Category Archives: Housing/public housing
Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:
In a New York Times op-ed, Peter Ubel, MD, examines the need for physicians to incorporate the cost of care into treatment conversations with patients. Ubel is an RWJF Generalist Physician Faculty Scholar and an RWJF Investigator Award in Health Policy Research recipient. “[T]he financial burden of paying for medical care can cause more distress in patients’ lives than many medical side effects,” he writes. Read more about Ubel’s views.
In lieu of expanding Medicaid under the Affordable Care Act, Pennsylvania Governor Tom Corbett proposes to direct low-income residents to insurance marketplaces to purchase state-subsidized private plans. In a Philly.com op-ed, David Grande, MD, MPA, discusses whether the plan will cost more than traditional Medicaid. Grande is the associate director of the RWJF Clinical Scholars program and an alumnus of the RWJF Health & Society Scholars program.
Human Capital News Roundup: Depression among nurses, health effects of foreclosures, heat waves, and more.
Ryan Greysen, MD, MHS, an alumnus of the RWJF Clinical Scholars program, spoke to the San Francisco Chronicle about the risks and benefits of social media in health care. Greysen and colleagues recently surveyed 68 executive directors of medical and osteopathic boards in the United States about violations of online professionalism among licensed physicians. Read more about the study.
One in five nurses is depressed—twice the rate of the U.S. population at large, according to a study led by RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantee Susan Letvak, PhD, RN. The study also looked at the impact of nurses’ depression on the quality of care they provide, and suggested that advanced practice nurses and nurse managers are well-positioned to identify depression and refer nurses for treatment. Health Leaders Media and the Cleveland Plain Dealer are among the outlets to report on the findings.
“Government can—and should—assist political scientists, especially those who use history and theory to explain shifting political contexts, challenge our intuitions and help us see beyond daily newspaper headlines,” RWJF Scholar in Health Policy Research Jacqueline Stevens, PhD, wrote in an op-ed for the New York Times. “Research aimed at political prediction is doomed to fail. At least if the idea is to predict more accurately than a dart-throwing chimp… I look forward to seeing what happens to my discipline and politics more generally once we stop mistaking probability studies and statistical significance for knowledge.”
RWJF Executive Nurse Fellows alumna Debra Ann Toney, PhD, MS, BSN, FAAN, will carry the Olympic torch through the English town of Kirtlington (near Oxford) in July, KSNV-TV (Las Vegas, Nevada) reports. Toney is one of 22 Americans selected by Coca-Cola, a sponsor of the Olympic Games, to carry the Olympic Flame in the London 2012 Olympic Torch Relay. Read a post Toney wrote for the RWJF Human Capital Blog.
As we head into 2012, the Human Capital Blog asked Robert Wood Johnson Foundation (RWJF) staff, program directors, scholars and grantees to share their New Year’s resolutions for our health care system, and what they think should be the priorities for action in the New Year. This post is by Corina Graif, PhD, RWJF Health & Society Scholar at the University of Michigan, Ann Arbor.
In the New Year I hope that our thinking about housing policy will more systematically incorporate the expanding evidence and relevance of housing conditions for population health and health care policy. Many aspects of internal housing conditions are known to affect health. For instance, heating, ventilation, mold and lead are linked to cardiovascular health, excess mortality, asthma, disability, intellectual functioning, ADHD [Attention Deficit Hyperactivity Disorder] and delinquent behavior.
We are also learning more and more about the health relevance of various characteristics of the physical environment surrounding one’s residence. For example noise, spatial proximity to vegetation, to grocery shops and to highways, and other sources of air pollution are linked to cardiovascular, mental health, obesity, asthma and allergic effects. Limited but important evidence also exists on the health implications of the socio-spatial context of housing. For instance, fear of crime, crowding, neighborhood disadvantage, social exclusion, and residents’ social exchange are linked to cardiovascular and mental health, obesity, diabetes and low birth weight.
