Does the value of housing assistance impact health outcomes?

The Robert Wood Johnson Foundation has awarded $99,850 to two BUSSW faculty members affiliated with the Center for Innovation in Social Work and Health (CISWH) at Boston University School of Social Work (BUSSW). Thomas Byrne, assistant professor, BUSSW, and Daniel P. Miller, associate professor, BUSSW, will pursue a research project that will examine whether the monetary value of federal housing assistance has an impact on the health of those who receive assistance.

While there is broad agreement that housing is an important social determinant of health and some evidence that housing assistance has a positive impact on health, research on the impact of federal low-income housing programs on health outcomes is limited. No study to date has explored whether the monetary value of housing assistance across households translates into differences in health outcomes.

“Sometimes the best research ideas come out of informal conversations with a colleague about things that you’re both interested in,” said Byrne. “We wanted to get beyond considering housing assistance as simply a yes-no indicator to explore whether variations in the monetary value of housing assistance received translates into meaningful differences in health outcomes.”

“This project is a convergence of our shared interest in policy and the well-being of low-income Americans,” said Miller. “The availability of a new dataset provided the catalyst that crystallized these ideas and helped them come together in a more coherent way.”

The research will leverage a newly available dataset that links data from two sources: The National Health Interview Survey from 1999 to 2012 and U.S. Department of Housing and Urban Development (HUD) administrative records from 1999 to 2014. These two data sources have been linked and made available to researchers as a restricted-use dataset through the National Center for Health Statistics. The data make it possible for Byrne and Miller to use a novel approach to calculate the value of housing assistance, one that will take into account a wide range of health outcomes including mental health, chronic and acute health conditions, and health care access; both adult and child health outcomes; and variations in cost of living across communities. As opposed to self-reported data which are prone to error, the more robust HUD data will allow the researchers to draw stronger conclusions about the causal relationship between housing assistance and health. Byrne and Miller anticipate a sample size of about 59,000 households nationwide, including both households receiving federal housing assistance and those who are eligible for but not receiving assistance.

The research will also consider the effect on health outcomes of several types of housing assistance programs that HUD offers to the roughly 9.8 million individuals receiving assistance. It will compare HUD housing assistance programs offered in three categories: the housing voucher program, public housing, and multifamily programs.

The grant is one of nine awarded to research teams across the country as part of the Robert Wood Johnson Foundation’s Policies for Action (P4A) research program. P4A’s goal is to generate actionable evidence about how, and how well, laws and policies work to promote population health, well-being, and equity. Byrne’s and Miller’s focus on how public housing assistance can impact health will contribute to the RWJF’s vision of building a culture of health that enables everyone in America to live longer, healthier lives.

“We are excited to be a part of an initiative that supports applied research that has a bearing on the health of people in the country,” said Miller. “The projects funded by the P4A program have immediate, actionable evidence attached to them.”

“It aligns closely with our goal to conduct research that has immediate relevance for policy conversations that can make people’s lives better,” added Byrne. “In the short term, this study will have a direct bearing on housing policy proposals under consideration. For example, findings from this study would speak directly to the potential health impacts of an increase in rent contribution from 30% to 35% of household income for those who receive housing assistance. Longer term, it might bolster the case for improving health outcomes by expanding housing assistance beyond the one-in-four eligible households who currently receive this scarce benefit.”

“This project contributes toward improving health equity, which is at the heart of our Center’s vision,” said Sara S. Bachman, Paul Farmer professor at the BUSSW, research professor of Health Law Policy and Management at the Boston University School of Public Health, and director of the CISWH. “That requires that we look beyond the health care system and use an upstream approach to improving population health by advocating for policy change more broadly. This research will provide advocates with a powerful tool to demonstrate to policy makers how improvements in housing policy can achieve a healthier population.”

“We pride ourselves at the BUSSW on our innovative research that informs social work practice and advocacy to advance a more just and compassionate society,” said Judith G. Gonyea, professor and dean ad interim, BUSSW. “By developing a deeper understanding of the interaction of health and housing, a key social determinant of health, this research has the potential to drive change that can promote the health and well-being of those affected by racial, social, and economic inequities.”

Learn more about the project Does the Value of Housing Assistance Impact Health Outcomes?

This work was funded by the Robert Wood Johnson Foundation’s Policies for Action program.

HRSA awards one-year grant to support leadership in the field of public health social work

 
The Center for Innovation in Social Work and Health (CISWH) at Boston University School of Social Work (BUSSW) has received a grant of $300,000 from the U.S. Health Resources & Services Administration to strengthen public health social work (PHSW) education at Boston University and nationally. PHSW is a sub-discipline within social work that draws on both social work and public health theories, frameworks, research and practice to promote health equity and mitigate human health problems, with a strong focus on health impact and population health. The grant aims to strengthen public health social work’s central role in efforts to address the unmet needs of racially diverse, economically disadvantaged and medically underserved communities. Betty J. Ruth, clinical professor at the BU SSW and director of the dual degree program in social work and public health (Master of Social Work and Master of Public Health or MSW/MPH) will serve as principal investigator on the project. The project leadership team will include Madi Wachman and Alexis Marbach from the CISWH.

