For over 20 years, John worked to develop, oversee, and evaluate programs addressing inequities in housing and health care. He forged innovative partnerships among government agencies, homeless services providers, housing agencies, hospitals, community health centers, behavioral health care providers, elected officials, and faith leaders. As a coach and consultant, he forges partnerships with his clients. With tools like adaptive leadership and mindfulness, they work together to make equity a reality rather than just a buzzword.
A Racial Equity Lens
John supports agencies prioritizing the work required to center racial equity in programs and policies addressing housing and health needs.
He believes that ending injustices like homelessness depends on calling out institutional racism and how it manifests as both implicit bias and outright discrimination.
He works to amplify the voices of people with lived experience of systemic racism and facilitate meaningful power sharing in planning and decision-making. In this and other ways, he helps organizations and communities improve understanding of the historical and ongoing structural barriers at the root of health and housing disparities impacting Black, Brown, Indigenous and other People of Color.
- Racial equity assessment and recommendations for change in the affordable housing policies of a large urban community
- Needs assessment and recommendations for a supportive housing provider serving an increasing number of aging individuals with acute behavioral health and cognitive impairment challenges
- Leadership coaching for C-suite executives and program managers
- Facilitation of racial justice-centered strategic planning for a coalition of agencies engaged in health equity advocacy
- COVID-response coaching and technical assistance to homeless Continuum of Care and other homelessness response leaders
- Research and consulting on meeting acute behavioral health needs in medical respite care programs
- Coaching for community health centers utilizing telemedicine to improve engagement and chronic disease outcomes of homeless patients
- Board retreats and executive team strategic planning for community health centers and homeless services agencies
- Research and analysis for the development of a state Medicaid medical respite care benefit
- Equity training for communities striving to achieve more racially just outcomes for people served by their homeless response systems
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Reflections on Leading for Racial Equity
Data unmistakably link race with poor health and housing outcomes, and leaders within public health agencies, community health care organizations, and housing and homeless services entities have attempted to develop new strategies to produce more equitable outcomes. In seeking deep and lasting impact, however, these leaders encounter barriers stemming from the persistent influence of unconscious bias and white supremacy that pervades our culture. For instance, researchers found that the most commonly used assessment tool for prioritizing access to scarce housing units for people experiencing homelessness results in statistically significant discrepancies in scores that favor whites over people of color. Genuine dialogue around these issues, which includes both clients and staff of color as well as managers at all levels, regardless of their racial identity, is needed.
Housing is Health Care. Yes, And…
As Public Health thought leaders push for greater understanding of the social determinants of health, they increasingly focus on stable, affordable housing as a critical piece of the puzzle for reducing the risk of worsening chronic health conditions, frequent and/or avoidable hospitalization, increased costs, and early mortality for vulnerable populations. Kaiser-Permanente Chief Community Health Officer Bechara Choucair and National Health Care for the Homeless Council CEO Bobby Watts persuasively argue in Rx for Health: A Place to Call Home that “homelessness itself can accurately be characterized as a dangerous health condition.” The statistics they cite demonstrating dramatic health outcome and mortality disparities for people experiencing homelessness strongly suggest that increasing access to safe and secure housing would, at a population health level, have an enormous impact.  Simply stated, preventing people from losing their housing in the first place also prevents poor health outcomes. In turn, re-housing people who have become homeless reduces the danger of rapidly deteriorating health that is part and parcel of homelessness. Yet there are thousands upon thousands of people across the U.S. whose unmanaged chronic conditions have already been exacerbated by homelessness. Effectively and sustainably addressing their needs entails grappling with an array of policy and operational challenges.
The Aging Homeless Population: Resetting Policy Priorities
National experts have called out the aging of the homeless population as an impending crisis.  This demographic shift is happening rapidly, mirroring general population trends. Nationwide, currently half of single homeless adults are aged 50 or older, compared to 11% in 1990.  Moreover, according to a white paper prepared by the Corporation for Supportive Housing (CSH) and presented to a New York City coalition studying ways to address the aging of the homeless population, “not only are those on the streets getting older, but their health is deteriorating at rates much faster than the general population.”  The paper cites research showing that homeless adults over 50 had a higher prevalence of geriatric conditions than that seen in housed adults 20 years older.  Another study showed that older homeless adults were 3.6 times as likely to have a chronic medical condition as homeless adults under 50.  Such findings clearly indicate a pressing need for housing and services that specifically address geriatric conditions among older homeless adults living across varied environments.