Thanks to Kaiser Permanente, The Colorado Health Foundation, the Robert Wood Johnson Foundation, the California Health Care Foundation, and The California Endowment, whose generous support made the theme issue possible.
Exploring the Many Connections Between Housing and Health
The February 2024 edition of Health Affairs is our first theme issue on the topic of housing and health.
Publishing the issue is the culmination of a year-long process involving nearly all members of the Health Affairs team. As is our custom for theme issues, we began with a planning meeting in March 2023 that brought together housing and health experts from academia, government, nonprofit organizations, as well as people who have lived experience with homelessness.
The meeting was led by our theme issue advisers, Ingrid Gould Ellen of New York University and Mariana Arcaya of the Massachusetts Institute of Technology.
The wide-ranging conversation at the planning meeting covered a broad array of topics, but one point came through loud and clear: Housing is much more than bricks and mortar.
Housing is a hub for accessing resources; housing is a platform for social connection; housing is opportunity.
Housing is so central to both short- and long-term health and well-being that the US Interagency Council on Homelessness has emphasized that “Housing is health.”
Following a day of brainstorming and sharing perspectives, our next step was to issue a request for abstracts. The response was tremendous, with more than 200 abstracts submitted.
After careful review by the editorial team and our outside advisers, we invited a total of 26 papers and a Narrative Matters essay. Following our standard peer review process, we selected 17 papers for publication, including overview articles, research papers, an analysis, and a Narrative Matters. The issue also includes a journalistic piece in our Entry Point section.
From this diverse mix of content, several themes emerged.
First, there is a two-way relationship between housing and health. The quality of the home you live in and the neighborhood where it’s located affect your health. Being unhoused has extremely negative repercussions for health and life expectancy. And on the flip side, poor health can affect housing status; research has suggested that health crises can precipitate homelessness.
Second, there are long-standing systemic factors that affect the interplay between housing and health. For decades, practices such as redlining and use of racially restrictive covenants were used to maintain neighborhood segregation. The adverse effects of these practices have endured for generations, creating persistent inequity.
As theme issue adviser Mariana Arcaya and colleagues describe in their overview paper, neighborhoods in the US are highly segregated by race, ethnicity, and income. Compared to Black and Hispanic families, White families, on average, live in higher income neighborhoods, with higher performing schools and lower rates of violent crime. A robust body of evidence has demonstrated an association between neighborhood characteristics and health.
In the February issue you’ll also find illustrations by artists involved with Art from the Streets, an Austin, TX-based nonprofit that enables people experiencing homelessness, at risk of homelessness, or in transition to nurture their creativity, make social connections, and generate income from the sale of their work.
I have learned so much from collaborating with my colleagues, our advisers, and the authors to produce the theme issue. I invite you to take the opportunity to explore it and gain new insights on the many connections between housing and health.
Health Affairs' Editor-in-Chief Alan Weil interviews Michael Mayer of the Boston Health Care for the Homeless Program on his recent paper that explores the impacts of encampment clearings on the homeless population in Boston and how transitional harm reduction housing provided a unique opportunity for former encampment residents.
Health Affairs' Ellen Bayer and Rob Lott go behind the pages of the new February issue focusing on Housing and Health. Their conversation provides insight into the approach taken for this particular theme issue, the relationship between housing and health, a number of the journal articles featured, and so much more.
Community & State is the business segment of UnitedHealthcare that provides health care coverage for the economically disadvantaged, the medically underserved and those without the benefit of employer-funded health plans. These state-based health plans meet local needs, while leveraging the national resources of UnitedHealthcare.
Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online.
Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.
