City and university using Invest Health program to determine relationship between housing and health
Wednesday, September 13, 2017

The University of Iowa is working with the city of Iowa City to promote better health among residents in three neighborhoods and recently conducted a survey to determine what challenges residents face in improving their health.

The UI College of Public Health is working with the city to develop a strategic plan through a program called Invest Health, which examines how neighborhoods and housing affect the health of the people who live in them.

Vickie Miene, interim director of the Iowa Institute of Public Health Research and Policy in the College of Public Health and Invest Health team member, says past studies have shown that the physical environment where we live can make us sick. It could be old carpet in an aging apartment building contributing to asthma symptoms, for instance, or high poverty rates contributing to feelings of depression.

“We know that even the ZIP code where you live influences your health and your life expectancy, so we’re trying to get a sense of how to improve health in specific neighborhoods,” she says.

The team is focused on three Iowa City neighborhoods—Hilltop, Town and Country, and Broadway/Davis/Taylor—and is developing a plan to address the incidence of asthma and mental health issues there. Residents were surveyed and focus groups were conducted last winter to find out what challenges they face.

Miene says the neighborhoods were selected based on information gathered through a needs assessment and on the high number of residents visiting the UI Hospitals and Clinics with an asthma diagnosis.

“Part of the process is understanding from the neighborhoods what the challenges are and engaging residents to participate in developing solutions,” she says. “We want to better understand the environmental conditions and social barriers that could be contributing to those chronic health conditions.”

Miene says common issues that have come up in conversations and survey responses include limited access to health care and mental health care, affordable child care, transportation, affordable housing, and safe places for kids to play.

She says one significant survey finding, completed by 171 households in the neighborhoods, is that only 12 percent indicated they know their neighbors.

“Knowing your neighbors is important,” Miene says. “Neighbors can serve as support systems for each other, providing materials, such as hand-me-downs, as well as emotional assistance in times of need. They can also buffer against feelings of isolation and provide each other with links to information about the community they live in. Neighbors can provide emergency help too, such as providing short-term childcare or keeping watch over your home while you are away.”

Other survey findings include:

  • 60 percent of respondents indicated their neighborhood makes them feel happy.
  • 45 percent report they “always” or “usually” feel safe in their neighborhood.
  • 56 percent report lack of health insurance was their biggest barrier to health care, 33 percent said lack of transportation, and 27 percent a language barrier.
  • 20 percent reported they were diagnosed with asthma, and 51 percent report feelings of mental stress. Of those with mental health symptoms, 45 percent say they seek help from a church.

The team is providing the survey results through several venues and is compiling a list of ideas to increase healthier living in the neighborhoods. Over the summer, residents helped prioritize the biggest needs while generating additional ideas. The Invest Health team will prepare a report by December that lists the residents’ ideas and priorities, as well as projects designed to improve health.

The Invest Health team also hopes to establish a new network of local health and housing officials who can sustain the program in the future. Historically across the nation, housing and health sectors have not worked closely together, but Miene says this project forces the collaboration.

“I am learning a lot about the housing sector, and the housing folks are learning a lot about health,” says Miene. “We educate each other at every meeting about some aspect of our programming and delivery systems.”

With state and federal resources shrinking, collaborations with new partners are becoming more important, says Tracy Hightshoe, neighborhood services coordinator for the city of Iowa City.

“Since this initiative began, we have been working on how to find and build partnerships we had never even considered before and building relationships with those in a position to help a number of residents through our combined resources,” she says. For instance, she says the city is partnering with the UI College of Nursing to provide in-home asthma education and rehabilitation to improve indoor air quality in the homes of children who have asthma.

“The collaborations that Invest Health fosters between health and community development sectors will be vital to improving the health and lives of our residents,” she says. “We need to find better, smarter ways to help people live healthy and enjoy the neighborhoods where they choose to live.”

Invest Health is funded by a $60,000 planning grant from the Robert Wood Johnson Foundation and the Reinvestment Fund, and one of its mandates is to find the optimal collection of people who can most effectively address health issues related to housing. Miene says programs designed to address these issues often have limited success because they didn’t include the right stakeholders in the network, including the residents who live, play, and work in the neighborhoods.

Looking to build the right network, the Invest Health program includes neighborhood advocates and representatives from numerous community and university entities, including the Housing Fellowship, Iowa City Compassion, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Abbe Mental Health Center, UI Department of Psychiatry, Johnson County Department of Public Health, Iowa City Community School District, Mercy Hospital, United Way of Johnson and Washington Counties, and other community service agencies, faith-based entities, and businesses.