February 2020 Newsletter


Health and Housing Equity Connection

Gilvar Consulting Services Newsletter

February 2020

This month’s topic:

The Public Health Lens on Homelessness Necessary to Evaluate Proposed New Policy Approaches

Despite the American Public Health Association’s many calls since the 1980s for homelessness to be understood as a Public Health crisis, policy makers have largely failed to attack the issue from this direction.  Like the correlations between race and homelessness and between race and poor health outcomes, the correlation between poor health and homelessness has, despite abundant empirical evidence, not yet inspired significant shifts in policy.  In fact, during my 20 years of developing clinical partnerships and managing Public Health interventions specifically tailored to assist people living homeless,  I only saw a widespread increase in understanding of the APHA’s basic message after the massive 2017 San Diego Hepatitis A outbreak that began among people living unsheltered, eventually hospitalizing over 400 people and killing 20. 

This month’s GCS newsletter provides resources for applying a Public Health lens to exploring blind spots in common analyses of homelessness, including the analyses that inform the Trump administration’s new proposed approach.  I’ve included my recent blogpost (https://gilvarconsulting.com/a-public-health-lens-on-homelessness-exposes-problems-with-the-trump-administrations-proposed-approach/) on this issue, which relies heavily on my experience addressing homelessness within Public Health – Seattle King County from 2008 to 2019, a period in which the number of people living unsheltered in the region skyrocketed, as did the total homeless population.

I’ve also included several articles that graphically illustrate how serious health issues often precipitate homelessness and undermine efforts to help people become and stay stably housed. I’ve also included a link to the APHA’s many policy statements on homelessness. 

I hope these resources prove helpful to those advocating on behalf of policies that support innovation around meeting the complex and intertwined housing and health needs of our most vulnerable community members.

A Public Health Lens on Homelessness Exposes Problems with the Trump Administration’s Proposed Approach (https://gilvarconsulting.com/a-public-health-lens-on-homelessness-exposes-problems-with-the-trump-administrations-proposed-approach/), Gilvar Consulting Services Blog, February 2020

The Impossibility of Managing a Chronic Disease While Homeless, by Dr. Maralyssa Bann

‘Heartbreaking’: Seattle’s Homeless Are Getting Sicker and Shelters are Struggling to Keep Up, by David Kroman

Medical Examiner Report: Homeless Community Deaths Up Nearly 15 Percent, by Ashley Archibald

Health and Housing Partnerships for Older Adults: Aging in Place in Supportive Housing, Corporation for Supportive Housing

Housing and Homelessness as a Public Health Issue, American Public Health Association

Other Articles

City of Dallas Equity Assessment of Affordable Housing Policies

Along with colleagues Christine Campbell and Michele Williams, John conducted a racial equity assessment of the City of Dallas’s affordable housing policies.  The assessment relied on extensive community input and culminated in a presentation of 11 recommendations for change to the Dallas City Council.  The findings and recommendations are summarized in this final report.  Recommendations start on page 8, following the executive summary.

Accelerating Organizational Anti-Racism Work with Adaptive Leadership and Mindful Communication Practices

Transformational change at an organizational or systems level requires both deep listening and the willingness of leaders possessing decision-making authority to collaborate with those most directly impacted by the problems necessitating change. Few leaders I know would dispute this premise in the abstract, but many might struggle to explain in concrete terms how they walk the walk as well as they talk the talk. Moving organizations and communities from words to action around redressing institutionalized racism requires leaders not only to put listening and collaboration skills to the test, but to leap beyond the comfort zone of routine approaches to problem solving. Adaptive leadership and mindful communication practices can provide an excellent platform from which to dive into the deep water of acknowledging racism and other structural forms of oppression as powerful drivers of inequities in the areas of health, housing, and economic advancement.

Cross-silo Partnerships Boldly Tackling Inequities in the Midst of the Pandemic

New COVID-19 hospitalization data shine a stark light on the connection between homelessness and poor health.  The Minnesota Department of Health found that people residing in homeless shelters who were diagnosed with COVID-19 were 4 times more likely to be hospitalized and 3 times more likely to be admitted to an intensive care unit (ICU) than the overall population of Minnesota residents with a COVID+ diagnosis.  The hospitalization and ICU rates for people living unsheltered were even worse:  almost 10 times more likely to be hospitalized and 7 times more likely to receive treatment in an ICU.