Housing IS Healthcare: A new Vision for Climate and Health Equity

What if we treated housing like healthcare?

It sounds radical, but it’s not. For millions of Americans, the quality of your home does more for your health than your doctor ever could. Poor ventilation, mold, extreme heat, and air pollution quietly shape life expectancy. Yet, despite this reality, housing and health still live in separate silos—funded separately, measured separately, and governed by systems that rarely talk to each other.

As climate change intensifies and housing becomes more unaffordable, these divides are becoming dangerous. It’s time to rethink what “health infrastructure” really means.

From Silos to Systems

At Sustento Initiative, we’re working with partners like Enterprise Community Partners, and UCLA to bridge the gap between housing, health, and climate. Our simple but powerful idea: if we can measure and account for the full health, social, and environmental benefits of better housing, we can unlock the investment needed to make it happen at scale.

Think about it—upgrading old apartment buildings with better insulation, efficient HVAC, and induction stoves doesn’t just lower emissions. It reduces asthma triggers, keeps people safe during heat waves, and improves residents’ quality of life. Those outcomes save lives—and money. So why aren’t they reflected in how we finance housing?

The Experiment: Data-Driven Health Equity

Together with UCLA and community housing providers, Sustento is bringing science to the street level, collecting real-world data from affordable housing properties across Los Angeles—tracking indoor air quality, temperature, and residents’ well-being before and after climate-resilience retrofits.

This data helps answer big questions:

• What’s the real “return on health” from green retrofits?

• How can we combine housing, healthcare, and climate funds to pay for them?

• What financial structures will make this kind of investment scalable nationwide?

By translating these findings into financial models, we can help investors and policymakers see what residents have known all along: a healthy home is a foundation for a healthy life.

Communities at the Center

Health equity can’t be achieved for communities—it has to be achieved with them.

That’s why our model centers resident voice and participation at every step. From community visioning labs to pre- and post-retrofit health surveys, residents are co-designers, not afterthoughts. They help shape project priorities, test new technologies, and even lead workshops—like induction cooking demos featuring culturally relevant recipes.

It’s a small but powerful shift: when residents are part of the process, solutions stick.

From Pilot to Pipeline

This isn’t just research for research’s sake. Over the next two years, we’re piloting 10–12 affordable housing projects across Los Angeles, implementing comprehensive retrofits in at least five. Using the Capital Absorption Framework, we’re aligning public, private, and philanthropic partners around shared priorities—and building an investable pipeline that connects health, housing, and climate outcomes.

That means blending capital from community lenders, health systems, and philanthropy. It means rethinking underwriting to include co-benefits like reduced hospital visits or improved resident comfort. And it means designing deals that make financial sense because they improve health, not in spite of it.

A New Model for Health Equity

It’s time for big, bold, community-rooted visions of well-being. This is ours: a model that redefines housing as health infrastructure, guided by science, powered by collaboration, and grounded in community experience.

Because health equity isn’t just about access to doctors or medicine. It’s about living in a home that’s safe, resilient, and affordable—a home that keeps you well.

When we invest in housing as healthcare, we invest in the long-term vitality of our communities. We reduce costs, cut emissions, and create systems that work across generations.

It’s time to stop patching problems in isolation and start building the healthy, affordable, climate-resilient homes our future depends on.