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HUD Addresses Housing Quality, Social Determinants of Health

The deal underscores the need for better housing security and support to address the social determinants of health.

social determinants of health

Source: Thinkstock

By Sara Heath

- The Department of Housing and Urban Development (HUD) has reached an agreement with the New York City Housing Authority (NYCHA) that aims to make housing and living conditions healthier for residents, addressing a key social determinant of health.

As healthcare professionals have continued to consider the social determinants of health in their work, they have recognized housing as a vital component. Not only does housing security and homelessness have an impact on patient health, but the quality and safety of a dwelling can also influence overall patient wellness.

It’s those principles that inspired HUD and NYCHA to sign a deal that aims to address issues with lead paint, mold, pest infestations, and inadequate heating and temperature control.

Per the agreement, New York City will invest $1.2 billion to get rid of lead paint in public housing units. HUD will also provide annual capital funding to NYCHA, totaling to $1.5 billion in 2018 alone. The deal also put NYCHA under a state of emergency, officials stated.

The agreement also involves officials from New York City, the Justice Department, and the Environmental Protection Agency (EPA). To the benefit of the nearly 400,000 individuals benefitting from the NYCHA, these organizations worked to bring higher quality healthcare and the eventual chance of improved patient wellness.

READ MORE: Using Social Determinants of Health in Patient-Centered Care

"This historic agreement marks a new era for New York City's public housing, one that puts families and their children first," said HUD Secretary Carson. "New York City and New York State are making an unprecedented commitment to put NYCHA on a new path. The cooperation of Federal, State and city officials will vastly improve the living conditions for hundreds of thousands of New Yorkers who call NYCHA home."

Housing is an essential social determinant of health. Individuals who cannot obtain stable housing tend to experience an onslaught of compounding health and social factors that hinder their ability to be well or work toward wellness.

Individuals living in substandard housing – meaning housing that is not up to code or riddled with environmental stressors such as mold or asbestos – face similar obstacles. Poor living conditions can exacerbate an already complex chronic illness or lead a patient to developing a chronic illness.

Creating community health initiatives to promote healthier housing and patient wellness will be essential moving forward. Part of those efforts should include better alignment between HUD and HHS, according to a recent paper from the Bipartisan Policy Center (BPC).

The report, HUD-HHS Partnerships: A Prescription for Better Health, outlined the ways in which the two agencies can work together to create healthier, higher quality living for patients and address the social determinants of health.

READ MORE: Programs Targeting Social Determinants of Health Improve Wellness

“Evidence proves our housing impacts our health. Living in unsafe housing or without housing, increases your risk of getting sick or injured,” said Anand Parekh, MD, BPC chief medical advisor. “That principle must be reflected in how our federal government works together. Developing new and stronger interagency partnerships between HUD and HHS will go a long way to improving health outcomes and reducing our nation’s healthcare costs.”

BPC offered five recommendations to HUD and HHS to better support interagency cooperation.

First, BPC suggested the two agencies share more data related to housing needs, housing security, and homelessness. HUD can share its housing data and integrate it with HHS Medicaid data to better pinpoint patients who may need housing assistance to improve their overall health.

Next, BPC suggested HUD and HHS combine resources for housing and behavioral health, two determinants of health that are largely tied.

Third, BPC recommended HHS and HUD work together to create healthier living spaces for patients, free of lead paint, asbestos, pests, mold, and other adverse living conditions. Those efforts are seen in HUD’s recent announcement with NYCHA, and may also be echoed across the country.

READ MORE: Using Community Health Partnerships to Address Social Needs

Fourth, BPC urged HUD and HHS to work together to bolster disaster recovery and disaster-related housing need. Following natural disaster, individuals are in need of a safe and reliable place to live. Storms have displaced up to 25 million people across the country, BPC reported.

Finally, BPC recommended HUD and HHS support the aging population by combining their efforts for healthy housing and social supports for this patient population. Specifically, those efforts should aim for safe, affordable housing with the proper social and medical supports suitable for an aging population with multiple chronic conditions.

Fundamentally, these efforts require collaboration and cooperation between HUD and HHS. This level of teamwork will ensure patients see all of their needs, both medical and social, met. Because medical and social needs are so intrinsically tied, this will ideally improve patient wellness.

“Improving the coordination of discretionary social spending, including investments in safe, stable housing, and housing-based interventions and services, can contribute to decreased hospitalizations, better health outcomes, and a reduction in spending to Medicaid and Medicare,” said Bill Hoagland, BPC senior vice president. “Given the departments’ often overlapping priorities, better coordination of spending makes sense and is essential to being good stewards of taxpayer dollars.”

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