For many years, healthcare experts have struggled to get more low-income residents in under-serviced communities to visit the doctor more regularly. Some poor Americans avoid doctors because they are uninsured; others, however, stay away even when free clinics are available because they lack time, awareness, or education about their healthcare needs.
In Brockton, Massachusetts, a largely immigrant community 40 minutes south of Boston, over a third live at or under 200 percent of the poverty threshold. This is, traditionally, hard terrain for medical-access reformers. But the local neighborhood health center believes it has developed an approach that works for their clients, of whom a full 19 in 20 fall below that threshold. Utilizing millions of dollars from an array of public and private sources, they have partnered with Vicente’s, a grocery store long owned by a Cape Verdean family in the area, to create a large new hybrid venture, combining the shopping and medical experience into one outing.
Four years ago, with their old store too small to cater to the thousands of local residents who shopped for an array of ethnic foods at their store, the owners of Vicente’s began researching ways to buy a new, 32,000 square-feet market. Aware that they didn’t have enough income to approach a bank for the sort of loan they would need, representatives from Vicente’s instead approached Deborah Favreau, the chief development officer of the Massachusetts Housing Investment Corporation, for help raising money.
Favreau was an expert in New Markets Tax Credits, a federal tax program, established in 2000 and aimed at promoting businesses in low income neighborhoods. The program offers tax credits in exchange for private investment in local projects. Favreau heard out the pitch from the Vicente’s rep and decided it was a perfect fit. By itself, the store would never be able to raise enough cash to open a large new site. With the credits, however, which would cover over 25 percent of the $14.5 million cost, and for which it would qualify based on the fact that the store was providing healthy, affordable food, in a poor, immigrant community, it would be able to expand.
In Brockton, word spread that Vicente’s was looking to go bigger. Within weeks, the neighborhood’s health center—a federally qualified clinic that was mandated to treat anyone in need—approached Vicente’s and suggested a partnership. In a city beset by all the illnesses of poverty, from diabetes to heart disease, it made sense to all parties, and, it also offered an opportunity for a number of other big-money funders to step in. Chief among these was Boston Community Capital, a regional group that soon would decide to kick in nearly $6 million; and the Local Initiative Support Corporation’s Healthy Futures Fund, a $100 million effort that is funded by Morgan Stanley and Kresge. “This is an expansion of adult care,” says the funds’ program director, Emily Chen. “We want the services to be more accessible to people. We really believe in co-located services for low-income residents, and co-programming—so that there is a deliberate push for access between the two locations.”