By Kristine Gonnella, Senior Director of Strategic Initiatives at the National Nurse-Led Care Consortium

The World Health Organization declared 2020 as “The Year of the Nurse and Midwife” in honor of the 200th birth anniversary of Florence Nightingale, the founder of modern nursing. Nightingale’s legacy exemplifies the nursing profession’s embodiment of compassion and commitment to optimizing whole person health and diminish suffering. This commemoration encourages us to reflect on the critical role nurses play in advancing the health and well-being of our nation’s most vulnerable and underserved through engagement with housing stakeholders.

Lillian Wald, born in 1867, was a social activist, mother of community nursing, and creator of the Henry Street Settlement. Ward demonstrated the early and powerful impact nurses had on the social determinants of health through school nurses, nurse home visiting, and women’s health initiatives. Ward believed everyone was entitled to health care regardless of social and socio-economic status, race, gender, and age.

Wald paved the way for an evolving model of health care delivery in the form of Nurse Managed Health Centers. Nurse Managed Health Centers (NMHCs), are staffed by registered and advanced practice nurses and provide health and wellness through primary and behavioral health care as well as a host of other integrated services. These centers are located and integrated into the communities they serve and provide a fertile training ground for the emerging nurse workforce.

Wald saw that the health of communities is directly tied not only to the health care services available to people in need, but also to the range of economic and social conditions in which people are born, live, work and age; NMHCs evolved to address that same truth. Just as Wald created innovative partnerships with community stakeholders to address these social determinants of health, so have modern day NMHCs. In particular, relationships between public housing authorities and schools of nursing continue to be one of the most exciting and innovative models of care. After all, research consistently shows that housing is a powerful social determinant of health and that stable, affordable homes are linked with better health outcomes across the lifespan (e.g., fewer child hospitalizations, ER visits, developmental delays, asthma cases, and mental health challenges; more preventative care visits; lower Medicaid costs). One promising model arises from the Topeka Housing Authority (THA), which currently runs a Nurse Managed Health Center, Pine Ridge Family Health Center, in partnership with Washburn University School of Nursing. These services are one way in which THA operationalizes their commitment to the dignity and respect of their residents.

Across the country, more in the healthcare sector are beginning to recognize the importance of stable, affordable homes to the health of their patients. Unfortunately, the nation is in the grips of an unprecedented housing affordability crisis in which wages for the lowest income people have stagnated while rents continue to climb. A lack of stable, affordable housing is a public health concern and one that the nursing community has a longstanding commitment to address. Through nurse home visiting programs, nurses witness firsthand the vulnerability of clients facing displacement or living in unsafe, unhealthy and insecure housing. As nurses, we partner with clients to obtain the services and supports they need to thrive in their homes and communities. Through nurse home visiting services, services delivered in Nurse Managed Health Centers, or other nurse-led models that are evolving to meet the needs of our community, we continually see housing as a foundation of health.

The National Nurse-Led Care Consortium is committed to advancing our work around safe, secure, healthy and affordable housing to ensure the health and well-being of the communities we serve, and we look forward to our continued partnership with like-minded organizations from many other sectors through the Opportunity Starts at Home campaign.

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3. Krieger, J., & Higgins, D. L. (2002). Housing and health: time again for public health action. American journal of public health, 92(5), 758–768. doi:10.2105/ajph.92.5.758. Accessed February 11, 2020.