Evaluating the Effect of Brigham Health’s Housing Program on Patients’ Experiences

Principal Investigator: MaryCatherine Arbour, MD, MPH

Authors: MaryCatherine Arbour, MD, MPH, Lynn Hur, Maahika Srinivasan, Cathy Garcia, Manuela Gonzalez, Margaret Joliffe, Thomas Kieffer, Placidina Fico, MPH
Lay Abstract

As a core social determinant of health, housing status has become the subject of intervention for many care systems. Similarly, the Brigham Center of Excellence in Primary Care’s Social Care Team (SCT) has been assisting patients obtain stable housing since 2019. This study uses a mixed-methods approach (via chart review and semi-structured interviews) to: 1) describe its patients served, services provided, and housing outcomes, 2) examine the association between program involvement and healthcare utilization/outcomes, and 3) elicit patients’ perspectives on the value of program participation. In its first 18 months, the SCT Housing Resource Specialists received a total of 977 referrals and successfully worked with 819 people, 20% of whom were facing eviction. People of color are disproportionately represented among Brigham patients referred to the SCT for housing support: 12% Black/African American, 36% Hispanic, 32% Other, and 9% White. Most patients referred for housing support speak a language other than English (59%) and live in one of Brigham Health’s priority neighborhoods: Dorchester, Mattapan, Roxbury or Jamaica Plain (58%). Preliminary analyses of semi-structured interviews yield several emerging themes, including the importance of customizing patient-Specialist relationships, the need for nimble search processes, and the impact of housing status on mental health.

Scientific Abstract

As a core social determinant of health, housing status has become the subject of intervention for many care systems. Similarly, the Brigham Center of Excellence in Primary Care’s Social Care Team (SCT) has been assisting patients obtain stable housing since 2019. This study uses a mixed-methods approach (via chart review and semi-structured interviews) to: 1) describe its patients served, services provided, and housing outcomes, 2) examine the association between program involvement and healthcare utilization/outcomes, and 3) elicit patients’ perspectives on the value of program participation. In its first 18 months, the SCT Housing Resource Specialists received a total of 977 referrals and successfully worked with 819 people, 20% of whom were facing eviction. People of color are disproportionately represented among Brigham patients referred to the SCT for housing support: 12% Black/African American, 36% Hispanic, 32% Other, and 9% White. Most patients referred for housing support speak a language other than English (59%) and live in one of Brigham Health’s priority neighborhoods: Dorchester, Mattapan, Roxbury or Jamaica Plain (58%). Preliminary analyses of semi-structured interviews yield several emerging themes, including the importance of customizing patient-Specialist relationships, the need for nimble search processes, and the impact of housing status on mental health.

Clinical Implications
Healthcare systems that aspire to redress systemic racism increasingly recognize the imperative of tackling social determinants of health. That said, healthcare-associated housing programs’ efficacy is undetermined. This study’s findings contribute to this field’s emerging literature while simultaneously enhancing Brigham’s program.

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One reply on “Bridget Faison, AA”

Great work on this! Really important work to be doing ahead of expanding the Housing program.

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