Housing Is Health Care
Housing improves health for the same reasons that homelessness is deleterious. A clean, dry, secure environment is fundamental to personal hygiene (including wound care and dressing changes), medication storage (refrigeration of insulin, safe storage of needles), and protection from assault and the elements.
Private space allows for the establishment of stable personal relationships; housing has been shown to reduce risky sexual behaviors. A stable residence facilitates effective interaction with others, including treatment providers and social support systems, and increases adherence to treatment plans including regular meals and keeping appointments.
Housing may reduce anxiety and consequently reduce stress-related illnesses. In these ways, housing both promotes healing and prevents the onset of new illnesses.
Housing must be considered a first-line response to the personal health problems of homeless individuals. Moreover, the creation of additional affordable housing must be understood as a critical public health responsibility, for the control of communicable disease and for efficient and effective health care planning and spending.
Public health has long understood the role of housing as a determinant of health, and has played an historic role in developing and enforcing housing standards. The known health effects of modern mass homelessness demand that public health renew and broaden its advocacy role to insist that affordable housing is a necessary prerequisite to eliminate homelessness.
A practical and comprehensive understanding of health necessarily includes housing and other social factors. Ultimately, these factors must be considered together in the political and funding arenas.
Divided funding streams and uncoordinated policy-making must yield to unified budgets and synchronized policies which will promote – in the language of the World Health Organization – “a state of complete physical, mental and social well being”.
A growing human rights movement offers new hope that this can be accomplished.
John Lozier
Executive Director National Health Care for the Homeless www.nhchc.org