Engaging Citizens in Health and Housing Interventions
by Ruth Gourevitch
Community collaboration results in better health outcomes, but engaging citizens is challenging for both health- and housing-sector stakeholders. It doesn’t have to be that way. At “Addressing Housing and Health: How Cities are Making a Difference,” the Urban Institute and National League of Cities elevated some best practices for community engagement around health and housing initiatives and shared promising examples and tools for engagement.
Health and housing partnerships are educating participants about how to mitigate the potentially harmful effects of poor housing quality on health. Resident education can help ensure an intervention’s sustainability, empowering participants to continue practicing good habits beyond the intervention. In addition, when informed residents share information within their spheres of influence, more people gain access to the initiative’s framework and information than if only the programmatic team was disseminating information.
Motivated by a theory of change that emphasizes community education, IMPACT DC meets families and children at schools and day care centers, in their homes, and at community events to educate people about how to prevent and combat asthma. According to George Washington University pediatrician and IMPACT team leader Ankoor Shah, “family-based education has the highest form of turnaround change [in asthma prevention]. Especially when you’re [educating] in the home and getting to where families are.”
The Vita Health and Wellness District in Stamford, Connecticut, takes a similar approach to using resident education as a tool. This partnership between the local housing authority and hospital has created a “health-themed neighborhood” that includes mixed-income housing, health care services, and supportive services. Partners in this initiative educate immigrant parents to help them navigate their child’s educational path and increase the access to quality services for youth.
Meanwhile, the City of Omaha is training 22,000 key professionals and residents on how to be a trauma-informed community. It’s striving to help trauma victims, including those struggling with health- and housing-related issues. Mayor Jean Stothert highlighted, “it’s really important to me that the neighbors feel engaged with the whole city.” The diverse initiative aims to promote a culture of health by educating residents on managing health, overcoming trauma, and improving opportunities for people and communities.
Giving residents a role in designing and implementing health and housing interventions is another key to creating successful engagement. Gail Livingston, deputy administrator for housing programs at the Boston Housing Authority, said it’s important to involve residents from the beginning to help identify needs, put them onto the agenda, and develop solutions. In Boston, she said, the “impetus came from residents” to go smoke-free because of their desire for a cleaner living environment eliminating harmful health effects, including from secondhand smoke. Community organizations and tenant associations became loud proponents and active partners to advance the residents’ agenda. Today, the Boston Public Health Commission and Boston Housing Authority’s asthma intervention includes “parent asthma leaders” who sit on advisory boards to help ensure asthma is given the attention it deserves.
In addition to direct resident participation, it’s essential to have an organization “function as the community integrator” that “listen[s] to the community and champion[s] those issues,” said Reverend Edgar, executive director of Community Development for All People. The Columbus, Ohio-based organization works with Nationwide Children’s Hospital on homeownership and rental housing projects through its Healthy Neighborhoods Healthy Families initiative. Edgar warned against engaging with organizations that are not “deeply rooted” in the community. Organizations may find it difficult to gain residents’ trust, which could lead to health and housing initiatives where residents do not feel engaged and empowered.
Transparent data practices
Though it’s more nascent, making program-related outcome data readily available can allow residents to engage more directly with an intervention’s progress. In Omaha, Mayor Stothert said city government is tracking the progress of the trauma-informed city initiative on its website “so all citizens can see what is going on.” Although these types of practices can be difficult with limited resources and data security protocols, it is an innovative way to promote transparency and empower residents to participate more fully in the health and housing intervention.
Whether through resident education, community participation, or transparent data practices, community members play an essential role in health and housing initiatives and need to be at the table and involved along the way. Collaboration with citizens allows health and housing professionals to deliver services effectively. Although tactics for community engagement are still developing, meaningful citizen engagement can strengthen the results of interventions and break down hierarchical silos that too often jeopardize the effectiveness of health and housing work.