October 2019
Housing as a Health Strategy: Removing Barriers to Improved Health Outcomes
By: Dr. Derek J. Robinson, M.D., MBA, FACEP, CHCQM, Vice President and Chief Medical Officer, Blue Cross and Blue Shield of Illinois (BCBSIL)
BCBSIL is focused on helping to address the needs of our members and the communities in which they live and work. We know that factors outside of direct clinical care – such as housing, nutrition, employment and transportation – play a major role in a person’s ability to be healthy.
The average life expectancy among America’s homeless is between 42 and 52 years old, much lower than the life expectancy for the general population at 78 years. One estimate is that more than 80 percent of all homeless people have at least one chronic health condition.1 This disparity in life expectancy is unacceptable. Imagine trying to manage diabetes while homeless, with limited access to nutritious food or a physical environment conducive to regular glucose monitoring. Homelessness is a primary social determinant that must be overcome before many individuals can be empowered to better manage their medical conditions.
As BCBSIL continues its work to implement strategies to help improve equity, I am pleased to announce that BCBSIL is among the first private funders in the public/private partnership known as Chicago’s Flexible Housing Pool (FHP). The $1 million investment by BCBSIL will help support the coordination of secure, quality, safe and affordable housing for members of Chicago’s homeless community. Over two years, the program will prioritize those experiencing homelessness who have been frequent users of hospital emergency departments and other crisis response systems. To help increase the likelihood of improved health outcomes, the housing subsidy is paired with intensive case management for health and social services.
The Flexible Housing Pool is modeled after a program in Los Angeles County that found that for every $1 invested in the program, Los Angeles County saved $1.20 by reducing health care and other social service costs. Emergency department visits decreased by 67.5% and the number of days of in-patient stays decreased by 77%. The Chicago program was launched in 2017 when then-Mayor Rahm Emanuel introduced an ordinance creating the FHP and established initial funding. The first participant received housing in March 2019 and a total of 26 people have been housed so far. The City of Chicago aims to eventually create 750 units of supportive housing.
Clarita Santos, executive director of Community Health Initiatives for BCBSIL, summarizes: “We are targeting our community investments to make a positive impact on community health and narrow the health disparity gap. This FHP grant is just our latest effort. Since 2017 we have given nearly $450,000 in funding for programs aimed at supporting access to housing to improve health. We’re not just paying rent, we are supporting people – giving them the tools they need to not only improve their health and reduce health care costs – but to live up to their potential.”
Our support of the FHP is part of our continued effort to help improve the social determinants of health and health equity. We are doing this in part by collaborating with other corporate citizens and health care organizations to invest in results-driven solutions. We also believe that these efforts represent important opportunities for synergy with you, our provider partners, who are focused daily on improving clinical outcomes for our members. Sometimes, the catalyst for improving health for some of the sickest patients is actually within reach. By working together, we can accelerate our learning and development of solutions to achieve health equity for our members, and your patients.
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Learn more about Dr. Derek J. Robinson
1Health Care and Homelessness. Published July 2009 on the National Coalition for the Homeless website at https://www.nationalhomeless.org/factsheets/health.html.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to third party sources or organizations are not a representation, warranty or endorsement of such organizations. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.