Networked and entrepreneurial approaches for public health: Leveraging community development investments

Public and non-profit public health agencies face an increasingly challenging funding environment of government shortfalls and a changing philanthropic model. Recognizing these trends, public health must adapt by better measuring and accounting for complex, multiple-intervention life cycles. They must simultaneously leverage capital from other agencies and sectors, including private and social investors. Public health stakeholders can achieve broader more sustained outcomes by expanding partnerships to tap these larger sources of capital and realize a collective impact. Both networked and entrepreneurial solutions are needed. Community development finance institutions are an especially promising partner, having a similar goal of public well-being and the expertise to secure capital. Community developers envision increasing returns on investments in housing and low-income neighborhoods by considering health outcomes. Healthy Communities forums sponsored by the Federal Reserve Banks nationwide have initiated this conversation. Similarly, public health agencies can do better by re-framing their work, as reflected in 2013 National Public Health Week: "Public Health is ROI". Expanding upon sentinel reports in this field, this paper discusses how public health can partner with community developers and social entrepreneurs. It examines the role of social impact bonds and opportunities for innovation. It offers ten recommendations for attracting investors and leveraging "outside" resources. Public health must learn to design, measure and market their interventions to demonstrate ROI. Ultimately, public health must remain committed to the social contact, yet be a convener and jointly seek private capital at a level that endows philanthropies, rather than fighting over the dividends.