Integrating Local Health and Housing Planning – Who Benefits?

poster promoting planned housing, circa 1936
This poster from the 1930's connects housing and health. In this century, we're still figuring out how to put this into practice.

Slowly but surely governments are coming to grips with the idea that housing affects people’s health. This should be good news, especially for the people who pay excessive amounts of money for housing that undermines their health.

How are housing and health being connected in practice?

One example comes from the United Kingdom, where there’s a mandate to reform health services and join up health, mental health and housing services. It’s a report called Healthy Foundations: Integrating Housing As Part Of The Mental Health Pathway. The group that produced this report consists of health and housing professionals.

Healthy Foundations identifies good practices that have been tested and could be implemented at a larger scale. For example, some people who are admitted to hospital for in-patient mental health care lose their housing. When their in-patient care is finished, they can wait months before being discharged, for lack of a home in the community. In a pilot where housing workers are part of the hospital care team, the wait from end of treatment to hospital discharge is much shorter.

The people who wrote Healthy Foundations also discuss the value of consulting with people who use health and housing services. The report strongly recommends that the government take advice from people who use the services when planning and rolling out health/mental health/housing program reforms.

Meanwhile in the United States, local data is increasingly being wound in to funding decisions:

  • Hospitals and community health providers are required to complete community health assessments if they plan to apply for public funding for health services including medicaid and health insurance.
  • Decisions about disbursing federal housing funding are also being built around an evidence based local needs assessment.

If the image of people chasing around after each other to gather the same data comes to mind, you’re not alone. Some data is useful to both the health assessment and the housing assessment. Local housing and health planners have begun working together to collect and analyse local data.

It’s easy enough to agree to work together, but what does it mean in practice? Time constraints alone will work against collecting and analysing data with new partners who have different mandates, accountabilities and deadlines.

That’s where external resource bodies can give local planners a lift. Local Housing Solutions is an external resource body, which is based at the Furman Center at New York University. Local Housing Solutions began supporting local housing planning in 2018. Currently, it provides tools, workshops and other supports to help identify the need for low income housing and to assess who benefits from land use decisions at a local level.

Earlier this year, Local Housing Solutions hosted an on-line training to encourage local housing and health planners to work together. The training highlights how joint planning benefits local health and housing work. The speakers discussed resources that can support local initiatives and answered audience questions. Thanks to being posted on line, the people who attended the training can review the session at a later time. As well, people who didn’t attend the training can access the resources.

In addition to planning and analysing local data, national funders in the United States are looking for evidence that end-users buy in to local community plans. Land use planners have a lot of experience with community consultations. When change is proposed for a specific piece of land, it’s pretty well guaranteed that neighbours will attend in droves. However, when it comes to planning for a whole community over a 10-year time line, it’s not so easy to attract attention or useful feedback.

This is where Harris County in Texas may be on to something. Normal consultation practice is to hold open houses and community meetings. Attendance figures usually hover in the hundreds. Harris County decided to try go a different route. It paid neighbourhood ambassadors to interview local residents to find out what they were looking for in a new home. This ensured that residents from different parts of the County were consulted.

The interview data was compared with existing policies to generate community goals that reflected local experience and knowledge. The community goals were tested on a broad scale in a county-wide survey. By the numbers alone, the process in Harris County was a success: more than 17,000 people participated.

Here are links to the resources that are discussed in this post:

The UK report is published by the NHS Confederation: Healthy foundations – Integrating housing as part of the mental health pathway

You can access the training video at Local Housing Solutions: Health and Housing: Opportunities for Collaborative Planning to Meet Community Needs

And for more about the community consultation in Harris County, you can check out this article at Next City1: What If There’s a Better Way to Collect Neighborhood Data?

Footnotes

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