Housing has major implications for people’s health: Housing quality is significantly associated with risk for childhood asthma and maternal housing instability significantly predicts low birth weight. Severe housing insecurity creates chronic health disparities, exacerbating hypertension, diabetes, and other medical conditions.
Black Philadelphians experience disproportionately high rates of homelessness, and women of color experience the highest eviction rates and housing cost burden — the COVID-19 pandemic has only deepened these disparities.
Accelerate Health Equity (AHE) is committed to amplifying and supporting the work of our affiliated institutions to combat health inequities in Philadelphia. Steven Carson, MHA, BSN, RN — Senior Vice President of Population Health at Temple Health and AHE Steering Committee member — and his team are at the helm of Housing Smart, an innovative initiative changing lives by combatting the cycle of housing insecurity and homelessness in the Temple community.
In 2019 alone, Temple University Hospital’s Emergency Department (ED) cared for hundreds of individuals experiencing homelessness. 350 of those patients each made at least four separate visits to the ED during the year — some were there daily.
With over two decades of experience at Temple Health — specifically in developing new ways to address social determinants of health within Temple’s community — Carson was uniquely positioned to launch a novel program like Housing Smart.
In partnership with Keystone First, Health Partners Plan, and Resources for Human Development, Temple Health launched the program in 2020 with a mission to improve the health of patients experiencing homelessness by providing them with housing subsidies and support services. Now, three years into the program, the results have been astonishing.
The Housing Smart team, working with the City of Philadelphia’s Office of Homeless Services, secured short-term housing for 25 program participants who displayed high healthcare utilization and also agreed to enroll in the program. Priority was given to participants with substance use disorder and/or persistent mental illness with co-occurring physical health conditions.
Housing Smart participants were not only connected to short-term housing, but the Housing Smart support staff also worked diligently to identify other critical needs like employment opportunities and training to sustain housing. Each Housing Smart staff member has real-life experience in working with individuals experiencing homelessness — building trusting relationships with program participants is key to overcoming barriers to care and fostering a supportive environment.
Since receiving stable, subsidized housing, the 25 participants have seen improvements in clinical outcomes:
75% decrease in ED visits
79% decrease in in-patient admissions
77% decrease in admission for observation
50% increase in outpatient appointments with a primary care provider
Over the next year, the project partners will explore program expansion options to serve more community members in need. The Housing Smart team is committed to ensuring that the program participants not only see these short-term improvements but also can reap the long-term health benefits of stable housing.
Disparities in access to housing and other essential needs result in poor health outcomes and life expectancy gaps. Programs like Housing Smart that address the holistic needs of vulnerable populations are vital in reducing these disparities. By harnessing the power of partnership and value-based solutions, health systems and other key players can help to promote health equity in Philadelphia — Housing Smart is proof of that.