Health Starts At Home is an initiative that began in Boston in 2014. The Boston Foundation initiated a collaboration between housing organizations and healthcare providers to try and provide more stability in terms of housing in the city. Research had shown that instability in terms of housing can have a negative effect on children's mental and physical health, and on their behavior. By tackling this instability, which was largely caused by high rents, huge savings could be made in health care. Families would not rely on these services as much because children would be happier and healthier. Although centered in Boston, this initiative highlights problems that are faced by families all over the country.
When a family's housing situation is unstable any health care that they receive is usually very fragmented. Very often families will only seek medical attention when a problem has escalated into a crisis. This means that they have to access emergency treatment which is usually very expensive. This often makes a difficult financial situation even worse. The person ends up in a vicious circle of not being able to afford quality housing, which leads to health problems and the treatment for these problems costs money that may have otherwise been spent on housing.
Another problem that was identified by the study is that when homelessness occurs, families become very isolated. This means that they often do not have access to health care at all. They also lose the ability to cook meals and have to eat whatever they can get their hands on which could make existing health problems worse. Feelings of isolation and loneliness can affect a person's mental health. Homelessness is a situation that is difficult to get out of without the right support. Very often, the focus of the family solely becomes finding somewhere to live and this can mean that everything else gets overlooked and this includes accessing basic health care.
The Health Starts At Home initiative in Boston looked to tackle these problems in several ways. By encouraging a link between housing providers and health care services, the most vulnerable families are able to be identified and they can then receive the help and support that they need to be able to find a home that they can afford. This work is carried out in the community so that people do not have to incur travel costs when they are looking for help. A series of questions has been introduced which can help healthcare professionals assess whether the person they are treating may be suffering because of housing instability. These questions are not intrusive but will provide all the information that is needed as long as they are asked in the right way.
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