Summary:
Many advocates hope that addressing the quality of housing, or similar social needs, can help us escape from the quagmire of ever-increasing US health care costs combined with stagnating health outcomes. Their logic is simple: low-income populations often live in dismal conditions that are associated with disease, and treating those diseases drives up health system costs. Improving housing quality might both prevent disease and reduce spending. The premise is attractive to cost-conscious health payers, who hope to achieve the Triple Aim of better care, better health, and lower costs as well as to budget-strapped housing authorities, who hope to recoup the costs of renovations with health care financing. Yet addressing housing quality is fundamentally different from prescribing medicine. By the standards used to evaluate medical interventions, housing improvements will rarely appear successful. That’s because the standards are misapplied in this context: better housing confers many benefits, and health outcomes are only a small piece of the very real value of improved housing to residents. As we move toward health in all policies, we need to make sure we don’t assume that health is all.
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