In my dissertation work and related projects, I ask questions about the spatial context of neighborhood effects to investigate how the urban geography of inequality and cumulative spatial disadvantage shape the health and well-being of the inner-city poor. I analyze residential mobility data from the Moving to Opportunity Experiment in Los Angeles, New York, Boston, Baltimore, and Chicago together with data from PHDCN [Project on Human Development in Chicago Neighborhoods], and a large collection of data based on Census and other administrative records over several years.
Craig Pollack , MD, Robert Wood Johnson Foundation Clinical Scholar alumnus (2006-2009), has been looking at the ways the nation’s housing crisis is harming the health of those affected by foreclosures. In a series of studies conducted with fellow scholars and an oped piece in the New York Times, “Foreclosures Are Killing Us,” Pollack takes an in-depth look at this issue. The Human Capital blog explored his views.
Human Capital Blog: How and when did you become interested in the subject of foreclosure and health?
Craig Pollack: As a medical student, I performed research in post-conflict Bosnia-Herzegovina. The research introduced me to the important connections between housing, displacement and health. This led to several epidemiologic studies looking at the nexus of home ownership, wealth and health in different contexts. The foreclosure crisis brought together many of these themes and was additionally compelling because of the potential implications for health disparities.
HCB: What aspects of the subject have you studied so far and what are your main conclusions?
Pollack: In our first study of foreclosure, Julia Lynch, PhD, (an associate professor of political science at Penn) and I surveyed 250 homeowners who were presenting for their initial mortgage counseling session at a Philadelphia mortgage counseling agency. Compared to a community sample and after adjusting for a range of economic factors, those facing foreclosure were more likely to report skipping going to the doctor and prescription medicines because of the cost. In addition, over a third of these homeowners had symptoms of major depression.
In the second study, homeowners who received a home foreclosure notice were matched to electronic health records at a university hospital system. In the two years prior to foreclosure, homeowners undergoing foreclosure were more likely than the control group to visit the emergency department, have an outpatient visit, and have a no-show appointment. The results reinforce that there are differences in health care utilization that are associated with foreclosure.
In the third, we performed a national survey of mortgage counselors.
In May, the U.S. Department of Housing and Urban Development (HUD) awarded a multi-year grant to an asthma prevention and treatment program run by 2008 Robert Wood Johnson Foundation Community Health Leader Ray Lopez of New York City. Lopez is the director of environmental health services at the Little Sisters of the Assumption Family Health Service in New York’s East Harlem. The grant award is shared with the New York Academy of Medicine.
Ray Lopez: Our mission is to serve children in East Harlem by helping their families treat and prevent asthma incidents. Asthma rates are unusually high in New York City in general, and the problem’s even more acute in Harlem, the South Bronx and Central Brooklyn where there are all kinds of environmental factors in children’s homes. We’re focused on children in public housing, where there are a number of problems. A lot of the apartments have mold that has grown as a result of leaks, and they’ve also got a lot of cockroaches, and mice, which all contribute as well. What we do, and what this grant will help us do a lot more broadly, is to get treatment for the kids, but also to go into their apartments and get to work on reducing the environmental factors. Sometimes that means identifying moisture sources and safely cleaning the mold. Sometimes it means pressing the city’s housing authority to do major work. Sometimes it involves teaching the adults in the family about the safe use of pesticides and cleaning products. For each family we visit, we work with them to create an individualized service plan, and then we focus on remediating the asthma triggers.
Teaching is a major part of this, too, and the plan is to teach by showing and doing. Families are enrolled with us for a year, and by end of year, we hope they will have accumulated skills to manage these problems on their own in the long-term. It’s a three-year project, in all: two-plus years working with the families, and then a final phase that consists of data analysis and policy initiatives led by the New York Academy of Medicine.
HCB: And then what’s the plan with the data and the analysis?
Lopez: The plan is to build the business case for this kind of intervention, and then to persuade insurance companies and providers that it’s worth the investment to them to spend a little money up front to prevent asthma incidents, rather than paying for them in the emergency room.