August 29, 2019

Housing for health: Why health cannot happen without housing

Bechara Choucair, MD, tells us why the health care industry needs to tackle the affordable housing and homelessness crisis.

A growing housing affordability crisis across our country is contributing to a range of health problems and increased costs for our communities and health systems.

As a mission-based nonprofit, Kaiser Permanente has a long history of investing in our communities to improve health. Bechara Choucair, MD, Kaiser Permanente’s chief community health officer, explains the connections between housing and health, and how the health care industry can play a key role in the effort to solve the affordable housing and homelessness crisis.

Q: Why should a health care organization be involved in tackling the affordable housing and homelessness crisis?

Bechara Choucair, MD

Health care organizations should be involved in addressing the homelessness crisis precisely because they are health care organizations. Homelessness and lack of stable housing are major health issues. Many people don’t make this connection, but the data makes the link for us. And we are seeing it every day on our streets. Becoming homeless can be dangerous, costly, and deadly. Safe, stable housing is key to a person’s physical and mental health.

I began my career as a family physician working with homeless populations in Houston, Chicago, and Rockford, Illinois. The limits of my medical training were tested as I struggled to treat patients who were spending winter nights on park benches or shelter hopping. That’s because health cannot happen without housing.

Across our country, there’s a growing housing affordability crisis, and this contributes to a range of health problems and increased costs for our communities and health systems. And, the financial stress associated with access to safe housing leaves adults particularly vulnerable to poor health.

Q: How is the affordable housing crisis affecting people’s health?

When people struggle with high housing costs, they can have trouble paying for food and medical care. And without a place to live, it’s nearly impossible for a person to take care of basic health needs.

The numbers tell a bleak story. Chronic homelessness can cut 27 years from a person’s life. And overall mortality rates among people experiencing chronic homelessness are 3 to 4 times that of the general population.

Serious, chronic diseases such as hypertension, asthma, and diabetes are more difficult to manage outside a home, especially if medications are lost or stolen. Infections and injuries are harder to heal, and pneumonia and other acute problems are aggravated without a place to rest and recover. Risks of diseases such as hepatitis and tuberculosis run higher. Necessary long-term treatment and counseling are nearly impossible to deliver.

Q: What is Kaiser Permanente doing to help alleviate homelessness and advocate for affordable housing?

We are leading efforts to end homelessness and preserve affordable housing on multiple fronts, by making investments, shaping policy, and encouraging innovation through partnerships.

In our hometown of Oakland, California, in partnership with Bay Area Community Services we have committed to find housing for 515 aging, homeless individuals with at least one chronic medical condition. More than 400 people have already been placed into stable housing, and we are hopeful that other communities across the country will be able to use this model.

We’re also making headway in 15 of our communities through our partnership with Community Solutions, which is working to end chronic and veteran homelessness in 70 communities across the country.

From a policy perspective, Kaiser Permanente is promoting federal affordable housing reforms and opposing cuts to affordable housing as a member of Mayors and CEOs for U.S. Housing Investment, a project of the National League of Cities.

Kaiser Permanente has also committed to invest up to $200 million in affordable housing through its Thriving Communities Fund. Working in partnership with Enterprise Community Partners, we’re seeing encouraging results already.

To date, 6 investments have been finalized, enabling preservation and production of 780 units of housing for veterans, seniors, formerly homeless, and other low-income Individuals and families, in California, Colorado, Maryland, and Washington, D.C. And, there’s more to come.

We cannot solve this problem on our own — but together we can make progress toward ensuring that everyone has an affordable home where they can live and thrive, and that no one has to sleep on the street.