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Integrating Housing and Health

Image of an apartment building surrounded by trees.At a recent Bipartisan Policy Center event, HUD Secretary Ben Carson and panelists discussed efforts to promote positive health outcomes through housing.

Research indicates that a lack of safe, affordable housing can negatively impact health. For example, the likelihood of having frequent and severe mental or physical illnesses is higher among individuals experiencing homelessness, and families who forgo healthy food or medicine to pay high housing costs may experience poor health outcomes. In addition, unsafe conditions within the home, such as the presence of lead, can trigger or worsen health issues. A new report from the Bipartisan Policy Center (BPC) highlights the link between housing and health and explores strategies to use this connection to improve health outcomes. To further the discussion, BPC held an event at which HUD Secretary Ben Carson and panelists discussed their efforts to promote positive health outcomes through affordable housing.

The Importance of Healthy Homes

BPC chief medical advisor Anand Parekh and BPC president Jason Grumet joined Secretary Carson to open the event by focusing on the importance of safe and healthy housing. Parekh stated that because people spend more time in their homes than anywhere else, improving housing quality is essential for promoting health. He also emphasized the need to assist those most vulnerable to negative health outcomes, such as low-income renters and households at risk of homelessness. Secretary Carson concurred, discussing how health issues such as in-home lead exposure not only have a monetary cost but also reduce life potential, and he stressed the economic and societal benefits of preventing lead exposure over treating its effects. “People are our greatest asset,” said Secretary Carson. “The poor, the disabled, [and] the elderly are at the greatest risk of health problems related to insecure housing.” As a society, we need to recognize how to provide a holistic, nurturing environment for everyone, noted Secretary Carson.

Secretary Carson described how HUD’s new EnVision Center Demonstration will help the department identify and address the health concerns of HUD-assisted households. The EnVision Center Demonstration will bring services offered by federal, state, and local governments; nonprofits; and the private sector into one centralized location in communities, improving access to these services. Health and wellness will be one of the four focus areas of the EnVision Center Demonstration, with a goal of increasing the number of annual physicals and screenings among area residents to identify health concerns.

Participating in the Health and Housing Connection

A panel discussion continued the conversation on the connection between housing and health. The panelists included Eileen Fitzgerald, president and chief executive officer of Stewards of Affordable Housing for the Future; Donald Moulds, executive vice president for programs at The Commonwealth Fund; and Samuel Ross, M.D., chief executive officer of the Bon Secours Baltimore Health System. Panelists discussed housing as a platform for health and described how different types of organizations can participate in the integration of housing and health services.

As a representative of a collaborative of nonprofit affordable housing providers, Fitzgerald promoted an increase in the supply of quality, affordable rental housing as an important strategy to mitigate negative health outcomes for low-income families. Providing affordable, healthy housing can improve health outcomes, for example, by reducing the number of emergency room visits. Housing in amenity-rich neighborhoods can also increase access to the social determinants of health, including healthy food, transportation options, and employment opportunities, noted Fitzgerald. In addition, once families have safe and affordable housing, that housing can be a platform for increased access to health care through onsite services or transportation to nearby health service providers.

Fitzgerald also provided examples of successful partnerships between housing and health services providers that have increased residents’ access to health care. Volunteers of America and Mercy Housing are collaborating with Colorado Access to have a Colorado Access-sponsored care coordinator onsite to educate residents and help them access healthcare services. In Chicago’s Woodlawn Park redevelopment, SGA Youth and Family Services offers onsite mental health services for low-income residents and refers only approximately 3 percent of those residents to offsite service providers. According to Fitzgerald, the organization has helped reduce the stigma of mental health conditions.

Ross outlined some of the ways in which healthcare leaders can help to meet local housing needs. First, Ross underscored the importance of conducting outreach and consulting with community members, whom he referred to as experts, about their health priorities and needs. In West Baltimore, the health issues that community members raised were not diabetes, heart disease, high blood pressure, or cancer but the effects of rats and trash from the area’s vacant and abandoned houses, said Ross. Ross also noted that healthcare providers typically are the largest employers and economic engines in their communities, and he stressed how, as anchor institutions, they have an opportunity to meet community-identified needs. Ross described how Bon Secours Health System has responded to the need for quality housing by building and redeveloping existing housing. Bon Secours has provided more than 800 affordable housing units, far more than the 70 beds in its hospital. Ross also described how Bon Secours is collecting data on participants in its health programs and working with research partners to better understand health outcomes.

Moulds focused on how philanthropic organizations can promote coordination between health and housing efforts. According to Moulds, philanthropic organizations have more freedom to explore and sponsor innovative solutions to health and housing problems than do government agencies. When a government agency provides funding for a new program, project, or development, it may have to reduce funding for other programs, developments, or projects if its budget does not increase. Philanthropic organizations can work quickly and seize opportunities to collaborate with healthcare providers and explore housing as a cost-effective health intervention.

Lessons on Linking Health and Housing

Because the availability of quality, affordable housing is linked to health outcomes, connecting housing and health efforts will help address community health issues more efficiently and effectively. The event highlighted the opportunity that governments, housing and healthcare providers, philanthropic organizations, and other entities have to contribute to the integration of housing and health services and promote positive health outcomes. Additional recommendations on linking health and housing efforts can be found in BPC’s report.