Housing is a health care issue. Here's what providers should do about it.

Why unstable housing is a health care issue

People often become housing-vulnerable due to economic and behavioral factors. For example, two-thirds of affordable housing units are unavailable to low-income households due to capacity and about one-fourth of individuals experiencing homelessness have a mental illness. These factors can cause at-risk individuals to fall somewhere on the housing insecurity spectrum, which ranges from living in inadequate housing to experiencing chronic homelessness.

People who live in unsafe or unhealthy housing are more likely to face an array of clinical challenges, including respiratory illnesses and physical injury. People experiencing homelessness face even more severe health risks, such as exposure to extreme weather conditions and assault.

In addition to grappling with greater health challenges, these patients are less likely to have access to preventative care or to be able to follow care recommendations than individuals in stable housing conditions. When unhealthy living situations are paired with a lack of access to care, individuals become more susceptible to chronic illnesses, dental problems, and behavioral health problems, leading to inappropriate emergency department utilization and longer length of stays in acute settings.

How providers can partner to mitigate harm

With the growing shift toward population health management, providers know they need to examine the underlying factors that affect community health. But few provider organizations currently have programs to help secure housing for patients experiencing homelessness. And due to the complex and interlocking economic and behavioral drivers of housing insecurity, as well as resource constraints, even the most motivated organizations find themselves stymied by this challenge.

Because housing insecurity is such a difficult social determinant of health to tackle, providers are forced to be strategic with their approach—they're partnering with community-based organizations that are already doing great work in this area.

When determining what role to play in these partnerships, provider organizations should consider their own strengths as well as what potential partners can bring to the table. By working in tandem with community organizations, providers can help patients not only with housing, but with their overall health.