Landlord Behavior After Receiving Pediatrician-Generated Letters to Address Poor Housing Conditions

Lax, Yonit; Cohen, Gabriel; Mandavia, Amy; Morrin, Steven; Avner, Jeffrey R.

doi:10.1001/jamanetworkopen.2021.28527

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…In addition, two trends suggest the value of direct elicitation of social needs information from patients. First, studies continue to show the value of eliciting social needs for outcomes important for patients, such as providing transportation to reduce missed medical appointments [14], providing housing to reduce COVID transmission [15], changing landlord behavior to reduce home health hazards [16], and using food prescriptions to address nutritional deficits [17]. Second, health care organizations and insurance plans are already acquiring social needs data by interrogating EHR records and geocoded public and proprietary databases.…”

Section: Discussionmentioning

confidence: 99%

Do patients want clinicians to ask about social needs and include this information in their medical record?

Albert

McCracken

Bui

et al. 2022

BMC Health Serv Res

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Background Social needs screening in primary care may be valuable for addressing non-medical health-related factors, such as housing insecurity, that interfere with optimal medical care. Yet it is unclear if patients welcome such screening and how comfortable they are having this information included in electronic health records (EHR). Objective To assess patient attitudes toward inclusion of social needs information in the EHR and key correlates, such as sociodemographic status, self-rated health, and trust in health care. Design, participants, and main measures In a cross-sectional survey of patients attending a primary care clinic for annual or employment exams, 218/560 (38%) consented and completed a web survey or personal interview between 8/20/20-8/23/21. Patients provided social needs information using the Accountable Care Communities Screening Tool. For the primary outcome, patients were asked, “Would you be comfortable having these kinds of needs included in your health record (also known as your medical record or chart)?” Analyses Regression models were estimated to assess correlates of patient comfort with including social needs information in medical records. Key results The median age was 45, 68.8% were female, and 78% were white. Median income was $75,000 and 84% reported education beyond high school. 85% of patients reported they were very or somewhat comfortable with questions about social needs, including patients reporting social needs. Social need ranged from 5.5% (utilities) to 26.6% (housing), and nonwhite and gender-nonconforming patients reported greater need. 20% reported “some” or “complete” discomfort with social needs information included in the EHR. Adjusting for age, gender, race, education, trust, and self-rated health, each additional reported social need significantly increased discomfort with the EHR for documenting social needs. Conclusions People with greater social needs were more wary of having this information placed in the EHR. This is a concerning finding, since one rationale for collecting social need data is to use this information (presumably in the EHR) for addressing needs.

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Section: Discussionmentioning

confidence: 99%

Do patients want clinicians to ask about social needs and include this information in their medical record?

Albert

McCracken

Bui

et al. 2022

BMC Health Serv Res

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“…Another example could be community listening sessions (DeSalvo et al., 2017) with policymakers or landlords to highlight the importance of minimizing residential moves for families with young children, as stability and predictability are important aspects of early‐life environments (Doan & Evans, 2020). In fact, a recent pilot project (Lax et al., 2021) demonstrated the potential of the tertiary relationship across health care and housing sectors to improve children's housing conditions. In this project, pediatricians provided letters to landlords based on screening results of unsafe housing conditions (i.e., roaches, utilities, mold, lead) that advocated for the landlord to fix the conditions; children whose landlord received such a letter were more likely than children who did not receive the letter to have the requested housing changes implemented (Lax et al., 2021).…”

Section: Strategies For Creating Relational Health Across the Child‐s...mentioning

confidence: 99%

“…In fact, a recent pilot project (Lax et al., 2021) demonstrated the potential of the tertiary relationship across health care and housing sectors to improve children's housing conditions. In this project, pediatricians provided letters to landlords based on screening results of unsafe housing conditions (i.e., roaches, utilities, mold, lead) that advocated for the landlord to fix the conditions; children whose landlord received such a letter were more likely than children who did not receive the letter to have the requested housing changes implemented (Lax et al., 2021). Efforts to engage stakeholders in the housing sector could also highlight that reduced tenant turnover may allow for improved relational health between landlord and lessee and ultimately greater dedication of the tenant to the rental property and potential adherence to payment schedules when possible.…”

Section: Strategies For Creating Relational Health Across the Child‐s...mentioning

confidence: 99%

From zero to thrive: A model of cross‐system and cross‐sector relational health to promote early childhood development across the child‐serving ecosystem

Miller

Stein

Sokol

et al. 2022

Infant Mental Health Journal

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Early relational health between caregivers and children is foundational for child health and well‐being. Children and caregivers are also embedded within multiple systems and sectors, or a “child‐serving ecosystem”, that shapes child development. Although the COVID‐19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the child‐serving ecosystem may promote child health and well‐being at a population level. Our model articulates what relational health looks like across levels of this ecosystem from primary caregiver‐child relationships, to secondary relationships between caregivers and child‐serving systems, to tertiary relationships among systems that shape child outcomes directly and indirectly. We posit that positive relational health across levels is critical for promoting child health and well‐being broadly. We provide examples of evidence‐based approaches that address primary, secondary, and tertiary relational health, and suggest ways to promote relational health through cross‐sector training and psychoeducation in the science of early development. This model conceptualizes relational health across the child‐serving ecosystem and can serve as a template for promoting child health and well‐being in the context of adversity.

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The Use of Telemedicine for Screening and Addressing Social Needs in a Primary Care Pediatric Population in Brooklyn, New York

Lax,

Keller,

Silver

et al. 2023

J Community Health

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Landlord Behavior After Receiving Pediatrician-Generated Letters to Address Poor Housing Conditions

Cited by 6 publications

References 5 publications

Do patients want clinicians to ask about social needs and include this information in their medical record?

Do patients want clinicians to ask about social needs and include this information in their medical record?

From zero to thrive: A model of cross‐system and cross‐sector relational health to promote early childhood development across the child‐serving ecosystem

The Use of Telemedicine for Screening and Addressing Social Needs in a Primary Care Pediatric Population in Brooklyn, New York

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