PLANNING

Strategists and Marketers Work to Elevate Their Hospitals' Ongoing Work on Housing Instability
New American Hospital Association resource details some of the key first steps to help SHSMD members steer their organizations in addressing this issue.

Hospitals are facing a growing urgency to address housing instability in their communities that is only worsening during the global pandemic and economic crisis, and marketers and strategists play a pivotal role in supporting this work.

It’s an issue that affects all communities from big cities to small towns and rural areas, and everything in between. Some of the numbers are stark: 1 in 3 U.S. households are burdened by housing costs, including half of all renters, yet only 25% of those who qualify for housing assistance actually receive it.  

Invariably, these problems spill over into health, the American Hospital Association (AHA) noted in a new report released this spring. Housing-insecure individuals have worse health status and outcomes; by one estimate in the report, the average life expectancy of an individual without a place to live is more than 27 years shorter than someone in a stable home.

It’s an issue linked to all of the objectives on planners’ lists: improving quality and outcomes, reducing readmissions and costs, and bolstering health equity. Providing permanent supportive housing for individuals experiencing homelessness, for instance, can reduce emergency department costs by 61% and inpatient hospitalizations by 77%, the report noted.

“Housing ties back to each of these strategic goals,” said Julia Resnick, senior program manager, strategic initiatives, for the American Hospital Association and one of the report’s authors. “This work doesn’t get done in a silo nor should it be disconnected from other strategic goals. They all fit together.”

On the marketing side, this is a deeply human and impactful issue that is ripe for exploration.

“These stories have power,” Resnick added. “If marketers can use their storytelling skills to illustrate the connection between health and housing — and show what a hospital can do to make an impact — they can really help elevate this topic in the eyes of the community.”

Getting Started
For those figuring out where to start, AHA’s “Housing and Health: A Roadmap for the Future” offers options. Resnick said planners can begin by reviewing the discussion questions in the toolkit with their teams: How does housing instability impact your patients? What tools or resources does your hospital have to contribute? And what role is your organization able to play in addressing housing insecurity during and after COVID-19?

“It’s OK to not have it all figured out from the start,” Resnick said, urging planners to speak with leaders from community development corporations, the federal government and other local leaders. “Every community is different, so housing strategies need to be designed to address each community’s unique needs. This is a new field, and everyone is learning together.”

The 11-page guide also details potential partners hospitals might seek in this work, including schools, social service providers, chambers of commerce, banks, entrepreneurs and insurers. Addressing housing instability is complex and requires multisector attention, the report noted. Hospitals will also need to determine what role they want to play, whether it’s anchoring the effort as a leader, partnering with a coalition, advocating policy positions or investing.

Health care leaders have already been grappling with this concern for several years, but its urgency has only intensified over the past year. Homelessness is expected to increase dramatically as eviction stays are lifted and landlords begin collecting back rent. Many may lack the resources and face instability in the coming months.

“I think the pandemic has raised awareness of the link between societal factors and health in new and very poignant ways,” Resnick said. “While the situation is devastating for the millions of people impacted by housing insecurity, I hope that it has illuminated the realities around health disparities and what factors influence health. It is really inescapable nowadays.”

Case Examples
The resource additionally offers case examples of hospitals that are leading the charge.

Nationwide Children’s Hospital in Columbus, Ohio, has collaborated with community stakeholders to create Healthy Neighborhoods Healthy Families. The initiative is focused on eliminating barriers to health for families in the surrounding neighborhood, working with partners such as a nonprofit housing organization and community development corporations. Affordable housing is key to the initiative, which has helped improve graduation rates, reduce crime, and limit emergency department use.

Provider organizations such as Kaiser Permanente have been on this journey for over a decade. John Vu, vice president of strategy in community health, said it was about four years ago that the Oakland, California-based organization started “scaling up” its approach to addressing housing insecurity, looking both up and downstream.

Vu said the ramp-up was partially motivated by the prominence of the crisis in Kaiser’s service areas, with homeless encampments growing in cities such as Oakland, Seattle, Portland, Los Angeles and Washington, D.C. Housing costs skyrocketed in those areas, only worsening matters. “It has become such a visible issue in our communities,” he said.

At the same time, Kaiser has excelled at addressing other social determinants of health to broaden its efforts, including policy, and system and environmental issues related to the obesity crisis.

“We were starting to develop that muscle and realized how important housing is to health, and making that strong connection. We thought it was time to bring it all together,” he said.

Kaiser has waged a multi-pronged effort to address the issue, mirroring the priorities in AHA’s roadmap — policy, investments in housing, and building up the homelessness safety net, just to name a few. Among the specific examples, Kaiser is soon to launch a new program to identify housing insecurity for health plan members and patients, and deploy a rapid rehousing pilot to steer individuals into permanent housing solutions. They’re also working on building out broad networks of legal support for eviction prevention. This is in addition to nearly $200M committed to support affordable housing development in all their markets along with policy advocacy at federal, state and local levels.

Vu, who was not involved in creating the guide, said the resource is a “cogent” and “distilled” blueprint to begin addressing a very complicated issue. He urges fellow strategists to dive in and believes momentum is starting to build as more hospitals work to prioritize this issue.

“If you pull out the mission statement of almost any health system, it’s going to say something about improving health for people and communities,” he said. “If you’re really committed to that mission, what bigger way to prove it than helping our patients and members find a safe, secure place to live and strengthening community systems for housing?”

For more information on AHA’s “Housing and Health: A Roadmap for the Future” report, click here.

 

This article features interviews with:

Julia Resnick
Senior Program Manager, Strategic Initiatives
American Hospital Association
Chicago 

John Vu
Vice President, Strategy, Community Health
Kaiser Permanente
Oakland, California