The Biden Administration has announced its U.S. Playbook to Address Social Determinants of Health, a comprehensive set of actions to better social determinants of health (SDOH), which affect the health and well-being of all Americans.
The Playbook highlights the importance of housing as a key driver of health outcomes, and lifts up examples of how U.S. Department of Housing and Urban Development (HUD) programs like Choice Neighborhoods are supporting collaborative efforts to address social determinants of health.
“All manifestations of inadequate housing can negatively impact health, and a variety of health conditions can negatively impact housing status. Housing insecurity is associated with increased rates of mental health challenges, adverse birth outcomes for pregnant mothers, and death from any cause,” reported the U.S. Playbook to Address Social Determinants of Health. “Homelessness is correlated with high rates of injurious health conditions such as HIV infection, alcohol and other substance use disorders, untreated mental illness, and tuberculosis. In a population-based study in San Francisco, people experiencing homelessness at the time of HIV diagnosis had 27 times higher odds of death compared to those who were housed. These conditions can shorten the lifespan and lead to a decreased quality of life. Studies show evidence that interventions providing supportive housing to individuals experiencing homelessness with substance use disorder are associated with decreased emergency room visits and hospitalizations. Similarly, a randomized trial in Chicago found that providing stable housing and case management to chronically ill, homeless adults reduced hospitalizations by 29%. Ensuring people have adequate housing can reduce their risk of these negative health outcomes.”
In addition, the U.S. Department of Health and Human Services (HHS) has also announced a new Medicaid and Children’s Health Insurance Program (CHIP) Health-Related Social Needs (HRSN) Framework. The Framework will help states support clinically appropriate and evidence-based interventions to support housing and nutrition needs for certain Medicaid enrollees, such as by providing medically tailored meals to pregnant and postpartum women, or helping individuals with chronic health conditions who are experiencing homelessness to find and obtain housing. Medicaid services provided under this Framework will complement existing HUD programs, including Housing Choice Vouchers and homelessness assistance grants.
Additionally, through the HHS and HUD Housing and Services Resource Center, HUD will continue to provide information to states and communities on how to better leverage Medicaid to cover housing-related HRSNs and coordinate these services with HUD’s programs.
As announced in early November, HUD and HHS are also selecting up to four states to receive federal technical assistance through the Housing and Services Partnerships Accelerator to help implement Medicaid housing-related HRSNs in coordination with HUD and state and local housing programs.
“Housing is foundational to health and lifelong success. Today’s Playbook and suite of actions are important steps forward in our efforts to advance health equity,” said HUD Secretary Marcia L. Fudge. “HUD continues to work with our partners across the Administration and the country to coordinate the housing, health care, and supportive services that enable Americans to thrive. I encourage HUD grantees and partners to utilize the Playbook to inform their work and engagement.”
The release of the U.S. Playbook and the HRSN Framework demonstrates the Biden Administration's commitment to advancing health equity by addressing social determinants and creating a more integrated approach to healthcare and social services.