Permanent Supportive Housing


Book Description

Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.




The Affordable City


Book Description

From Los Angeles to Boston and Chicago to Miami, US cities are struggling to address the twin crises of high housing costs and household instability. Debates over the appropriate course of action have been defined by two poles: building more housing or enacting stronger tenant protections. These options are often treated as mutually exclusive, with support for one implying opposition to the other. Shane Phillips believes that effectively tackling the housing crisis requires that cities support both tenant protections and housing abundance. He offers readers more than 50 policy recommendations, beginning with a set of principles and general recommendations that should apply to all housing policy. The remaining recommendations are organized by what he calls the Three S’s of Supply, Stability, and Subsidy. Phillips makes a moral and economic case for why each is essential and recommendations for making them work together. There is no single solution to the housing crisis—it will require a comprehensive approach backed by strong, diverse coalitions. The Affordable City is an essential tool for professionals and advocates working to improve affordability and increase community resilience through local action.




Housing and Neighborhood Dynamics


Book Description

This book assesses the effects of spatially concentrated programs for housing and neighborhood improvement. These programs provide direct assistance to low-income property owners in an attempt to arrest neighborhood decline and encourage revitalization. The authors used the Harvard Urban Development Simulation Model (HUDS) in evaluating these programs. HUDS, a large-scale computer model, represents the process of housing rehabilitation, the production and consumption of housing services, household moving decisions, and other determinant of neighborhood change. The model simulates the behavior of approximately 80,000 individual households in two hundred residential neighborhoods of various quality levels. Unlike more aggregate models of urban development, HUDS has the capacity to identify how specific housing policies affect individual households as well as particular neighborhoods. Since program evaluations are no better than the models on which they are based, the authors provide sufficient detail to permit those readers primarily interested in the policy analysis to assess the methodology and to understandhow the policies are represented in the model; a more technical discussion of the model is then presented in appendixes. Although the simulations focus on policies that induce central-city property owners to upgrade their properties and thus stimulate revitalization, many of the authors' findings are relevant to larger issues of urban development. For example, the analysis of how housing rehabilitation subsidies affect the investment behavior of nonsubsidized property owners provides insights about the link between initial upgrading and sustained neighborhood improvement. The analysis also demonstrates how differences in location, household, and housing stock characteristics affect a particular neighborhood's responsiveness to a common policy initiative.




Strong Towns


Book Description

A new way forward for sustainable quality of life in cities of all sizes Strong Towns: A Bottom-Up Revolution to Build American Prosperity is a book of forward-thinking ideas that breaks with modern wisdom to present a new vision of urban development in the United States. Presenting the foundational ideas of the Strong Towns movement he co-founded, Charles Marohn explains why cities of all sizes continue to struggle to meet their basic needs, and reveals the new paradigm that can solve this longstanding problem. Inside, you’ll learn why inducing growth and development has been the conventional response to urban financial struggles—and why it just doesn’t work. New development and high-risk investing don’t generate enough wealth to support itself, and cities continue to struggle. Read this book to find out how cities large and small can focus on bottom-up investments to minimize risk and maximize their ability to strengthen the community financially and improve citizens’ quality of life. Develop in-depth knowledge of the underlying logic behind the “traditional” search for never-ending urban growth Learn practical solutions for ameliorating financial struggles through low-risk investment and a grassroots focus Gain insights and tools that can stop the vicious cycle of budget shortfalls and unexpected downturns Become a part of the Strong Towns revolution by shifting the focus away from top-down growth toward rebuilding American prosperity Strong Towns acknowledges that there is a problem with the American approach to growth and shows community leaders a new way forward. The Strong Towns response is a revolution in how we assemble the places we live.




Healthy, Resilient, and Sustainable Communities After Disasters


Book Description

In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges. Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery. Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.




Social Capital and Health


Book Description

As interest in social capital has grown over the past decade—particularly in public health —so has the lack of consensus on exactly what it is and what makes it worth studying. Ichiro Kawachi, a widely respected leader in the field, and 21 contributors (including physicians, economists, and public health experts) discuss the theoretical origins of social capital, the strengths and limitations of current methodologies of measuring it, and salient examples of social capital concepts informing public health practice. Among the highlights: Measurement methods: survey, sociometric, ethnographic, experimental The relationship between social capital and physical health and health behaviors: smoking, substance abuse, physical activity, sexual activity Social capital and mental health: early findings Social capital and the aging community Social capital and disaster preparedness Social Capital and Health is certain to inspire a new generation of research on this topic, and will be of interest to researchers and advanced students in public health, health behavior, and social epidemiology.







9 Ways to Make Housing for People


Book Description

Combining how-to with why-to, '9 Ways to Make Housing for People' lays out the core principles that David Baker Architects uses to help communities develop great urban housing. Written for architects and residents - as well as officials, developers, and planners - this book is a kit of parts: nine proven strategies for getting the best outcomes for housing in urban contexts. Detailed explorations and comprehensive case studies show how to apply and combine the principles creatively to meet the needs of sites, people, and budgets. Pragmatic and imaginative, this book is a modern manual for urban housing - getting it built and making it great.




Revitalizing Urban Neighborhoods


Book Description

Since the 1950s and the advance of urban renewal, local governments and urban policy have focused heavily on the central business district. However, such development has all but ignored the inner-city neighborhoods that continue to struggle in the shadows of high-rise America. This analysis of urban neighborhoods in the United States from 1960 to 1995 presents fifteen essays by scholars of urban planning and development. Together they show how urban neighborhoods can and must be preserved as economic, cultural, and political centers.




Investing in Interventions That Address Non-Medical, Health-Related Social Needs


Book Description

With U.S. health care costs projected to grow at an average rate of 5.5 percent per year from 2018 to 2027, or 0.8 percentage points faster than the gross domestic product, and reach nearly $6.0 trillion per year by 2027, policy makers and a wide range of stakeholders are searching for plausible actions the nation can take to slow this rise and keep health expenditures from consuming an ever greater portion of U.S. economic output. While health care services are essential to heath, there is growing recognition that social determinants of health are important influences on population health. Supporting this idea are estimates that while health care accounts for some 10 to 20 percent of the determinants of health, socioeconomic factors and factors related to the physical environment are estimated to account for up to 50 percent of the determinants of health. Challenges related to the social determinants of health at the individual level include housing insecurity and poor housing quality, food insecurity, limitations in access to transportation, and lack of social support. These social needs affect access to care and health care utilization as well as health outcomes. Health care systems have begun exploring ways to address non-medical, health-related social needs as a way to reduce health care costs. To explore the potential effect of addressing non-medical health-related social needs on improving population health and reducing health care spending in a value-driven health care delivery system, the National Academies of Science, Engineering, and Medicine held a full-day public workshop titled Investing in Interventions that Address Non-Medical, Health-Related Social Needs on April 26, 2019, in Washington, DC. The objectives of the workshop were to explore effective practices and the supporting evidence base for addressing the non-medical health-related social needs of individuals, such as housing and food insecurities; review assessments of return on investment (ROI) for payers, healthy systems, and communities; and identify gaps and opportunities for research and steps that could help to further the understanding of the ROI on addressing non-medical health-related social needs. This publication summarizes the presentations and discussions from the workshop.