HUD Healthy Communities Transformation Initiative

The Healthy Communities Transformation Initiative (HCTI), funded by the U.S. Department of Housing and Urban Development’s (HUD) Office of Lead Hazard Control and Healthy Homes (OLHCHH), searched for ways to improve the systems and the physical, social, and economic service structures that support healthy living and behaviors in our communities. From June 2012 through 2016, Healthy Housing Solutions, Inc. (Solutions) led a diverse team of partners in developing this project which included two key elements: creation of a Healthy Communities Index (HCI) and development of the Healthy Communities Assessment Tool (HCAT), which used HCI indicators to measure community health at the neighborhood level..

Solutions designed the HCI to help communities identify baseline conditions, prioritize investments, and evaluate progress towards their community health goals. The HCI contains 10 domains:

  • Educational Opportunities,
  • Economic Health,
  • Employment Opportunities,
  • Environmental Hazards,
  • Health Systems and Public Safety,
  • Housing,
  • Natural Areas,
  • Neighborhood Characteristics,
  • Transportation, and
  • Social Cohesion.

For each domain, Solutions selected evidence-based community health indicators based on their measurability at the neighborhood level, connection to health outcomes, relationship to public health objectives, ability to be scalable and easily interpreted, and finally, on their capacity to motivate and create actionable policy and program change. Solutions’ team began with a list of more than 150 indicators drawn from peer-reviewed journal articles and other technical documents and ultimately selected 31 core health indicators, six optional health indicators, and five demographic and contextual measures.

The Healthy Communities Assessment Tool (HCAT) employs HCI indicators to help communities evaluate neighborhood level health factors, build partnerships, and engage diverse stakeholders in efforts to improve community health. The HCAT serves as a downloadable web-based tool to enable communities to rank individual neighborhoods according to how they well they meet HCI indicators compared to other neighborhoods within their individual City. Data to populate the HCI indicators are pulled from a variety of distinct resources to more accurately reflect specific neighborhoods, from census tract and block to scorecards and rankings developed by national organizations for specific indicators. Due to the complexities involved in identifying, computing, and uploading a city’s first set of HCI indicator data, Solutions created a detailed HCAT manual to help users create their initial data sets and accurately upload data to the HCAT.

For nearly a year, Solutions worked with four cities (Albuquerque, New Mexico; Minneapolis, Minnesota; San Diego, California; and Providence, Rhode Island) to pilot test both HCI and HCAT. In addition to the initial piloting, Solutions also worked with partners in Houston, Texas, and Opelika, Alabama, to test the effectiveness of the HCI and HCAT in a very large city (Houston) as well as in a small, more rural community (Opelika). Solutions helped each of these communities populate and launch the HCAT as well as offered training and technical assistance on how to better understand how social determinants of health impacted their neighborhoods.

Although the HCAT is no longer available to download from HUD, the list of HCI indicators as well as their potential uses, the HCAT Administrative Guide and an archived demonstration of the tool are still available to interested stakeholders. Access an archived version of the HCAT demo and access additional resources related to social determinants of health here.

Contact Noreen Beatley for more information about this project.

Overview of the HUD Healthy Communities Transformation Initiative [pdf]