Study: Housing insecurity common among patients at community health centers

Housing instability is a common problem for patients who regularly seek care at community health centers, according to a new study. 

Researchers from Massachusetts General Hospital, Boston Health Care for the Homeless Program (BHCHP) and the University of North Carolina, Chapel Hill, reviewed survey data on more than 3,100 adults at community health centers and found that 44% reported a history of housing issues, according to the study published in the Journal of the American Medical Association. 

Of those surveyed, 1.2% said they were currently homeless, a rate about seven times higher than that estimated among the general population, according to the study. Twenty-seven percent said they were "unstably housed," meaning they had moved two or more times in the previous year or had been unable to pay their rent or mortgage at any time in the past. 

In addition, 9% said they "doubled up" on housing, where they live in a home or apartment they do not rent or own, and 6.5% said their housing situation was currently stable but they had previously been homeless. 

"Stable housing is essential for health," lead author Jessie Gaeta, M.D., BHCHP's chief medical officer, said in an announcement. "We've seen time and time again in our research and clinical practice that when people lack that basic need, their health and well-being suffer." 

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Community health centers provide care for millions of people—about 23 million in 2016—and the findings suggest that these providers should screen patients for housing instability or homelessness when they visit for treatment, according to the researchers. 

Screening in a clinical setting allows for referrals to housing assistance or other social services, Seth Berkowitz, M.D., assistant professor at UNC Chapel Hill and one of the study's authors, said in the announcement. 

Twenty-nine percent of the homeless patients said the community health center they visited assisted them in finding housing, according to the study, as did 1.1% of those doubling up and 2.5% of those who said they were unstably housed. 

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A number of providers have taken steps to address housing insecurity as part of their population health work. Boston Medical Center, for example, "prescribes" housing to patients who need it and works with community groups to address those concerns. 

Cleveland-based University Hospitals is taking another approach by investing in the local community—buying local goods, for example—to stimulate economic opportunity. 

Helping the homeless or patients with housing insecurity can pay off financially for hospitals, research suggests. Supportive housing can reduce unneeded healthcare use and associated costs.