Homelessness Jeopardizes Health! Who Knew?

In 2008, the AIDS Foundation of Chicago led a coalition of hospitals and housing groups in conducting a study that investigated the impact of housing on health. The study was called the Chicago Housing for Health Partnership, or CHHP.

The study surveyed a group of 407 homeless folks that were battling with chronic illnesses. Half of the participants were placed in permanent housing with intensive follow-up by a social worker. The other half received ‘usual care,’ which included access to emergency shelters as well as recovery programs. Over the course of four years, doctors measured the health implications of permanent versus non-permanent housing.

The findings were stark.

The participants living in permanent housing utilized “one-third fewer inpatient hospital days and one-quarter fewer emergency room visits” than folks receiving ‘usual care.’ Additionally, there were 583 hospitalizations in the permanent housing group, while there were 743 in the ‘usual care’ group. Such results prove that permanent housing improves health dramatically.

Specifically, participants battling with HIV saw their health significantly enhanced. The study found the following:

  • After one year, 55 percent of HIV-positive participants in the intervention arm had a relatively healthy immune system, compared to 34 percent in the usual group.
  • 40 percent of HIV-positive participants in the intervention group had undetectable levels of HIV in their blood, indicating that treatment was highly successful, compared to 21 percent of usual care participants.
  • The median HIV viral load was 87 percent lower in the intervention group. A low viral load is evidence that treatment is working and reducing levels of HIV in the bloodstream.

Permanent housing accompanied by case management not only improved participant’s health, but it also saved the city a significant amount of money. The experiment proved that of “every 100 chronically homeless individuals housed [the government] will save nearly $1M in public funds per year.” According to The Wall Street Journal, the study elucidated that 201 participants living in permanent housing spent 5,500 days in nursing homes, while 206 ‘usual care’ participants spent 10,023 days in nursing homes. The difference in services amounted to approximately $500,000. While some perceive permanent housing as an unreasonably high expenditure, continuing to pursue the status quo is perpetuating our current deficit.

The CHHP study illustrates that permanent housing breaks the cycle of poverty. As affordable housing becomes scarcer and government continues to cut social services, we worry that folks with low or no income will have less access to permanent housing.  To adequately lessen the pervasiveness of homelessness and curtail chronic illness, providing stable and sustainable alleviation measures is necessary.

Housing is Healthcare for Folks Battling with HIV/AIDS!

Housing is Health care

Last month, a landmark court case, Short v. Manhattan Realty Inc., upheld the rights of tenants living with HIV/AIDS who receive government assistance. U.S. District Court Judge Samuel Conti ruled that Manhattan Apartment Inc. (MA) and Abba Realty Associates, Inc. (Abba), two of New York City’s largest realtors, were guilty of discriminating against persons receiving HIV/AIDS Services Administration (HASA) benefits. At the time of his apartment search, plaintiff Keith Short was battling with AIDS and receiving support from HASA.  Both MA and Abba “refused to assist Mr. Short because he was on HASA,” claiming that their apartments were not available to folks receiving government subsidies.

HASA is a NYC program that provides essential services to persons living with AIDS or clinical symptomatic HIV illness.  The program operates under the assumption that without access to housing, folks’ immune systems will suffer and surviving with the disease will prove even more arduous. Therefore, housing is an essential tool in combating HIV/AIDS. To put it simply, housing is healthcare.

MA and Abba’s reasoning for not allowing HASA clients rent their apartments is illegal.  In 2008, New York City Council passed Local Law 10 which prohibits landlords from discriminating against tenants based on government subsidies, including HASA.  What landlords often fail to acknowledge is that government subsidies are lawful sources of income.  To deny tenants the ability to utilize governmental programs is to deny tenants their rights.

Many of the tenants that we work with receive some form of government assistance as a result of disability or other health concerns. The pain of enduring those experiences is hard enough. To then experience “insult, expense, and indignity of discrimination” as a result of those obstacles is unacceptable. In order to enhance the health and preserve the integrity of tenants in New York City, enforcing Local Law 10 is imperative.

World AIDS Day: Reflections on Housing Inequality

AIDS was first reported in 1981, three decades ago this year. In one generation, the disease has transformed the public health community and the world, known more and more as a vicious killer. According to the Center for Disease Control, nearly 1.2 million people are living with HIV in the United States, and more than 16,000 people a year die of AIDS. The disease disproportionately affects minority communities: while individuals identifying as black represent approximately 14% of the U.S. Population, they account for nearly half of people living with HIV in the United States. Latino-identifying people are also disproportionately impacted, accounting for 16% of the total population and 17% of people living with HIV. (Read more at the CDC.)

Financial burden and discrimination contribute to a severe lack of affordable housing for those with an HIV diagnosis. Doctors at Columbia University, however, site that after medication, stable housing is most necessary to adequately treat HIV/AIDS. Without safe housing, it is difficult to receive decent health care and disease education.  (Read more at the National Coalition for the Homeless.) Tragically, the unfortunate housing reality contributes a very high mortality rate.

The HIV/AIDS Service Administration (HASA) is a government agency created to respond to the AIDS epidemic in New York City. HASA’s mission is to provide education and services for low-income, HIV positive New Yorkers including emergency housing for homeless clients. Housing is provided through public/private partnership: HASA secures units in multi-family buildings through contracts with private landlords, and then places low-income, HIV-positive individuals in these apartments. Unfortunately, many of the landlords who sign contracts with HASA are inattentive to the point of being downright abusive. Ultimately, HASA pays high rent for apartments where tenants live with roaches, faulty plumbing, security concerns, and inadequate heating. In a sentence: slumlords profit and HIV-positive tenants suffer. New York City taxpayers foot the bill.

In honor of World AIDS Day, we are writing to demand better oversight on the part of government agencies such as HASA. By allowing tenants to live in such unsafe conditions, we are doing a disservice to a population that is already at risk. There is a dangerous perception that HIV/AIDS is a result of a supposed moral failing (homosexuality, poverty, drug use) on the part of the affected, and they therefore deserve less than those without an HIV/AIDS-positive diagnosis. HASA does nothing to fight this misconception when they place HIV-positive individuals in some of New York City’s worst multi-family buildings.

It’s certainly hard to fathom a world before AIDS, and it may seem idealistic to imagine a world after it. In the meantime, we are working hard to temper the storm the disease creates. We are inspired by organizations like VOCAL New York, GMHC, and Housing Works who have made incredible strides in the fight for equal access to services for HIV/AIDS positive people. At TheSurrealEstate, we urge you to use today as motivation to get involved in your community and to fight housing inequality everywhere. You can start by calling HASA at (212) 971-0626 and letting them know that they should not allow tenants to live in buildings with high code violations. Even if the unit that the HASA tenant will live in is violation-free, a building that has more than three violations per unit is considered statutorily distressed by the city of New York. This definition indicates that the building has a negligent landlord who does not provide tenants with adequate services. Help your fellow New Yorker and urge HASA to stop putting HIV-positive individuals at risk!