There's an Inextricable Link Between Housing and Health

By: Mark McDermott and Thomas J. Strauss

During the past election, there was much dialogue around the Affordable Care Act and safety-net programs such as Medicaid. Based on exit polls, there is a resounding recognition that covering the uninsured and protecting individuals from pre-existing conditions are vital for the health of our nation. We applaud the support for ensuring health coverage for our community. Health insurance makes a difference.

In fact, in the most recent report from the Ohio Department of Medicaid, Ohio's Medicaid expansion has reduced health care costs and financial exposure for 650,000 Ohioans and reduced the uninsured population by half. These numbers remind us that Medicaid expansion has made a tremendous positive impact in our community.

Our work is not complete, however. When the news reports on a historically low unemployment rate or on record highs for stock indices, those of us working with the community's underserved feel an uneasy disconnect between the apparent prosperity of the affluent and the harsh realities for those who feel underwater and left behind in today's economy. We see it right here in Cleveland. Many of the jobs available do not pay enough to make ends meet.

For the 219,000 Cuyahoga County residents who rent housing, each household must earn at least $15.10 per hour full-time to afford a modest two-bedroom apartment. They have an uphill battle for many reasons. Chief among them: Wages are stagnant, while the cost of housing and health care continues to rise. It has simply become too expensive to maintain or improve quality of life and enable families to thrive.

We see firsthand the inextricable link between housing and health. Low-income families spending more than half of their income on housing often forgo preventive care or early treatment, making toxic tradeoffs between rent and preventive health visits. People experiencing homelessness, especially, remain far more likely to go to the emergency room, if at all, for conditions that could be more effectively and efficiently managed on an ongoing basis if they had a medical home or stable housing connected to supportive services.

We would like to encourage business and community leaders to support all programs that address the health of our community including the social determinants of health. This means we need your support for vital programs such as food stamps and assistance, quality early childhood programs, rental assistance for families and other aid for the nation's poorest urban and rural communities.

We encourage our elected leaders in Ohio and around the country to understand and act to expand beyond the clinical aspects of health — to more holistically address what causes health problems in the first place. At the Sisters of Charity Health System, we understand that, for many, housing is fundamental to one's health.

Elected officials must look to invest in innovative and progressive strategies that address the root causes of poverty. Strategies such as providing a stable home with support services (also known as permanent supportive housing) or placing lawyers in hospitals, and efforts to provide lawyers to low-income individuals and families to prevent evictions, and many other practical steps acknowledge that health outcomes are impacted by a number of social factors — stable housing among them. It is worth considering how housing can better serve as a platform for improving health outcomes in a cost-effective manner.

As we debate the continuing resolution in Congress and prepare for 2019 midterm budget cycles, we have to remember to outline priorities beyond funding vital safety-net programs — ways to invest in our community to make real impact for Cleveland. By addressing unsafe housing, housing insecurity and homelessness, our state and nation can impact the health of individuals, families and communities. It is time for community leaders and our elected officials to take an innovative approach to focusing current resources on the social determinants of health.

McDermott is vice president and Ohio market leader for Enterprise Community Partners Inc. Strauss is president and CEO of the Sisters of Charity Health System.

This article originally appeared in Crain's Cleveland Business.