Kaiser Permanente takes social determinants head on with new housing investments

The link between housing and health has long been established, but here are a few statistics that drive the point home.

Studies have shown that access to stable housing lowers hospital stays by 29 percent and emergency department visits by 24 percent. Additionally, being chronically homeless lowers life expectancy by nearly 20 years.

Health and Human Services Secretary Alex Azar has previously spoken about potentially directing Medicaid dollars to allow providers to directly pay social services like housing. One study found a 55 percent reduction in Medicaid claims for individuals 1 year after finding housing.

It’s an oft-mentioned point – but one that bears repeating –  social determinants have a much bigger impact on general health than clinical practice.

Kaiser Permanente has been one of the healthcare systems that has taken this mantra to heart investing in and researching issues ranging from gun violence to climate change.

When the managed care organization said last year that it was pledging $200 million towards fighting homelessness and supporting affordable housing, the move was rightly viewed as a major step by a private healthcare company to address one of the social factors that most affects health.

Now the initial phases of their plan are becoming clearer.

The effort has been launched with three major initiatives: Housing 500 homeless Oakland seniors and – in partnership with nonprofit Enterprise Community Partners – purchasing a 41-unit affordable housing project in East Oakland and starting a $100 million loan fund dedicated toward the preservation of affordable housing.

“We believe that the notion or the idea that someone should have to go to bed with the streets of America as their home is unacceptable,” said Kaiser Chairman and CEO Bernard Tyson at a press conference announcing the moves.

“This is the beginning of us being in traffic and backing our talk that we want to help make a difference in Oakland, the Bay Area and in this great country.”

In partnership with public agencies and organizations Kaiser identified 500 individuals over 50 who have at least one chronic disease and have committed to housing them and helping them with wraparound services. Still, details are scant about how exactly the groups are looking to provider services.

The apartment complex, located in the rapidly gentrifying San Antonio neighborhood in Oakland, is being renovated and preserved as affordable housing in partnership with the East Bay Asian Local Development Corporation.

“We don’t have the time or the money to just build our way out of the problem,” said Oakland Mayor Libby Schaaf. “This is a call to action to other affordable housing developers to join this strategy.”

Enterprise Community Partners and Kaiser both invested $50 million in the housing fund, which will be offered as low-interest loans to people seeking to preserve affordable housing across Kaiser’s service areas.

“Housing and health go hand-in hand, its not fair to expect people to live healthy lives if they don’t have stable housing,” said Bechara Couchair, Kaiser’s Chief Community Health Officer.

As a integrated healthcare system Kaiser is additionally incentivized to keep the people in their community healthy outside the hospital as well. The company has focused on a concept known as “total health” where patients are cared for physically, mentally and spiritually.

In Kaiser’s hometown of Oakland, homelessness has increased by 25 percent between 2015 and 2017. Affordable housing has been difficult to find as well, with monthly 1-bedroom rents in the city topping $2,000.

“Up close you start to see it’s a complicated problem, but a solvable one. Maybe they lost their job, had a major traumatic experience or have mental challenges,” Tyson once told me about his experiences visiting the homeless encampments that dot the city.

Picture: baza178, Getty Images