PORTLAND, Ore. – Health care doesn't stop after a person leaves the doctor's office. Factors outside of the traditional care setting such as housing play a pivotal role in a person's overall health.

Michael Mellick, a housing case manager with CareOregon, says anybody who has experienced chronic homelessness most likely experiences other issues as well.

"It's safe to assume they're going to have substance-use dependence issues, which we try to help them with,” says Mellick. “There's mental-health issues that often come into play. There are criminal background involvement issues that have to be remedied."

Addressing social determinants such as adequate housing are mandates for coordinated care organizations, which manage the Oregon Health Plan in local communities.

In Portland, six health organizations, including CareOregon and Kaiser Permanente, launched the "Housing is Health" initiative in 2016. Funding from it has supported two developments for low-income tenants, and another project is scheduled to open this summer.

Housing is Health is one part of CareOregon's response to housing issues. Case managers such as Mellick help non-residential clients look for solutions to their unique needs.

He describes a client who had lived on the streets for two years with a chronic lung disease. After helping to clear up his legal issues, Mellick found housing for the client.

He says the man is older and in a vulnerable position, and housing is helping to extend his life.

"He continues to engage in behaviors that aren't necessarily the healthiest for him but his utilization and the cost of his care drastically decreased for the simple fact that he was now sleeping inside in a warm, safe place,” says Mellick.

Mellick says one common thread among clients is a feeling of isolation. It can come from a variety of sources, such as trauma at an early age or the effects of racism or poverty.

He says addressing this could make for a better society.

"You're not just ending with the individual,” says Mellick. “You're looking at the individual's relationship with community. Healing, recovery, renewal. It goes back to the notion of relationships and the person's place in the community."

Rural New York organizations are working to tackle issues with rural housing. Rural counties throughout the state are suffering from aging housing stock and an ever dwindling supply.

In 2021, the New York State Comptroller found 10 rural counties had 5,500 fewer housing units than in 2016.

Megan Murphy, executive director of the rural housing organization Adirondack Roots, said places like Essex County are seeing the ripple effects of rural New York's housing problems.

"The county itself has dozens of jobs that are going unfilled because one of the hardest parts of this is that hiring in people from outside, they're not able to find housing," Murphy observed. "We're hearing this from health care institutions, we're hearing this from nonprofits, and from others."

She argued solutions require new rental units and affordable housing projects in rural areas. Murphy added while most rural counties are facing a housing shortage, the problems look different in each place. Essex County, for example, needs increased funding for Adirondack Roots' existing home rehabilitation, and New York State's mobile home replacement program.

New York State is investing in rural areas. Several new rental developments have been built across the state in 2023. But Murphy pointed out new projects are expensive and potential renters are already struggling to make ends meet with low wages.

"When you're talking about new builds, it's 'how do we figure out how to create a situation where we can either reduce the cost of building, or create a situation where there is a subsidy for folks so that they can get into new homes?'" Murphy explained.

She emphasized it also applies to maintaining existing homes. Murphy acknowledged there is no silver bullet to the issues surrounding rural housing, but contended it will take an interconnected, holistic approach to solve them.


get more stories like this via email

Advocates for the homeless in Ohio say effective and well-funded federal programs have helped cut the number of homeless veterans nearly in half over the past decade.

Federal agencies with a "housing first approach" have prioritized getting veterans into stable housing quickly without preconditions and provided greater assistance to landlords willing to help.

Marcus Roth, communications/development director for the Coalition on Homelessness and Housing in Ohio, said the same approach should apply to all homeless people.

"It's been really refreshing to see that we can make progress for homeless veterans," he said. "If we apply the same approach to other populations, we can help other folks, too."

There are still more than 600 homeless veterans in Ohio, according to federal data.

Advocates for these veterans have said high rental prices and increasing eviction rates statewide could add to that number. Rent prices skyrocketed a year into the pandemic, increasing nearly 25% in Ohio from 2021 to 2022 with Cleveland and Cincinnati alone showing some of the highest rent increases in the country.

Roth said the state's continued lack of affordable housing is driving people into homelessness.

"We hear about tenants that are getting bills with a rent increase of 40% to 50%," Roth said, "and a lot of people can't afford that, and then they look around to find another place to live and they can't find anywhere else that's affordable either."

Roth said the General Assembly's creation of a new affordable-housing tax credit could offer some relief. The Senate Select Committee on Housing has been holding a series of hearings to address the affordable-housing crisis.

This story was produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


get more stories like this via email

A Connecticut group is holding several roundtable discussions about ways to end homelessness.

The Connecticut Coalition to End Homelessness is speaking with elected officials to bridge the gap between understanding what it will take to reduce homelessness in the state and actually ending it. Between 2021 and 2022, a point-in-time report tracked a 13% increase in homelessness on a single January night. This year's report saw an almost 3% increase.

Sarah Fox, CEO of the Connecticut Coalition for Ending Homelessness, said the numbers are trending up for several reasons.

"They're becoming homeless due to poverty from returning back to the community after incarceration, from just generally not being able to thrive in the current environment," Fox observed. "We also know that you cannot uncouple homelessness from the affordable housing crisis."

Other reasons people are becoming homeless include the economic impacts of the pandemic, and rising rents. While Fox is eager to see progress, she is aware of the challenges ahead. In addition to competing fiscal priorities in the General Assembly, there is also the need to raise funds for homeless service systems. She said helping legislators understand the pressure the system is under to serve a growing population is a step in the right direction.

During the past session, the group brought legislation to the General Assembly to allocate funds to begin work necessary to end homelessness. The bill called for $50 million in funding to improve Connecticut's Homeless Response System.

Fox noted lawmakers approved far less.

"We received in total, $7 million, including $5 million for shelters, and $2 million that the Gov. had issued for flexible funding subsidies."

She added though it was not nearly enough, it is more money than other groups and causes got, many of whom received nothing.

As winter approaches, Fox is concerned about how to keep the growing elderly homeless population safe. A National Alliance to End Homelessness report predicted senior homelessness will grow from 40,000 to 106,000 by 2030.


get more stories like this via email