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Monday, February 5, 2024 | The Latest Research, Commentary, and News from Health Affairs

Dear John,

The February 2024 issue of Health Affairs is devoted to exploring the complex relationship between housing and health.

Mariana Arcaya and coauthors open the issue with an overview that explores how neighborhoods affect health and health inequities ([link removed] ) and discusses policies that promote equity.

Cheyenne Garcia and coauthors follow with an overview discussing how homelessness affects health ([link removed] ) and how the health sector can respond.

Structural Racism

Arthur Acolin and coauthors examine the relationship between gentrification and five contextual determinants of health and life expectancy ([link removed] ) in six large US cities during 2006–21.

They find that gentrification was associated with increased social deprivation for Black people, Hispanic people, and people of other races. When people in these groups were residents of gentrifying neighborhoods, they had worse health outcomes than White and Asian residents.

Kierra Barnett and coauthors describe the long history of discriminatory housing policies ([link removed] ) in a neighborhood in Columbus, Ohio, which led to it having the highest infant mortality rates in its county.

Noting the limitations of race-neutral policies, the authors call for community investments that incorporate a structural racism framework to reverse the effects of a legacy of racism.

Read More
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Interventions

In 2018, Brigham Health in Boston, Massachusetts, developed a social care program for patients receiving care at its primary care sites who were experiencing homelessness or housing instability.

MaryCatherine Arbour and coauthors find that program enrollees had fewer primary care and outpatient visits ([link removed] ) than those who were not enrolled and that participants reported improved physical and mental health.

Using mixed methods, Katie Huber and coauthors provide insights from North Carolina Medicaid’s Healthy Opportunities Pilots program ([link removed] ) , which was designed to address social needs.

Among the findings are that defining and pricing housing services within the Medicaid program is complex and that housing is the most expensive service domain within the program.

Sandra Newman and coauthors analyze experimental data from housing voucher programs in two cities ([link removed] ) and find that voucher recipient families experience less stress, likely because of relief from financial pressure and improved housing conditions.

Read More
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Homelessness

Devlin Hanson and Sarah Gillespie examine the effects of participation in a Denver, Colorado–based Housing First program ([link removed] ) , which prioritizes rapid, stable housing.

During the two-year study period, those assigned to the program had “significantly more office-based care for psychiatric diagnoses, fewer [emergency department] visits, more unique prescription medications, and greater use of other health care.”

Through interviews with former residents of a tent encampment in Boston, Michael Mayer and coauthors find that the encampment clearing created significant health and safety harms ([link removed] ) for the residents.

A unique harm reduction housing approach taken in this instance greatly mitigated those harms.

Three articles discuss mortality among people experiencing homelessness.

Matthew Fowle and Giselle Routhier find large increases in mortality in people experiencing homelessness ([link removed] ) during 2011–20 that were largely due to drug and alcohol overdose, diabetes, infection, cancer, homicide, and traffic injury.

David Bradford and Felipe Lozano-Rojas find that higher rates of homelessness are associated with significant increases in substance use disorder–related mortality ([link removed] ) .

Hannah Decker and coauthors find that veterans who received a lung, colorectal, or breast cancer diagnosis during 2011–22 had better survival rates if they were continuously housed or gained housing compared with those who were consistently unhoused ([link removed] ) .

Read More
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Housing Costs

Mir Ali and coauthors find that large disenrollments from TennCare in 2005 ([link removed] ) led to about a 25 percent increase in eviction filings and completed evictions in Tennessee compared with other southern states in the subsequent five years.

Alec Chapman and coauthors explore the effects of temporary financial assistance ([link removed] ) received through Supportive Services for Veteran Families.

Among veterans included in the study, the assistance “reduced the risk for housing instability for slightly more than one year after entering [the program], with the effect peaking at…forty-five days and diminishing thereafter.”

Eva Laura Siegel and coauthors investigate indicators of energy insecurity in New York City ([link removed] ) . Black non-Latino and Latino residents, renters, recent immigrants, and households with children had higher levels of energy insecurity than others, and residents with three or more indicators of energy insecurity had higher odds of respiratory, mental health, and cardiovascular conditions.

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If you haven't already, join Health Affairs Insiders to access our current and past issues ([link removed] ) and our premium newsletters and virtual events.

Are We Valuing Prescription Drugs Appropriately? ([link removed] )

Peter J. Neumann and Joshua T. Cohen

Much Ado About Nothing: Why 'March-In' Rights Won’t Lower Drug Prices ([link removed] )

Alfred B. Engelberg

health-affairs-event-housing-health-02-2024_enewsletter ([link removed] )

Millions in the United States experience housing instability (the continuum between homelessness and stable, secure housing), which can threaten their health and well-being.

The February 2024 issue of Health Affairs explores health across a range of housing policy areas, centered around health equity; highlights best practices and lessons learned by communities across the country; and identifies potential policy interventions.

You are invited to join us on Tuesday, February 6, 2024, at 1:00 p.m. (Eastern) for a virtual forum at which authors will present their work, engage in discussion, and answer questions on these important issues. Panels include:

- Communities And Neighborhoods
- Health Sector Interventions
- Homelessness
- Housing Costs, Quality, and Stability

Register and learn more about the participating speakers below!

Find Out More
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health-affairs-journal-video-abstract-43-02-2024_barnett-enewsletter ([link removed] )

For this issue, eleven authors filmed a video version of their abstracts.

These video abstracts are available with open access on the article's pages and on our YouTube channel ([link removed] ) (Please subscribe!)

Check out the video abstracts below:

- Kierra S. Barnett A History Of The Impacts Of Discriminatory Policies On Housing And Maternal And Infant Health In An Ohio Neighborhood ([link removed] )
- Ashley C. Bradford TennCare Disenrollment Led To Increased Eviction Filings And Evictions In Tennessee Relative To Other Southern States ([link removed] )
- Hannah C. Decker Housing Status Changes Are Associated With Cancer Outcomes Among US Veterans ([link removed] )
- Devlin Hanson ‘Housing First’ Increased Psychiatric Care Office Visits And Prescriptions While Reducing Emergency Visits ([link removed] )
- Katie Huber Addressing Housing-Related Social Needs Through Medicaid: Lessons From North Carolina’s Healthy Opportunities Pilots Program ([link removed] )
- Margot Kushel Homelessness And Health: Factors, Evidence, Innovations That Work, And Policy Recommendations ([link removed] )
- Lawrence Lincoln Finding A Place To Be Somebody ([link removed] )
- W. David Bradford and Felipe Lozano-Rojas Higher Rates Of Homelessness Are Associated With Increases In Mortality From Accidental Drug And Alcohol Poisonings ([link removed] )
- Michael Mayer Encampment Clearings And Transitional Housing: A Qualitative Analysis Of Resident Perspectives ([link removed] )
- Eva Laura Siegel Energy Insecurity Indicators Associated With Increased Odds Of Respiratory, Mental Health, And Cardiovascular Conditions ([link removed] )

health-affairs-43-01-order-issue-housing-health_eNewsletter-banner ([link removed] )

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About Health Affairs

Health Affairs is the leading peer-reviewed journal ([link removed] ) at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online.

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