Articles

The Capitol

A Public Health Lens on Homelessness Exposes Problems with the Trump Administration’s Proposed Approach

A recent
University of California study titled Health
Conditions Among Unsheltered Adults in the U.S.
brings into focus
public policy blind spots that make progress challenging for clinicians and
other professionals working to end homelessness.  Personally, the study’s findings evoke a
question that preoccupied me during my tenure as director of a 10-agency
health care network
treating over 21,000 unduplicated homeless individuals
per year: Why do policy debates about homelessness pay such scant attention
to significant health needs that both precipitate the loss of housing and
create daunting obstacles to regaining stability after an individual or family has
become homeless?

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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.  

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The Aging Homeless Population: Resetting Policy Priorities

National experts have called out the aging of the homeless population as an impending crisis. [1] 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. [2] 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.” [3] 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. [4] Another study showed that older homeless adults were 3.6 times as likely to have a chronic medical condition as homeless adults under 50. [5] Such findings clearly indicate a pressing need for housing and services that specifically address geriatric conditions among older homeless adults living across varied environments. [6]

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Coaching

Coaching can have a profound impact on leadership skills, relationships with staff and board members, overall job satisfaction and work-life balance, confidence, and adaptability.  John Gilvar’s approach to professional and leadership coaching emphasizes the following touchstones:

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Capacity Building for Health and Housing Equity

I started Gilvar Consulting Services to partner with organizations providing health care, housing, and homeless services and help expand their capacity to meet the needs of patients, residents, clients, and the broader community.  I especially wanted GCS to support community partnership development and efforts to bring to scale cross-agency collaborations integrating physical and behavioral health care as well as housing and shelter services.  As the director of large Health Care for the Homeless programs in both Texas and Washington, I developed and managed numerous successful collaborative initiatives with these same goals. I’m now using my strategic planning, advocacy, policy development, and operations management experience in a variety of new ways.

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