Meeting Housing Needs Improves Health Outcomes for At-Risk Families
Families facing housing instability or homelessness who enroll in a program designed to support their housing and health needs see significant improvements in child health and parent mental health outcomes within six months, according to a new study by researchers from Boston Medical Center.
The program, called Housing Prescription as Health Care (HPHC), helps families experiencing homelessness and housing instability in Boston and uses a multi-dimensional approach to address families’ specific needs. The program is led by Children’s HealthWatch at Boston Medical Center.
Between the years 2016 and 2019, the HPHC pilot program enrolled 78 families to determine whether the coordination of services that address housing, financial, legal, social, and health needs may improve health outcomes when compared with current approaches.
The intervention was shown to reduce the number of children with fair or poor health by 32% in the first six months of the study.
The study findings are published in the journal Health Affairs.
“Our study aimed to explore how a multi-faceted intervention designed for families experiencing housing instability and homelessness might improve the health of children and their families,” said Allison Bovell-Ammon, M.Div, director of policy strategy at Children’s HealthWatch and the study’s corresponding author. “Secure housing allows families to direct focus toward their health, while living in an environment that allows them to thrive.”
At the start of the randomized controlled trial, 71% of families in the intervention group and 64% of those in the control group identified as homeless, while 58% and 55% reported they were behind on rent.
At the six-month mark, 67 families completed the follow-up, and an analysis showed improvement in the number of children identified as having fair or poor health and in the average anxiety and depression among parents in the intervention group.
On average, scores for anxiety and depression among adult family members declined by 1.38 and 1.04 points, using the Patient Health Questionnaire-2 for depression and the Generalized Anxiety Disorder two-item scale for anxiety.
Within the intervention group, there were also significant changes in child health status, and at the 6-month point, children who were housed had a lower prevalence of developmental risk than kids who were not housed. The families in the intervention group also showed a decrease in being behind on rent, and both groups demonstrated significant reductions in their use of health care.
“Without significant new investment from the federal government, it will be difficult for health systems to adequately respond to housing needs,” said Megan Sandel, MD, MPH, a pediatrician at Boston Medical Center and coauthor on this study. “Our goal is to set families on a positive trajectory toward stability, but we can’t do this alone.”
More research is needed to determine the long-term impacts of this model and to define the cost benefits associated with the direct benefits of improving child physical health and parent mental health services. This is important for understanding the ways in which tailored housing and health interventions may be able to produce a positive return on investment within pediatric populations.
Funding for this pilot study was supported by Boston Foundation’s Health Starts at Home Initiative, and the Social Interventions Research and Evaluation Network. This project was done in partnership with Project HOPE, the Boston Housing Authority, MLPB, and Neustra Comunidad.
Source: Boston Medical Center
Pedersen, T. (2020). Meeting Housing Needs Improves Health Outcomes for At-Risk Families. Psych Central. Retrieved on September 22, 2020, from https://psychcentral.com/news/2020/04/10/meeting-housing-needs-improves-health-outcomes-for-at-risk-families/155606.html