Housing insecurity is a major social determinant impacting public health, and hospitals across the country are taking steps to target it, according to a new white paper.
The report (PDF), released by the Root Cause Coalition, notes that housing issues can take a number of forms, including homelessness or housing options that are financially out of reach. These concerns impact millions of Americans, according to the report, and can have significant impacts on both mental and physical health. Patients with housing insecurity may be less likely to seek needed care, making “toxic tradeoffs” to make ends meet—for example, passing on a key prescription to pay for groceries.
Because of these potential impacts, hospitals like those under Partners Healthcare are screening patients more closely for housing insecurity and other social determinants of health, according to the report. Patients flagged by the health system as potentially at risk for or suffering from housing concerns are connected with community organizations that offer support like short-term rental assistance, financial coaching, job training and other potentially beneficial programs.
Boston Medical Center has partnered with a number of community groups to target children in families that have high rates of emergency department use, according to the report. ER “superusers” are a significant burden on the industry, and BMC’s program offers housing prescriptions to patients and connects them with care coordination services to prevent unneeded ED visits.
In Cleveland, University Hospitals are instead using their role as an economic driver to stimulate local finances, according the article. A decade ago, the system kicked off a five-year, $1 billion program to buy local goods and hire local people, and its economic stimulus program includes a housing component as well. Local purchasing can ensure that hospitals are investing in the communities that truly need it.
Supportive housing for the homeless has been a boon for hospitals, as it can reduce the costs of care for patients that frequently have chronic conditions that require inpatient stays. Homeless patients are also more likely to be readmitted.