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At the crossroads of housing and health care

It isn't every day that I get the chance to meet with senior members of the Administration on issues critical to the well-being of low-income communities. So, when the invitation came to join a discussion on the intersection of affordable housing and health care, I jumped at it.

The impetus was the much-debated Affordable Care Act (ACA). But, this wasn't about the pros or cons of the law. It was about keeping people in the neighborhoods where we work from falling through the cracks of a complicated system.

Bob Van Meter

I joined my colleague Jeanne Cola, from Rhode Island LISC, and more than 80 community development and health advocates to talk about ways to make sure disadvantaged people understand how to access new health insurance options.

And, in the process, we were charged with thinking about ways we could work together to sever the relentless link between poverty and poor health.

It was particularly interesting for me, coming from Massachusetts, where we already have near-universal health coverage.

While we certainly don't have all the answers when it comes to improving wellness in our troubled neighborhoods, we have in recent years developed a keen focus on the social determinants of health and the ways comprehensive community development can help short-circuit chronic disease.

In Boston, for instance, LISC integrates a public health perspective into our programming in neighborhoods like Mattapan, Codman Square and Roxbury so we can support better access to fresh food and safer streets, as well as green and healthy housing and community health centers. They all help people live better.

As was made clear during the gathering in Washington, that requires an understanding the myriad dynamics at work in our communities.

"We can't miss this generational opportunity to improve lives," stressed Shaun Donovan, Secretary of Housing and Urban Development, as he challenged all of us gathered on that chilly February day. "We as a country need to keep the promise of opportunity to all Americans, and health care is vital to that," he added, quoting President Obama.

In fact, housing and health care are foundational for family well being, agreed Mary Wakefield, administrator of the Health Resources and Services Administration—a part of the Department of Health and Human Services.

She urged us all to be innovative and collaborative, citing as example the joint effort between the Boston Medical Center and the Boston Housing Authority to improve asthma outcomes in public housing.

That struck a chord with me, given LISC's deep roots in Boston. But it also resonated beyond geography.

How do we mine our creative relationships—as well as reach out to new partners—to bring low- and moderate-income people into the mainstream health system?

Creative partnerships underpin almost all successful community development efforts. They are at the core of our efforts to revive commercial corridors, improve schools, create jobs and more. So, how do we mine those same relationships—as well as reach out to new partners—to bring low- and moderate-income people into the mainstream health system?

It became clear during the meeting that some of the easiest answers might lie in process: Should we add a question about health insurance coverage to the annual income recertification form required for residents of assisted housing? Could we use tax preparation efforts at the community level to do outreach around the health and the ACA? Both might help identify people who need targeted support.

Or should we go bigger? In Chicago, for instance, the Illinois Department of Public Health tapped LISC to organize a network of health navigators through 21 community partners across the city, all with the goal of helping educate people about their ACA options and apply for coverage.

Is that a model that can or should be replicated in other places?

"This is about hope," Sec. Donovan emphasized when he spoke to us. And so it is.

The diverse relationships at the heart of comprehensive community development mean our industry can make connections around a host of health care issues that others might not. We owe it to our communities to think beyond traditional development work and forge those innovative partnerships. Lives depend on it.


Bob Van Meter is the executive director of Boston LISC

A version of this story first appeared on the LISC website

Posted in Health & Wellness, Thinking Out Loud

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