Social determinants of health are the conditions where people are born, live, work, worship and play that affects their overall health and wellbeing. The built environment is a social determinant that includes housing, transportation, safety, greenspace, pollutants, and overall geographical environment. In Cumberland County, NC, the built environment within the county, specifically poor-quality housing, disproportionately impacts the rate of asthma-related emergency department (ED) visits and hospitalizations, disproportionately affecting Black children from birth to five. To address this inequity, we proposed the formation of an Accountable Care Community (ACC). The goal of the ACC is to provide funding for the implementation of the Community Asthma Initiative program and passing a mandatory annual building inspection policy. Both interventions will identify and remove asthma triggers to improve the county’s built environment and reduce asthma-related ED visits and hospitalizations for children from birth to five by 40% over a five-year period.