Housing Intervention For Medically Complex Families Associated With Improved Family Health: Pilot Randomized Trial

Health Aff (Millwood). 2020 Apr;39(4):613-621. doi: 10.1377/hlthaff.2019.01569.

Abstract

The effects of housing instability and homelessness on child and adult health are well documented. However, few studies have explored health and housing interventions for families with children with the objective of health improvement. Housing Prescriptions as Health Care is a randomized controlled trial that is investigating the impact on physical and mental health of integrating priority placement in affordable housing and the provision of services (case management, financial, and legal), compared to the standard of care (providing resource guides and hospital-based social work or care navigation services). In 2016-19 seventy-eight homeless or housing-unstable families defined as "medically complex"-with a child or adult member who used more health services than usual or had a chronic disease or disability-were enrolled in the trial, and sixty-seven completed a six-month follow-up. A difference-in-differences analysis at six months showed decreases in the share of children in fair or poor health and in average anxiety and depression scores among parents in the intervention group, relative to the control group. Findings suggest that a population-specific model that integrates health, housing, legal, and social services can improve health-related outcomes at the household level.

Keywords: Caregivers; Case management; Children's health; Depression; Emergency departments; Family health; Homelessness; Housing; Housing stability; Randomized control trials; Social services; Supportive housing; health policy; mental health; public health.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Family Health
  • Housing*
  • Humans
  • Ill-Housed Persons*
  • Mental Health
  • Pilot Projects