« October 2016 Issue

Home Is Where the Health Is

Health + Housing

The fact that there is a strong linkage between health and housing is not a new revelation, but the push for “healthy housing” is gaining traction as an emerging social justice area ripe for advocacy. The Flint, Michigan water crisis, where nearly 100,000 residents in the financially-strapped city were exposed to dangerously high levels of lead in their water after the city’s water source was changed in a cost-cutting measure, put a vivid national lens on one connection between health and housing. The cost to replace tainted pipes and water source infrastructure is estimated at more than one billion dollars, but the long-term cost of providing care for residents, particularly children, who could end up with significant ongoing physical and cognitive health problems associated with lead exposure will not be known for a generation.

But it doesn’t end with bad pipes and poisoned water. Substandard housing conditions such as water leaks, poor ventilation, dirty carpets and pest infestation can lead to an increase in mold, mites and other allergens associated with poor health, notably the development of asthma. A 2001 study attributed 40 percent of asthma diagnoses in children to residential exposures, the treatment of which costs the health care system billions of dollars every year. And beyond substandard housing, there is the chronic crisis of homelessness in America. According to the Department of Housing and Urban Development, more than 610,000 people experience homelessness in the United States and over 250,000 individuals within that population are living with a severe mental illness and/or a substance use disorder that often forces them to repeatedly seek costly care in emergency rooms.

Connecting housing and health care advocacy is a new bridge-building exercise for Community Catalyst that came about after staff from our children’s health, hospital accountability, health system transformation and substance use disorders projects learned they had something in common: advocacy partners at the state and community levels who they learned were working on housing issues as a means to improve the health of the populations they serve. At the same time, addressing these and other social and economic determinants of health was named as a key policy priority by the Community Catalyst’s Center for Consumer Engagement in Health Innovation, which is actively exploring how ACA-sponsored Medicaid reforms could boost the availability of supportive housing to older adults and people with disabilities.     

“Though health and housing advocacy organizations have often worked independently, we noticed a considerable uptick in coalition building on the ground among these camps,” said Michele Craig, Outreach, Training and Evaluation Manager for the Hospital Accountability Project.

For instance, Pennsylvania Health Access Network works on a health and housing project overseen by our Value Advocacy Project and funded by the Robert Wood Johnson Foundation. The Housing as Health campaign is a statewide initiative focused on raising awareness of how health coverage and housing stability are linked, as well as educating advocacy organizations about how Medicaid could support housing initiatives. This, combined with their storytelling project, aims to build a sustainable coalition and spur innovative thinking about the links between housing and health in the Keystone State.

We also see housing-related initiatives in the Bronx (focused on the environmental effects substandard housing has on health); Portland, Oregon (focused on transforming communities through economic growth, without displacing existing residents - in this case many Asian cultures - including mixed-use redevelopment); and Boston (through focusing on connecting families to housing supports and other social services).

As a result, our program staff has been collectively reaching out to housing partners who have expertise in areas ranging from affordable housing to supportive housing for people living with disabilities, older adults, and people with substance use and behavioral health concerns.

“Our goal is to highlight the range of health policy opportunities to improve housing access and quality so we can support health advocates who want to effectively engage on housing issues (and vice versa),” said Craig. “We’ve been doing this through a webinar series that brings together state advocates, community development organizations, housing groups, hospitals, health plans, government and foundation staff.” 

Most importantly, the work ties directly to Community Catalyst’s goal of health equity. It is impossible to ignore the disproportionate impact these issues have on communities of color. A legacy of discriminatory practices in employment, economic policy and housing have all conspired to leave people of particular economic standing or racial/ethnic identity in substantially greater danger of developing complex health needs as a result of their housing.

“Because health equity is a core focus of Community Catalyst’s work, we hope that breaking down silos between health and housing advocates will help erode the greater barriers of injustice and inequity,” Craig added.

Jack Cardinal, Communications Manager

O N   T H E   W I R E

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Follow the Center for Consumer Engagement in Health Innovation on Twitter at @CCEHI for health system transformation updates!

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Community Catalyst issued Hospitals Investing in Health: Community Benefit in Massachusetts, which takes an in-depth look at the state of hospital community benefit in Massachusetts and finds there’s little evidence that millions of dollars in hospital investments are impacting community health. The report findings and recommendations are instructive for other states.

Michael Miller, strategic policy director, was quoted in a New York Times article about whether the Affordable Care Act’s tax penalty is motivating people to sign up for coverage.

Kimá Taylor, MD, has joined the Community Catalyst Board of Directors. Dr. Taylor is the founder of Anka Consulting LLC, a health care consulting company. She previously served as director of the National Drug Addiction and Harm Reduction program at Open Society Foundations.

Susan Sherry, deputy director, spoke to Modern Healthcare about new principles for patient-centered care developed by the Healthcare Transformation Task Force, of which Susan is a member.

The Center for Consumer Engagement in Health Innovation launched its new website and received coverage in Fierce Healthcare and Becker’s Hospital Review for its report on Medicaid Accountable Care Organizations (ACOs).

Hospital Accountability Project Program Director Phillip Gonzalez and Senior Advisor Jessica Curtis were quoted in a Pittsburgh Post-Gazette article about charity care at Pennsylvania hospitals.

Join us in welcoming new staff members. Helen Hendrickson, state advocacy manager, Dental Access Project; John Morgan, senior accountant; Celeste Davis, state advocacy manager, Children’s Health Initiative; Danielle Garrett, strategic policy manager, Center for Consumer Engagement in Health Innovation, and Marc Cohen, PhD, research director, Center for Consumer Engagement in Health Innovation.

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