Nav: Home

Housing for health

August 03, 2018

COLUMBUS, Ohio - In a recent publication in the journal Pediatrics, researchers from Nationwide Children's Hospital present a case study for treating a neighborhood as a patient.

Neighborhood effect syndrome, characterized by symptoms of extreme poverty including blight, housing insecurity, racial segregation, trauma, violence, poorly performing schools, low social cohesion and support and environmental toxins, has debilitating consequences on child health. Health care providers frequently encounter challenges to caring for children from affected neighborhoods, and these children often experience poorer outcomes compared to peers in unaffected neighborhoods. Historically, institutions have been largely ineffective in changing these outcomes with one-child-at-a-time tactics.

In a novel approach to improving outcomes for these children, Nationwide Children's leaders with community partners decided to address neighborhood effect syndrome as a target for pediatric health care - treating the neighborhood as a patient. In 2008, Nationwide Children's began collaborating with residents, government entities and social services agencies to develop the Healthy Neighborhoods Healthy Families (HNHF) initiative.

The hospital's first patient neighborhood was the Southern Orchards neighborhood of Columbus, Ohio, located adjacent to the Nationwide Children's main campus. Before the intervention, the neighborhood experienced high rates of poverty and violent crime.

"The Southern Orchards neighborhood, right by the hospital, was one with gun violence, high infant mortality rates and high asthma rates in children," says Kelly J. Kelleher, MD, director of the Center for Innovation in Pediatric Practice at Nationwide Children's and lead author of the publication. "Houses were boarded up and vacant. You didn't see kids playing outside much."

The target area includes all of Census Tract 56.10 and Census Tract 56.20. In 2009, the neighborhood was characterized by the following:
  • Home to 4,300 persons, 23 percent of whom were children
  • 50 percent of children in the neighborhood were living in poverty
  • 50 percent of the children in the neighborhood were African American
  • 25 percent of children in Livingston Elementary School and 33 percent in South High School were regularly changing schools
  • 1 in 3 residents over the age of 16 were employed full time
The chief concern uncovered through multiple sources of data and information was neighborhood safety associated with population loss and surge in vacant and abandoned property.

"Residents were deeply concerned about blight and gang/drug activity, including on vacant properties in proximity to the school," says Dr. Kelleher. "Our primary target for intervention became housing. Our collaboration committed to renovating, building and developing mixed income housing to reduce crime, improve the vacancy rate and better family outcomes."

According to Dr. Kelleher, the publication describes $23 million invested in upgrading more than 300 homes through the HNHF Realty Collaborative, which was formed with not-for-profit development corporation, Community Development For All People. The entity is owned by Community Development For All People with a board of directors selected by the two groups. To date, the investment has grown to more than $40 million.

The partnership, with collaboration from the Columbus Mayor's Office, accessed Neighborhood Stabilization Program funds from the city, acquired properties from the city's Land Bank program and gathered support from contractors and realty agents.

The multifaceted intervention launched by the collaborative included a home repair program, rehabilitation and home ownership program, home construction program, workforce development program and rental housing development.

The community development efforts by the HNHF Realty Collaborative are still in early phases, considering Southern Orchards has experienced neighborhood effects syndrome for 80 years. Still, some measurable outcomes are observed:
  • Investments have transformed housing stock in the area and reduced blight.
  • The vacancy rate declined from more than 25 percent to 6 percent.
  • Youth who have participated in area development programs have shown progress in emotional health and academic performance.
  • The high school graduation rate has risen from 64 percent in 2013 to 79 percent in 2017.
  • For owner-occupied homes, the market has seen a 50 percent increase in sales volumes and a 22 percent increase in sales prices.
  • Homicides have declined, and while homicide rates in Columbus overall have risen, none were reported in the immediate Southern Orchards neighborhood in the last year.
"By taking both short- and long-term views of community development, Nationwide Children's and our partners have ambitious goals across many domains," says Dr. Kelleher. "The community-level approach allows the integration of epidemiology approaches, business resources and neighborhood development to support a mixed income community. Our next challenges will be to continue growth with new partners and to measure outcomes on children's health in the neighborhood."
-end-
HNHF community partners include Community Development for All People, United Way of Central Ohio and the City of Columbus.

Nationwide Children's Hospital

Related Health Articles:

Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
Generous health insurance plans encourage overtreatment, but may not improve health
Offering comprehensive health insurance plans with low deductibles and co-pay in exchange for higher annual premiums seems like a good value for the risk averse, and a profitable product for insurance companies.
The Lancet Planetary Health: Food, climate, greenhouse gas emissions and health
Increasing temperatures, water scarcity, availability of agricultural land, biodiversity loss and climate change threaten to reverse health gains seen over the last century.
With health insurance at risk, community health centers face cut-backs
Repeal of key provisions of the Affordable Care Act, combined with a failure to renew critical funding streams, would result in catastrophic funding losses for community health centers-forcing these safety net providers to cut back on services, lay off staff or shut down clinical sites, according to a report published today.
Study clusters health behavior groups to broaden public health interventions
A new study led by a University of Kansas researcher has used national health statistics and identified how to cluster seven health behavior groups based on smoking status, alcohol use, physical activity, physician visits and flu vaccination are associated with mortality.
Tailored preventive oral health intervention improves dental health among elderly
A tailored preventive oral health intervention significantly improved the cleanliness of teeth and dentures among elderly home care clients.
Study finds that people are attracted to outward signs of health, not actual health
Findings published in the journal Behavioral Ecology reveal that skin with yellow and red pigments is perceived as more attractive in Caucasian males, but this skin coloring does not necessarily signal actual good health.
In the January Health Affairs: Brazil's primary health care expansion
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
University of Rochester and West Health Collaborate on d.health Summit 2017
In collaboration with West Health, the University of Rochester is hosting the third annual d.health Summit, a forum for health care and technology leaders, entrepreneurs, senior care advocates and policymakers to exchange ideas, create new partnerships, and foster disruptive technological and process innovations to improve the lives of the nation's aging population.
Study links health literacy to higher levels of health insurance coverage
The federal Affordable Care Act is intended to make it easier for individuals to buy health insurance, but are the uninsured equipped to navigate the choices faced in the insurance marketplace?

Related Health Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Changing The World
What does it take to change the world for the better? This hour, TED speakers explore ideas on activism—what motivates it, why it matters, and how each of us can make a difference. Guests include civil rights activist Ruby Sales, labor leader and civil rights activist Dolores Huerta, author Jeremy Heimans, "craftivist" Sarah Corbett, and designer and futurist Angela Oguntala.
Now Playing: Science for the People

#521 The Curious Life of Krill
Krill may be one of the most abundant forms of life on our planet... but it turns out we don't know that much about them. For a create that underpins a massive ocean ecosystem and lives in our oceans in massive numbers, they're surprisingly difficult to study. We sit down and shine some light on these underappreciated crustaceans with Stephen Nicol, Adjunct Professor at the University of Tasmania, Scientific Advisor to the Association of Responsible Krill Harvesting Companies, and author of the book "The Curious Life of Krill: A Conservation Story from the Bottom of the World".