In recent years, public health organizations have increasingly acknowledged the impact that housing can have on health.
Source: HUD Office of Policy Development and Research
Photo: Courtesy
Cover Photo Caption: Salt Lake City-based Intermountain Health is investing in housing to help serve its patients across the Western United States, which faces a shortage of affordable housing.
In 2024, an analysis of federal data showed that Utah was the nation’s ninth most expensive statewide housing market, and housing prices increased by 651 percent from 1991 to 2024, the largest increase of any U.S. state during that period. Although housing prices have stabilized since 2022, housing across the state remains out of reach for many.
The effects of this crisis extend beyond the housing market and into other systems, including health care. In recent years, public health organizations have increasingly acknowledged the impact that housing can have on health. High housing costs drain residents’ resources for other basic needs such as health care and drive households into low-quality housing and unsafe or underinvested neighborhoods, leading to negative health outcomes.
Recognizing these connections, some health institutions have taken direct action to combat the housing crisis. Intermountain Health, a nonprofit health system based in Salt Lake City, has established several programs to support residents’ health through housing access and financial wellness. These efforts include past and present investments to support the development of affordable housing across Utah and other states in the system’s operating region.
Investing for Impact
Intermountain Health’s commitment to community health began in 1975, when the Church of Jesus Christ of Latter-Day Saints transferred its hospitals into a nonprofit. Intermountain Health operates 33 hospitals and 400 health clinics across Utah, Nevada, Wyoming, Colorado, Montana, and Idaho, with its most significant community investments concentrated in Utah. In recent years, Intermountain Health joined a broader movement among health systems to address housing stability and economic opportunity, recognizing that these factors play an essential role in health outcomes.
Starting in 2018, Intermountain Health began to participate in what it calls “place-based” investing and formalized its commitment to the strategy in 2019 by hiring a director for the program. Intermountain Health has pledged at least 2 percent of its overall investment portfolio to projects and programs that support economic well-being and development across three areas: housing stability, employment, and financial wellness. The nonprofit identifies community needs through independent research and by conducting regular community health needs assessments for its hospitals. Unlike traditional philanthropy, place-based commitments recover the original amount invested, allowing Intermountain Health to make larger commitments to community well-being.
Intermountain Health makes most of its place-based investments through indirect lending via community development financial institutions (CDFIs) and other intermediaries. This strategy initially was difficult because of the lack of intermediary organizations in the state, but it has become Intermountain Health’s primary strategy for place-based investing. For example, in 2023, Intermountain Health announced a $10 million investment in a partnership with NewWest Community Capital. The Boise-based CDFI loans money to distressed communities across the western United States, with projects in Utah, Montana, Idaho, Arizona, New Mexico, and Nevada.
Intermountain Health’s investments have had a substantial impact on housing in Utah. The nonprofit committed $111.2 million toward place-based investments between 2019 and 2023, including $44.9 million in 2023 alone, financing 2,056 units of affordable housing and delivering financial wellness services to 939 individuals. Between 2019 and 2021, Intermountain directed most of its total place-based investments toward combating housing instability and financed 1,058 affordable units.
The Utah Housing Preservation Fund
In addition to its ongoing place-based investments, Intermountain Health played a key role in forming the Utah Housing Preservation Fund (UHPF), a nonprofit organization that acquires and preserves affordable housing at risk of conversion to market-rate housing. Intermountain Health provided $4 million to help launch UHPF in 2020 alongside other partners. The UHPF was initially structured as a series of individual deals for which Intermountain Health helped reduce risk by serving as a secondary lender. This cross-sector partnership enabled the fund to make larger loans by sharing some of the associated financial risk.
The fund has since become a separate legal entity, managed by the Utah Nonprofit Housing Corporation, which Intermountain Health continues to support. UHPF acquires both naturally occurring affordable housing and properties developed through low-income housing tax credits with timed deed restrictions that are set to expire. Once UHPF acquires the housing, it creates a new deed requiring the properties to remain affordable for households earning up to 80 percent (or, in some cases, up to 60 percent) of the area median income (AMI). In addition to ensuring affordability, the fund renovates acquired properties in need of repair and connects residents with wraparound services such as health care, childcare, and credit counseling.
Since its inception, UHPF has provided housing to 2,437 tenants with an average household income of 46 percent of AMI. The fund also ensures statewide benefits by aiming to commit 30 percent of its acquisitions to rural areas; 242 of the 1,015 affordable units that UHPF has preserved are in rural areas. At least 604 units are deed restricted to be affordable for households earning up to 80 percent of AMI; 96 are restricted for households earning up to 60 percent of AMI.
Health Care as a Financial Anchor
Intermountain Health’s strategic investments in housing illustrate how health systems can move beyond traditional care delivery to strengthen the communities they serve. By explicitly directing funds to support residents’ economic well-being, Intermountain Health serves as a financial anchor in the communities it serves.
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