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Housing is a Health Priority 
By: Mary Zhou, Community Organizing Fellow

The moratorium on evictions in Washington expires on December 31st, just weeks from now. Washington Physicians for Social Responsibility (WPSR) - a statewide, health professional-led advocacy organization that leverages the trusted voices of health professionals to advocate for public policies that protect health and promote peace, climate justice, and economic equity - worked with the Housing Alliance to draft a letter to Governor Inslee urging him to extend the current eviction moratorium to March 31, 2021 (full text below). We’re excited that they share the belief that stable, affordable housing is a priority. Additionally, as a young professional hoping to combine my interests in health and social change, I was especially looking forward to learning more from them. Dr. Jesse Paulsen, who serves on the Economic Inequity Task Force of WPSR and is currently a psychiatry resident, and his psychiatry mentor, Dr. Christine Curry, were gracious enough to join me for an interview. Both physicians have worked directly with clients facing housing instability and homelessness.

When asked what motivated WPSR to send the letter, and what connections they’re seeing between housing and health, Dr. Paulsen explained that “health is so much more than healthcare.” The professionals of WPSR routinely see folks struggling with issues that cannot be cured by the biomedical model of care. This motivates them to advocate for equitable social and economic policies - like access to safe and stable housing - that have the greatest long-term impacts on their patients' health. Dr. Paulsen noted that walking through Seattle and seeing the effects of homelessness, you could see how “if people don’t have a safe place to feel at home, everything else just comes second.”

Dr. Curry noted that people often don’t appreciate the effort it takes folks who are unhoused to meet daily needs, including receiving mail, securing medication, doing laundry, taking showers, and finding bathrooms. She acknowledged that COVID-19 creates anxiety for everyone, and that “when you have fewer options or fewer safety nets, that anxiety can be heightened.” On the flip side, she noticed that whenever clients were finally able to get housing, they were able to engage in recovery more deeply - “what’s powerful about models where housing comes before goals is it empowers people to decide their own course for treatment and their own course for their lives.”

In the first years of his residency, Dr. Paulsen saw patients returning from the hospital to insecure housing conditions and developing more severe symptoms because of the significant drop-off in structure, safety, and trust. “I can imagine that’s even more so with COVID, where going into a crowded shelter is so terrifying right now,” he added. One patient he worked with a year ago, a middle-aged woman who immigrated from Central Africa with 3 young children, was living in a women's shelter in a large shared room. She had developed symptoms of a psychotic disorder and a concerned friend brought her to the emergency room. Her condition improved significantly with the structure and support of inpatient treatment, but it felt futile to release her back to the crowded conditions of the shelter.  “It was really evident to me that when you talk about mental health care, if you don’t talk about having a solid, secure, reliable place for people to go when it’s time to leave the hospital, it can undo so much of the work leading up to that - it really is a vital part of an effective care system.”

A recent study from Sheen et al., which WPSR cited in their letter, notes that evictions would have a significant impact on the spread of COVID-19 in cities, and that policies like eviction moratoriums are critical for public health. With so many Washington residents behind on rent and facing potential eviction, Dr. Paulsen added that if the moratorium isn’t extended, “we’ll see not only rising COVID-19 cases, but also all physical and mental health conditions will be significantly exacerbated.” With the medical care system already overwhelmed, this would further overload providers and hospitals and could prevent many people from receiving crucial care. The connections between housing and health are clear and essential. As WPSR stated in their letter, there are “direct physical and mental health impacts of being unhoused” - for those unhoused, for providers, for the communities they are a part of - no one is left unaffected.

When asked for concluding thoughts, Dr. Paulsen explained that while medical education is starting to recognize the effects of social factors on health, more needs to be done to teach trainees how to go upstream and be effective advocates. Many medical professionals recognize systemic change as necessary, but often feel too taxed or powerless to make social change. “We’re all thinking about these things, but maybe we need to get a little more active,” he added. WPSR, as a collective of health professionals, has demonstrated through their recent letter just what taking political action can look like.

Finally, Dr. Curry closed with hopes for folks facing housing insecurity: “I hope they can find a place to be heard, whether it’s a health provider or a family member or community member, to sustain hope or give you a chance to keep going. I hope they know there is support, and despite how hard it is to keep reaching out, to find people who understand how difficult it is.”

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If you’d like to share your story and advocate for change with the Housing Alliance and Resident Action Project, you can get in touch with us here.

If you’d like to take action yourself, you can email Gov. Inslee to urge him to extend the eviction moratorium here.

You can read the letter WPSR sent to Gov. Inslee here.