Impact of a New York City Supportive Housing Program on Housing Stability and Preventable Health Care among Homeless Families

Lim, Sungwoo; Singh, Tejinder; Hall, Gerod; Walters, Sarah; Gould, L. Hannah

doi:10.1111/1475-6773.12849

Cited by 25 publications

(15 citation statements)

References 21 publications

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“…Housing instability in general has been shown to be negatively associated with access to health services, mental health, and quality of life . Predictably, interventions that have been targeted at reducing housing instability have been associated with improvements in health and reductions in emergency department services . Evictions, a specific and very acute form of housing instability, have substantial and far‐reaching consequences.…”

Section: Introductionmentioning

confidence: 99%

The effect of evictions on accidental drug and alcohol mortality

Bradford

2019

Health Services Research

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the years listed for the study data in Data Sources and Study Design sections of the Abstract should be "2004 to 2016" instead of "2003 to 2016." The corrected text should read: Data Sources: Eviction rates from 2004 to 2016 provided by the Princeton University Eviction Lab were merged with Multiple Cause-of-Death Mortality Files and aggregated to the county-year level.Study Design: All opioid (prescription and heroin), cocaine, psychostimulant, benzodiazepine, antidepressant, and alcohol poisoning-related deaths per 100 000 people, eviction rates, and socioeconomic indicators were merged at the county-year level from 2004 to 2016. We estimated a series of mortality rate models with county and year fixed effects and used a control function (2SRI) method to adjust for the endogeneity of eviction rates. R E FE R E N C E

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Section: Introductionmentioning

confidence: 99%

The effect of evictions on accidental drug and alcohol mortality

Bradford

2019

Health Services Research

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“…12 Several subsequent publications have also shown benefits from housing-focused interventions. [23][24][25] In general, however, the evidence for health outcome improvements from interventions focused on social determinants is thin. A different systematic review of interventions related to social determinants that included sixty-seven articles published up to 2017 found that only 30 percent (twenty articles) reported health out-comes and 27 percent (eighteen) reported health care costs.…”

Section: Discussionmentioning

confidence: 99%

Quantifying Health Systems’ Investment In Social Determinants Of Health, By Sector, 2017–19

et al. 2020

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The past decade has seen a growing recognition of the importance of social determinants of health for health outcomes. However, the degree to which US health systems are directly investing in community programs to address social determinants of health as opposed to screening and referral is uncertain. We searched for all public announcements of new programs involving direct financial investments in social determinants of health by US health systems from January 1, 2017, to November 30, 2019. We identified seventy-eight unique programs involving fifty-seven health systems that collectively included 917 hospitals. The programs involved at least $2.5 billion of health system funds, of which $1.6 billion in fifty-two programs was specifically committed to housing-focused interventions. Additional focus areas were employment (twenty-eight programs, $1.1 billion), education (fourteen programs, $476.4 million), food security (twenty-five programs, $294.2 million), social and community context (thirteen programs, $253.1 million), and transportation (six programs, $32 million). Health systems are making sizable investments in social determinants of health.

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“…Regarding the larger context, clearly, it is illegal for pharmacies to offer to purchase ART from PLWH, and study findings highlight the important role that supportive, ethical pharmacies play in the lives of this population. Barriers such as poor-quality housing are addressable, and studies with similar populations have shown that providing quality housing can be effective [ 106 ] and cost-effective [ 107 – 109 ]. Last, the present study uncovers numerous ways that African American/Black and Latino PLWH in low-SES contexts successfully manage a range of serious challenges and thus demonstrate substantial resilience.…”

Section: Discussionmentioning

confidence: 99%

Stopping, starting, and sustaining HIV antiretroviral therapy: a mixed-methods exploration among African American/Black and Latino long-term survivors of HIV in an urban context

Gwadz

Cleland

Freeman³

et al. 2021

BMC Public Health

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Background Although periods of HIV antiretroviral therapy (ART) discontinuation have deleterious health effects, ART is not always sustained. Yet, little is known about factors that contribute to such ART non-persistence among long-term HIV survivors. The present study applied a convergent parallel mixed-methods design to explore the phenomena of stopping/starting and sustaining ART, focusing on low-socioeconomic status African American or Black and Latino persons living with HIV (PLWH) who face the greatest challenges. Methods Participants (N = 512) had poor engagement in HIV care and detectable HIV viral load. All received structured assessments and N = 48 were randomly selected for in-depth interviews. Quantitative analysis using negative binomial regression uncovered associations among multi-level factors and the number of times ART was stopped/started and the longest duration of sustained ART. Qualitative data were analyzed using a directed content analysis approach and results were integrated. Results Participants were diagnosed 18.2 years ago on average (SD = 8.6), started ART a median five times (Q1 = 3, Q3 = 10), and the median longest duration of sustained ART was 18 months (Q1 = 6, Q3 = 36). Factors associated with higher rates of stops/starts were male sex, transgender identity, cannabis use at moderate-to-high-risk levels, and ART- and care-related stigma. Factors associated with lower rates of stops/starts were older age, more years since diagnosis, motivation for care, and lifetime injection drug use (IDU). Factors associated with longer durations of sustained ART were Latino/Hispanic ethnicity, motivation for ART and care, and recent IDU. Factors associated with a shorter duration were African American/Black race, alcohol use at moderate-to-high-risk levels, and social support. Qualitative results uncovered a convergence of intersecting risk factors for stopping/starting ART and challenges inherent in managing HIV over decades in the context of poverty. These included unstable housing, which contributed to social isolation, mental health distress, and substance use concerns, the latter prompting selling (“diverting”) ART. Primarily complementary quantitative and qualitative findings described mechanisms by which risk/protective factors operated and ways PLWH successfully restart and/or sustain ART. Conclusions The field focuses substantially on ART adherence, but greater attention to reducing the frequency of ART non-persistence is needed, along with creating social/structural conditions favorable for sustained ART.

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Impact of a New York City Supportive Housing Program on Housing Stability and Preventable Health Care among Homeless Families

Abstract: Supportive housing placement was associated with improved housing stability and reduced preventable health care visits among homeless families.

Cited by 25 publications

References 21 publications

The effect of evictions on accidental drug and alcohol mortality

The effect of evictions on accidental drug and alcohol mortality

Quantifying Health Systems’ Investment In Social Determinants Of Health, By Sector, 2017–19

Stopping, starting, and sustaining HIV antiretroviral therapy: a mixed-methods exploration among African American/Black and Latino long-term survivors of HIV in an urban context

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