Access to safe, affordable housing is a critical determinant of health. Yet, millions of Americans are living in unsafe, unstable and/or unaffordable homes, or experiencing homelessness. Due to structural racism and discrimination, the housing crisis disproportionately impacts people of color, who are significantly more likely to be cost burdened, and thus to experience homelessness.1

Homelessness is associated with well-described health inequities, including a large burden of acute and chronic disease, decreased access to primary and preventative care, increased rates of acute healthcare utilization, and premature mortality.2 Housing and appropriate supports, delivered via a Housing First approach, increases housing stability even among those with high medical needs and serves as a foundation for essential interventions to improve health and well-being.3

Over the past decade, the State of Colorado has become one of the least affordable states in the nation.1 In metropolitan Denver alone, more than 30,000 people accessed the region’s homeless services or housing supports over a one-year period between July 1, 2020, and June 30, 2021.4 More than 10,000 of them were experiencing unsheltered homeless and those identifying as newly homeless rose by 99%.

In advance of the SGIM 2023 Annual Meeting: Meeting the Promise of Tomorrow in Aurora, Colorado, we have partnered with the Colorado Coalition for the Homeless—a leading provider of housing and integrated healthcare services—to identify opportunities for SGIM members to participate in advocacy at the intersection of housing and health. The Colorado Coalition for the Homeless5 works collaboratively to create lasting solutions for individuals and families throughout Colorado who are experiencing or are at at-risk of homelessness. The coalition is a key partner of the National Low Income Housing Coalition’s Opportunity Starts at Home campaign, a multi-sector collaboration working across 23 states to advance federal policies that expand access to affordable housing (especially for the lowest-income renters), bridge the gap between income and housing costs, protect existing rental assistance programs, and prevent homelessness.6

SGIM members will have a variety of opportunities to learn, engage, and participate in housing-health advocacy in conjunction with the annual meeting. In advance of the meeting, SGIM will highlight relevant educational and advocacy opportunities through its online media communications. This includes our #HousingIsHealthCare social media campaign where members are invited to share their perspectives regarding whatever aspect of the housing-health connection feels most important to them as clinicians, researchers, or educators, and how they are advocating in this space within their own communities. During the annual meeting, members will be able to visit the Colorado Coalition for the Homeless education booth to learn more about their work and legislative priorities, as well as local and national advocacy opportunities with the Opportunity Starts at Home campaign.

Across all facets of patient care, we witness how lack of housing affects our patient’s lives and health in innumerable ways. We understand that housing is health care. Effectively responding to this issue and shifting the paradigm will require bringing together cross-sector partners to correct longstanding racial and economic injustices and address housing as an important health-related social need. Together with our partners, general internists can be a powerful voice in advocating for policies that can help prevent and ultimately end homelessness. Join SGIM members in ‘meeting the promise of tomorrow’ through advocacy at the intersection of housing and health.

References

  1. National Low Income Housing Coalition. Out of reach: The high cost of housing. https://www.nlihc.org/oor. Accessed February 15, 2023.
  2. Fazel S, Geddes J R, Kushel M. The health of homeless people in high-income countries: Descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014;384(9953):1529-1540.
  3. Committee on an Evaluation of Permanent Supportive Housing Programs for Homeless Individuals. Permanent Supportive Housing: Evaluating the
    Evidence for Improving Health Outcomes for People Experienc-ing Chronic Homelessness
    . Washington (DC): The National Academies Press; 2018.
  4. Metro Denver Homeless Initiative. Annual ‘State of Homelessness’ report released. MDHI. https://www.mdhi.org/blog/annual-state-of-homelessness-released. Published January 20, 2022. Accessed February 15, 2023.
  5. Colorado Coalition for the Homeless. https://www.coloradocoalition.org. Accessed February 15, 2023.
  6. National Low Income Housing Coalition. Opportunity starts at home. https://www.opportunityhome.org/. Accessed February 15, 2023. 

Issue

Topic

Advocacy, Health Equity, SGIM, Social Determinants of Health, Social Justice, Vulnerable Populations

Author Descriptions

Dr. Stella (sarah.stella@dhha.org) is a hospitalist at Denver Health and associate professor of in the Department of Medicine at the University of Colorado School of Medicine. Dr. Lessing (juan.lessing@cuanschutz.edu) is an associate professor in the Department of Medicine, Division of Hospital Medicine, at the University of Colorado School of Medicine. Dr. Saunders (msaunders@uchicago.edu) is an associate professor of medicine at University of Chicago Medicine, a clinician-investigator, and the living donor advocate physician for the transplant center. Dr. Fluker (shelly-ann.fluker@emory.edu) is an associate professor of medicine at Emory University School of Medicine and the J. Willis Hurst Internal Medicine residency program primary care track director.

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