Thu, 16 September 21

Home Is Where the Health Is

by Madeleine Richter-Atkinson, Jamie Dudensing

Experts estimate that direct medical care affects only 15-20% of a person’s overall wellness , whereas the conditions in which people are born, grow, live, and work — social determinants of health (SDOH) — play a much greater role. To encourage better outcomes, health plans are working in communities to help address SDOH, including the need for safe, secure housing.

It’s no surprise that a lack of stable housing would affect the health of individuals and families, even if they have access to medical care. 

Housing that is not well-built, well-maintained, and is not regularly inspected for code violations can result in serious, avoidable health consequences. Recently, we’ve seen that poor housing conditions are an indicator for higher risk of severe COVID-19 symptoms. Mold can lead to or exacerbate respiratory problems such as asthma or pneumonia, which can quickly develop into emergency cases that result in costly ER bills.

Likewise, sewer leaks can lead to infections, pest infestations can lead to contracting diseases, and fire hazards can easily end with severe burns. A whole host of other issues — poor ventilation, lead in pipes and paint, poor insulation, residential crowding — can all contribute to poor health outcomes.

Studies show that children in households behind in rent, experience frequent moves, or who have a history of homelessness experience poorer health outcomes.

The up-front cost of addressing housing can be much lower than the costs accrued from emergency bills. In one case, a client’s medical costs averaged $12,945 per month when unhoused — once housed, that amount dropped by more than 80% to $2,073. Programs that incorporated housing for clients with medical and behavioral health needs, saw an overall cost savings to taxpayers as high as 20%.

Secure housing can help individuals successfully address other struggles, like addiction or unemployment, that previously kept them homeless. Addressing social determinants of health like housing can help individuals lead healthy, independent lives as a part of their community.

Health plans are actively working to provide housing solutions for their members and their communities. They work alongside local governments and nonprofits to connect clients with safe and affordable housing options.

UnitedHealthcare partnered with New Hope Housing in Harris County to help individuals experiencing homelessness. UnitedHealthcare additionally connects their patients to housing programs in Texas through Health Service Coordinators, as in the case of Gregory, a Medicaid client in Austin who lost housing when he was unable to pay a surgical bill after going into cardiac arrest.

Other health insurance providers, such as Blue Cross Blue Shield and Amerihealth Caritas, have provided significant funding towards organizations that embrace effective re-housing initiatives. CVS Health and Humana have each invested millions of dollars into building affordable housing to address homelessness as well as other life and health situations.

Additionally, Molina Healthcare of Texas and Superior HealthPlan partner with PROSPERA Housing Community Services, which aims to restore communities by providing safe, high-quality, affordable housing with support services to those in need. Not just a housing program, PROSPERA works to ensure that families and individuals are able to remain safely housed while still receiving the support they need to stay healthy.

These interventions are both producing better health outcomes and saving money.

One lesson is that there is no one-size-fits all solution. Health plans, which have a personal interest in individual clients, can help coordinate the care needed that takes into account that person’s specific needs, risks and opportunities.

Home is where we spend the greatest amount of our time. Health plans are working to make sure it is also the foundation for our wellbeing.

This article is part of a series on five categories of social determinants of health (SDOH). Learn more about SDOH and read our articles on transportation, education, employment, and food to learn more about how each category affects overall health. 

Make sure to check out our Texas Covered conference this November, where our panels on SDOH and health equity will feature experts discussing current issues and solutions to improve health outcomes and reduce the cost of care.

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