From sleeping in cars to being forced out of homes due to unsafe conditions or missed payments, roughly 30 million Americans have been at risk of losing housing since 2020. 

We’ve already talked about the five non-medical social drivers of health — economic stability, access to quality healthcare, social and community context, access to quality education, and neighborhood and built environment — and what they look like in everyday life. 

Now, we’re diving into another social driver of health, uncovering some of the most common ways community health workers (CHWs) can improve health and well-being by addressing a critical need for safe and stable housing.

What is the neighborhood and built environment SDOH?

The neighborhood and built environment social driver includes access to safe and stable housing, as well as transportation, walkable streets, accessible recreation facilities, such as parks, and other factors that are determined by where you live.

Like all social drivers of health, the cycle of housing security or insecurity can impact every aspect of a person’s life. That’s especially true in cases where people are living between locations or may not have an address at all. 

Without that key piece of personal data, normal life occurrences, like maintaining bank accounts, being a reliable employee, and registering kids for school, can feel impossible. 

Consider this example: Jessica has two elementary-aged kids. Last month, her landlord raised her rent by $400 per month, pricing her out of her one-bedroom apartment. Waitlists for subsidized housing are long, and she can’t afford to wait for assistance. 

She packs what she can in her car and moves her family into a motel that accommodates short-term stays, but it’s further from her place of work and the kids’ school. Jessica is constantly late for shifts, stressed, and worries about how the changes will affect her kids.

Without intervention, people like Jessica are at higher risk of becoming unhoused, experiencing social isolation from friends and community, losing income, and not utilizing preventative healthcare services. When assistance takes too long or comes up short, individuals and families often rely on community health workers or community-based organizations (CBOs) to step in for emergency rental assistance or to help them meet other needs related to being unhoused. 

Why housing matters to overall community health outcomes

Housing is more than where someone lays their head at night. It points to larger issues of a lack of social support and can cause devastating negative health outcomes.

Safe housing can reduce the prevalence of disease in adults and children. Adults who are homeless experience 60 to 70 percent higher rates of cardiovascular events compared to the general population. 

Secure housing and an affordable housing infrastructure can improve healthcare utilization. Low-income families that move into more affordable and stable housing had 18% fewer emergency department visits and 20% more primary care visits.

Secure housing aids in mental health crisis and substance-use recovery. For those re-entering the community after incarceration, secure housing can significantly reduce recidivism rates, too.

Common CHW housing services

Community health workers can often support clients at every stage of a housing crisis, from finding housing to staying up on rent, improving housing conditions, transitioning to new housing, and fighting eviction. 

Establishing connections through housing-related case management

Case management is a cornerstone of effective community health work. CHWs and promotores can be case workers or housing coordinators with first-hand experience, allowing them to provide real help. CHWs establish trust to get to the heart of a person’s risk of housing insecurity or homelessness.

They build trust by establishing a social or cultural connection through language, shared experiences, and meeting individuals where they are, whether that’s a local clinic, shelter, or hospital. CHWs gather information about a person’s income, health history, family dynamics, coverage status, and other social and health needs to best determine how to help. 

When it comes to housing, help usually comes in the form of assisting people with applying for emergency assistance, completing housing applications, understanding and complying with complex rental agreements, securing official documentation, intervening to prevent evictions, getting connected to shelters and transitional housing, and navigating the Housing Choice Voucher Assistance program (or Section 8 housing).

Organizations like Assured Lifestyle Housing, Inc, provide case management services, such as housing referrals and transportation, as well as re-entry and winter shelters as a way to break cycles of homelessness and improve the well-being of individuals in the community. 

Securing funds through housing-related financial assistance 

During transitional or crisis periods, financial assistance programs help those experiencing homelessness. Rescue-A-Life Foundation’s rental assistance program is a rapid-response option for high-risk individuals, specifically focusing on people who are formerly incarcerated. Secure housing can dramatically reduce recidivism and set someone on a road to success.

CHWs and the organizations, like Rescue-A-Life, connect community members to short-term financial assistance for expenses related to security deposits, rent, and sometimes food and utilities. An area where CHWs and community-based organizations can provide significant financial assistance is in rental application fees, which can be an additional burden even for those who have the means to cover rent.

Keeping at-risk individuals in their homes with accessibility services

Habitat for Humanity is, perhaps, one of the more well-known organizations for bringing secure and stable housing to communities across the country. But they’re not the only ones. Serving West Hollywood, Los Angeles, and Glendale, West Hollywood Community Housing Corporation builds new apartments and renovates old ones to provide housing to lower and fixed-income individuals, like seniors. 

In West Hollywood alone, they’ve developed over 900 affordable housing units across 18 properties in the West Hollywood area. By providing affordable housing options to people most at risk of homelessness, they act as a critical safeguard against worse health and life outcomes. 

Care navigation software helps CHWs provide housing services, increase revenue

Pear Suite supports organizations like these and others to address housing challenges, among other social drivers of health. Its AI-powered care navigation software digitizes client and care management, documentation, referrals, and claims processing, making organizations more efficient, enhancing Medicaid and Medicare billing procedures, and simplifying reporting of positive health outcomes and impact. 

Pear Suite ends the reliance on paper, spreadsheets, and manual processes with HIPAA-, HITRUST-, and SOCS 2-compliant software that tracks outreach, including call logs, and daily team activities and workloads. And because it’s designed around community health workflows, even those as complicated as Enhanced Care Management, implementing Pear Suite can reduce tech sprawl and keep your team from having to jump from system to system to get their work done. 

For example, combining these capabilities in one solution is helping one housing CBO bring in $20,000 of additional revenue per month, and has allowed them to purchase a refrigerator truck so they can store and deliver culturally relevant foods to individuals experiencing housing insecurity.