For Ruth, the grant is the culmination of decades of work to advance the field of PHSW. In addition to shepherding the MSW/MPH program to its current status as a vibrant trainer of leaders in PHSW widely recognized for its excellence, Ruth has regularly promoted PHSW at national conferences and co-founded the national Group of Public Health Social Work Initiatives. In 2013, she was named Insely/Evans Public Health Social Worker of the Year by the Public Health Social Work section of the American Public Health Association (APHA).

The project, named Boston University Advancing Leadership in Public Health Social Work (BU-ALPS), will strengthen the public health social work field at Boston University, at other higher education institutions in the U.S., and beyond through four goals:

1. 1. Strengthen the public health social work leaders of the future. The project will provide the opportunity to 6 current MSW/MPH students to attend the APHA annual conference in 2017. It will allow the program to provide stipends to 6 students currently enrolled in the MSW/MPH program, support them in attending and submitting proposals for presentations to the APHA 2018 conference, and provide additional mentoring opportunities to enhance their skills and experience. Working with the CISWH, the project will expand on a Social Work and Health Equity Speaker Series launched in 2016 to develop an enrichment series of webinars. Open to all social work students, faculty, alumni, and practitioners, this series will focus on key areas of PHSW practice such as community engagement, cross-sector partnerships, policy brief writing, and culturally responsive trauma-informed approaches to working with communities.

1. 1. Promote PHSW faculty development. The project will convene a nationwide learning community to create a PHSW toolkit that can be used by educators not only in MSW/MPH programs but in all academic programs interested in enhancing the skillset of social work students to encompass a public health approach to address social determinants of health. The toolkit will include model syllabi, exercises, case studies with explications, and other teaching materials to enable educators to convey a public health social work perspective to their students.

1. 1. Share promising practices to enhance MSW/MPH programs. Project staff will draw on the experience and insights of thought leaders and faculty with an interest in PHSW to create a best practices guide that institutions of higher learning can use to enhance a MSW/MPH or related program. Staff will also develop a listserv to enable communication between MSW/MPH program directors and those seeking technical assistance to enhance new or existing programs.

1. Create a strategic vision for the future of PHSW. Through an action plan working group comprised of leaders in the field of PHSW, project staff will guide a strategic thinking process about ways for the social work workforce to integrate and promote a PHSW approach in social work practice. The group will produce a PHSW action plan with recommendations and concrete suggestions for next steps for all members of the field.

“There is no question that the almost 400 people who have graduated from BU SSW’s MSW/MPH dual degree program are working in leadership capacities, pushing the public health social work model forward,” said Ruth. “But we’re one of only forty or so programs in the country. There are many more people who need access to public health social work education and who can’t either afford or access MSW/MPH programs.”

“Social work has always had within its values and goals the desire to be a high-impact profession at the level of structural change to society. And it is one of the only professions that’s everywhere—in schools, police stations, the military, prisons, health centers, social welfare institutions… we are well placed to reach people across broad systems to address the structural inequalities in our society. But we do not always work as effectively as we could, because we’re not using public health approaches. This project will help to share this knowledge more broadly. We will have a place where people can draw on PHSW experts’ collective knowledge, experience, and resources to make a commitment to using public health social work approaches. Educators will have a starting point if they want to start a MSW/MPH program or integrate public health social work into their programs. And most importantly, we will have a plan for moving the field of PHSW forward.”

“The vision of our Center is to elevate social work leadership and cross-sector collaboration to promote health, health equity, and social justice, said Sara S. Bachman, Paul Farmer professor at the BUSSW, research professor of Health Law Policy and Management at the Boston University School of Public Health, and director of the CISWH. “This project provides an opportunity to bring that vision closer to reality by making the tools and knowledge of public health social work more accessible to the next generation of social work leadership.”

“The recent BUSSW additions of the Center for Innovation in Social Work in Health and a new specialization within the MSW program on Health/Behavioral Health Practice reflect Boston University’s commitment to advance a public health approach to address social determinants of health,” said Judith G. Gonyea, professor and dean ad interim, BUSSW. “This year-long initiative will build upon three decades of experience to enhance the training of public health social workers within our MSW/MPH program and to advance the field of public health social work nationally.”

Learn more about the BU-ALPS Project.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number G05HP31425, Leadership in Public Health Social Work Education Grant Program, in the amount of $300,000 awarded to Trustees of Boston University. No percentage of this project was financed with nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.