March 2020 Newsletter


Health and Housing Equity Connection

Gilvar Consulting Services Newsletter

March 2020

This month’s topic:

COVID-19 and Homelessness: Resources and Challenges for Service Providers and Policy Makers

The studies and articles highlighted in last month’s newsletter argue for increasing policy makers’ focus on the indisputable links between homelessness and health care challenges related to chronic disease, aging, and increased risk for communicable disease transmission.  Unfortunately, the COVID-19 outbreak has brought that need into sharp relief, as local governments and organizations serving the homeless scramble to develop strategies to prevent outbreaks in shelters and to protect the thousands of people who have compromised immune systems and no home in which they can self-quarantine, whether they live outside or in a shelter. 

This month I’m focusing completely on COVID-19 and recommending a one-stop webpage, which links to numerous resources, including prevention guidelines specifically developed by federal and local agencies for working with sheltered and unsheltered homeless populations.  Created by the National Health Care for the Homeless Council, this page will be updated regularly as guidelines and recommendations evolve.

I also recommend this article describing how one community hard hit by the pandemic, Seattle WA, has grappled with developing an outbreak response that accounts for major vulnerabilities common to people living homeless. 

Another great resource: On Friday March 20 12:30 -2:00 PM EST the National Health Care for the Homeless Council will sponsor a webinar in collaboration with the CDC and HUD titled Coronavirus and the Health Care for the Homeless Community: Status Updates, Available Guidance, Local Preparations, and Outstanding Issues.

Finally, I’ve included an advocacy letter that powerfully and succinctly calls on Washington state officials to take special action for people living homeless as part of their overall COVID-19 response.  This letter points to many of the challenges that I witnessed first-hand in representing homeless healthcare providers, shelter operators, and other homeless services agencies within Incident Command structures created to respond to hurricane evacuations and communicable disease outbreaks.

My thoughts and prayers go out to those working to prevent the spread of COVID-19 as well as those who have already been infected.  Please follow the ever-evolving guidelines and directives from local, state, and federal Public Health officials and stay healthy.

Be well,


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.