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A practical proposal for addressing health and housing gaps

How might the health sector help to reduce the toll of poor housing and homelessness?

Some clues are emerging from an innovative collaboration in Victoria that aims to establish a health and social housing hub, so that disadvantaged people with high health needs can live close to services.

The report below is by Lanie Harris from cohealth, a community health service provider involved in the collaboration.


Lanie Harris writes:

Community health services have long cared for people facing disadvantage, but a groundbreaking proposal in Victoria could see them also tackling one of the most significant “upstream” drivers of poor health – poor housing.

In a joint proposal, two of Victoria’s leading not-for-profits are lobbying the Victorian Government for funding to bring community health and social housing together under one roof.

Community health service, cohealth, and social housing provider, Unison Housing, have outlined a vision for a “health and housing hub” based in Collingwood in Melbourne’s inner north.

cohealth’s Interim Chief Executive Nicole Bartholomeusz says:

We know that people in insecure housing or experiencing homelessness are more likely to suffer from poor health.

And the perverse cycle continues because people with high health needs are more likely to be living in substandard accommodation, or at risk of homelessness.

Our idea is to create a supercharged health centre complete with health and social services on the ground floor and build social and affordable housing above.

We have a unique opportunity to partner with a community housing organisation to tackle two significant social problems.”

Nicole Bartholomeusz

Joining the dots

As the housing affordability crisis in Australia grows, and the gap between rich and poor widens, community health services such as cohealth are seeing the impacts of poor housing on vulnerable clients.

Bartholomeusz says:

People living in substandard rooming houses, families in severely overcrowded homes, young people sleeping in their car – these are all conditions which directly impact on people’s health.

We must join the dots between poverty, housing and poor health. We can prevent many illnesses by addressing the social conditions that cause them, rather than paying for expensive hospital care.

With more than 190,000 Australians waiting for social housing, we must grasp every opportunity to boost housing stock. Using the airspace above a new health centre makes a lot of sense.”

cohealth says the proposed health and housing hub would allow the elderly and other disadvantaged people with high health needs to live close to the health services they need.

Despite their higher health needs, many people facing disadvantage are not able to afford the health care they need, and may struggle to follow treatment plans, which means their health problems snowball.

Integrated approach

cohealth and Unison’s proposed hub would include a range of services including GPs, community nurses, chronic disease specialists, physios, pharmacy, dieticians, family violence support, alcohol and drug services and housing support – all working in an integrated way.

“By co-locating housing and primary health care we have the opportunity to establish a ground-breaking community hub centred on the whole person,” said Bartholomeusz.

“Imagine health practitioners being able to catch a lift up to a patient’s home to do a home visit, or to check on a client who hasn’t attended an appointment?”

With isolation and loneliness emerging as serious health problems, health and housing hubs could also be part of the solution, particularly for older people who are living longer and living alone in their later years.

“The beauty of co-locating housing and healthcare is that people can live independently for longer with health practitioners nearby,” Bartholomeusz said.

Australia is increasingly moving toward ‘hub’ models of care. Already there are examples of co-location of low-cost housing for families alongside services that they will need, such as childcare, but we have yet to see housing and community health under one roof.

United States experience

In 2010, the US Department of Housing and Urban Development released a report that strongly recommended the co-location of housing and health services.

It found that when housing was combined with appropriate services, practitioners reported residents experiencing better outcomes across health and quality of life, education, and self-sufficiency.

The report also found that the benefits can translate directly into public cost savings due to reduced reliance on emergency services

The 1700sqm site of the proposed development, in a prime location at 365 Hoddle Street Collingwood, is currently home to cohealth’s ageing community health centre (affectionately called ‘365’).

Nearly 12,000 people per year use the 365 centre, a number which is expected to rise by 30 percent by 2031.

After 50 years of operation, cohealth says the ageing 365 clinic is in urgent need of overhaul. Rising population and growing demand from increasingly complex clients means 365 is struggling to support the local community.

Seeking support across portfolios

cohealth and Unison are seeking funding from the Victorian Government across portfolios including Housing, Health, Ageing, Mental Health and Women.

The proposal has yet to secure funding, but the community is currently rallying to build political will, with an online campaign and digital petition.

The project partners say that the State Government should realise the opportunity to utilise the prime inner-city location to create a community asset that will improve the health of people experiencing disadvantage and deliver much-needed social and affordable housing.

Social policy experts have long called for governments to address the social determinants of health – to improve the conditions in which people are born, work, live, grow and age.

Although the 365 project is only in the preliminary stages, it represents an important step towards joining the dots between secure housing and good health.

• Lanie Harris is an advocacy and communications professional who has worked across housing, homelessness, health and Indigenous issues. She is currently employed at cohealth in the advocacy space.

• See the Croakey archive on housing and health.

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Australian Palliative Care Conference
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