Nearly two million lower-income seniors live in independent, federally subsidized rental housing throughout this country. The average age for someone living in affordable senior housing subsidized by the U.S. Department of Housing and Urban Development’s Section 202 program is 79 years old – up from 74 in 2006. More than 80 percent of older adults in the U.S. have at least one chronic condition – and half have two or more. These conditions can lead to severe and immediate disabilities like hip fracture and stroke. They can also trigger progressive ailments that slowly erode the ability of older adults to care for themselves. Chronic illness, along with poor health status and functional limitations, are more prevalent among the lower-income seniors. It would follow then that a large portion of residents in affordable senior housing would suffer from chronic illnesses and disabilities.

In fact, an analysis of data from the American Community Survey found that subsidized senior renters are much more vulnerable than those who own their own homes. According to the data, they are older, twice as likely to experience conditions and limitations that threaten their ability to live independently and three times more likely to live alone. Due to their low-incomes and high levels of disability, these renters are three times more likely to be at risk of needing Medicaid(A public program that assists the poor in paying for their medical care). Independent senior housing communities were never intended to be nursing homes. That said, many of these communities – typically in collaboration with community health providers – have taken steps to address the needs of their residents and provide them with access to basic health and preventative services. Research supports this. Taking relatively simple and inexpensive steps to support residents in adopting healthier lifestyles and getting regular health screenings can dramatically reduce an older adult’s risk of chronic illness, disability and premature death. Conversely, poor management of chronic conditions often leads to frequent emergency room visits and hospital stays and may necessitate the transfer of some older adults to nursing homes prematurely.

A wide range of health and preventative services have been made available to older adults living in subsidized housing communities across the country. Their availability is influenced by several variables, including the characteristics and preferences of residents; resident eligibility  for different programs; the philosophy and commitment of housing managers; the availability and knowledge base of service coordinators; the availability of health services programs and providers in the community; the relationship between the housing property and potential community collaborators; characteristics of the physical plant (e.g., availability of common space, accessibility, etc.); and the resources available to support the work.

There is no one right way of choosing services delivery strategies – no one model that will work for all. There are, however, a number of lessons learned from the experiences of housing and services providers about the value to each of providing health and preventative services in affordable senior housing communities. Affordable senior housing communities can provide a means of delivering a broad range of services to low-income seniors. Building awareness of and disseminating information on new health program opportunities is easier when a large number of older adults live in close proximity to one another rather than being scattered across many locations. This economy of scale can also offer service providers a time and resource advantage. It is convenient for residents, especially those who are frail or have difficulty accessing public transportation, since they do not have to leave to participate in programs or access services.

Interested in learning more about affordable housing with services? Join our study tour to learn more about financing, delivery, and integration of services in the affordable housing setting.

Article by Alisha Sanders, reproduced with permission from the LeadingAge Center for Applied Research.

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