BLOG: Cross-sector Partnerships: Developing Solutions from Untraditional Collaborations

Cross-sector Partnerships: Developing Solutions from Untraditional Collaborations

“Innovative cross-sector partnerships” sounds just like another string of buzzwords, trite, overused, and only deemed relevant until the next new phrase catches on. The idea of needing cross-sector partnerships to achieve health equity is not a new concept, but one that needs dire attention and incorporation into more organizations’ missions. The U.S. health system is complex, consisting of public, private, community-based, for-profit, and non-profit organizations that typically function in isolated silos, often too overwhelmed with their own narrow duties to have the capacity to collaborate with each other, let alone with partners outside of the healthcare sector. However, health disparities did not come into existence as a result of singular causes, but rather due to multiple, systemic root causes that uphold disparities. Therefore, collaboration and engagement across fields and organizational interests are crucial in order to truly eliminate health disparities on a national scale and to foster health equity for all. The best solutions might result from the most unexpected partnerships and require innovative, out-of-the-box engagement with stakeholders from a variety of fields.

Multi-Faceted Problems Require Multi-Faceted Solutions

Enterprise Community Partners (Enterprise), a partner of The Root Cause Coalition, has engaged in numerous cross-sector initiatives to improve the health of low-income Americans and the communities they serve. As an affordable housing intermediary organization, Enterprise has played a key role in the development of affordable housing communities across the country since 1982, through capital, policy, and programmatic solutions. Although their work focuses primarily on housing issues, Enterprise understands the value and significance of engaging peer organizations to address other interdependently connected social determinants of health. According to Brian Rahmer, Vice President of Health and Housing at Enterprise “for every 10% of households in the country that are severely cost-burdened, there are 29,000 more children linked to poverty, 86,000 more people who are food insecure, and 84,000 more people who reported poor or fair health outcomes.” Housing issues cannot be viewed as an isolated problem, and thus, housing solutions must be considered utilizing a variety of perspectives across different sectors and fields.

The Power of Partnership

There are significant opportunities and collective social power that can arise from partnerships. Mary Ayala, Program Director for National Initiatives at Enterprise shared an exciting process, the Health Action Plan, that Enterprise developed to facilitate cross-sector partnerships in the affordable housing development process. “We believe there is a lot of potential to integrate health through the design, operations, and programming of affordable housing.”  Affordable housing developers can pursue the Health Action Plan independently or as an optional criteria in the Enterprise Green Communities Certification. The Health Action Plan was developed in partnership with U.S. Green Building Council and the Health Impact Project and guides housing developers through a process of partnering with a public health professional, collecting and analyzing health data, engaging residents and community stakeholders and developing a plan centered on the design, operations and programming of the development to improve the health outcomes of residents in that housing development, and then implement and monitor the impact of the plan. The Health Action Plan has produced many partnerships that would otherwise might not have been formulated, most notably a collaboration with Kaiser Permanente. The major invested $50M into the Housing for Health Fund for the preservation and development of affordable housing communities in Oakland, California in collaboration with Enterprise to ensure that the health of low-income residents is regarded beyond simply just having shelter. Developers who utilize the fund are required to develop a health action plan, implement the plan, and monitor the health outcomes of residents to collect data on the initiative. Through the cross-sector partnership between an affordable housing intermediary and one of the largest healthcare systems in Northern California, the organizations developed integrated solutions to address the broader implications of how housing impacts health outcomes.

Challenges of Collaboration

Fostering collaborative relationships between organizations in different fields is easier said than done. Many organizations who are interested in forging a relationship with a partner in another field may be faced with a variety of challenges. Smaller or newer direct service organizations may lack the capacity to provide the additional staffing or resources required to manage or maintain partnerships with larger businesses or health systems. There might be a lack of trust or relationships that are too shallow between organizations to effectively collaborate with each other. Some organizations may not even realize the potential of cross-sector partnerships and require more time to understand the role their organizations can play in such opportunities. Although not all organizations may be ready to pursue these types of collaborative partnerships, all organizations have the potential to play a role in the partnerships needed to achieve health equity. Organizations that have the means to do so can play a critical role in supporting other organizations that are still growing by aiding in capacity building and strengthening existing assets. Enterprise Community Partners, Inc. recognizes that housing developers and public health professionals may not have the financial resources and capacity to tackle housing as a health issue independently. That is why integrated solutions that bring together the resources and expertise of multiple partners in new ways, like the Housing for Health Fund, as we start to treat health in America at its root causes.

In order to tackle the myriad of health disparities disproportionately impacting Americans, we need to work together, across sectors and traditional boundaries. Only when we break down silos and collectively leverage our strengths will we be able to achieve our shared vision of health equity for all.


Enterprise is a proven and powerful nonprofit that improves communities and people’s lives by making well-designed homes affordable. We bring together the nationwide know-how, partners, policy leadership and investments to multiply the impact of local affordable housing development. Over 35 years, Enterprise has created nearly 470,000 homes, invested $28.9 billion and touched millions of lives. Join us as

Thank you to Mary Ayala, Program Director for National Initiatives, and Brian Rahmer, Vice President for Health and Housing, for informing this blog post.