated to provide coverage, the market becomes sensitive to those it could previously leave out.