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A 5-Year Boston Area Housing Study Shows How Housing Stability Is Tied To Health Outcomes

Triple-deckers along Edgewood Street in Boston. (Jesse Costa/WBUR)
Triple-deckers along Edgewood Street in Boston. (Jesse Costa/WBUR)

A five-year study by the Boston Foundation makes the case that housing instability threatens the health of low-income Boston area residents.

The Boston Foundation's Health Starts at Home initiative began in 2016, with funding for four local organizations that work on the two issues in question: housing and health care. (Disclosure: The Boston Foundation financially supports WBUR.) Those groups hired housing counselors to connect struggling families with resources available in the community, and researchers said that allowed previously isolated families to learn about support options.

Stefanie Shull, of the participating nonprofit Neighborhood Developers in Chelsea, says respondents were clear that housing stability meant less illness.

"They would say their child is more healthy — I myself am more healthy — which is highly correlated with actual health," Shull said.

The project served 261 families over the course of the project — in several cases providing financial support to pay for housing. 78% of the families involved were Hispanic or Black, and two-thirds spoke Spanish at home.

Released on Tuesday, the final evaluation of Health Starts at Home found that the families saw significantly improved health outcomes. Researchers also found decreased stress around housing. For example, at the start of the study, 37% of families worried about eviction or foreclosure — that dropped to 18% one year into the project.

The research found children's emergency room visits were nearly cut in half when families were connected with housing counselors, and in some cases with subsidies to pay rent.

Researchers say the most striking result involved the mental health of caregivers. At the start of the study, 60% of participants had symptoms of depression — that dropped to 37% a year later.

Heather Nelson, of the nonprofit Health Resources in Action, was a lead evaluator for the study. She said by merely participating, families gained a sense of hope.

"So much human contact really helped improve people's health and quality of life," Nelson said. "We [measured the hopefulness of participants] and people's hope improved before their housing situation actually did."

According to the study, participating families were less likely to face a lack of affordable housing, poor or crowded living conditions, of homelessness and displacement. The use of homeless shelters and emergency housing also went down.

Nelson said the pandemic has helped shed light on the connection between housing and health, and she hopes the research will bring about policy changes.

"I think the public now tends to know what public health is for once, and is looking at it like, 'Oh housing. That's important! Oh, frontline workers [need housing],' " she said.

"I just hope that we will leverage it well, so we're not back here again in the same situation."

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