Building Health through Housing Sustainability
Written by Jaime Meyers, read the original story in the Summer 2019 edition of Panacea.
It may be common sense to most health care professionals that safe, stable housing is a social determinant of health. However, supporting science is only nascent. Two UMSN faculty members are leading synergistic efforts to build the body of evidence through a series of research projects in collaboration with community and academic partners.
“Nurses not only should, but must be part of the research with homeless individuals and families,” said Barbara L. Brush, Ph.D., ANPBC, FAAN, UMSN’s Carol J. and F. Edward Lake Professor in Population Health. “Our focus on addressing social determinants that compound and lead to unstable housing and poor health provides a critical lens.”
Brush, who has more than 20 years of research and practice expertise focusing on homelessness, recently served on a National Academies of Sciences, Engineering, and Medicine committee tasked with understanding the connection between housing and health outcomes. The lack of linked information surprised the panel of experts and prompted Brush to start a new research project with the goal of informing future policy.
“I’m planning to conduct a longitudinal study of families experiencing homelessness to determine how the complexity of individuals, the systems and organizations supporting them, and policies intersect in the overall care,” said Brush.
“Injustice in the forms of institutional racism and resource inequity that underlie housing instability results in toxic stress for entire communities. If we are thoughtful about how to address disparities among those most vulnerable to them, we will inevitably begin to correct disparities for those in less dire circumstances.”
— Laura Gultekin, Ph.D., FNP-BC
Laura Gultekin, Ph.D., FNP-BC, was inspired to develop interventions addressing homelessness after studying under Brush as a master’s and Ph.D. student. Now as an assistant professor, Gultekin’s focus is on helping families, especially single mothers and their children, prevent and recover from homelessness.
“We recognize that many mothers draw strength and identity from that role,” said Gultekin. “We are working with collaborators from Johns Hopkins to provide an evidence-based positive parenting program at a family shelter in Detroit. We anticipate this program will help mothers gain confidence and aid them in managing challenging childhood behaviors in a way that makes them and their children feel empowered.”
Brush and Gultekin see stable housing as a conduit to reducing multifaceted disparities.
“People with unstable housing rarely have just that,” said Brush. “They have poor health that requires support; they may end up in prison; and they may need child support, all of which translates to real economic costs. Moreover, homelessness can have lasting effects on children who may eventually continue the cycle.”
“Injustice in the forms of institutional racism and resource inequity that underlie housing instability results in toxic stress for entire communities,” agreed Gultekin. “That’s compounded by environmental issues that disproportionately impact low-resource communities, such as higher rates of air pollution and water contamination, and contributes to increased morbidity and early mortality. This directly impacts the individual’s ability to contribute productively to society. If we are thoughtful about how to address disparities among those most vulnerable to them, we will inevitably begin to correct disparities for those in less dire circumstances.”
Both Brush and Gultekin stress the importance of collaborative efforts with members of the community in the creation, implementation and evaluation of their research.
“We are not so much ‘helping the public’ as ‘working with the public to help itself,’” said Brush. “Interventions need to be designed with the community or else they won’t work or be sustainable.”
