Time to reshape our delivery of primary care to vulnerable older adults in social housing?

HOUSING IS A SOCIAL DETERMINANT OF HEALTH

Housing is a social determinant of health that fundamentally affects health and wellbeing.¹ A UK study found housing to be a unique predictor of health outcomes, after accounting for income.¹ Although social housing can improve health through the financial benefit of lower rent,² it also has negative impacts due to building disrepair,² and policies resulting in clusters of residents with poor mental health and substance issues.³ Social housing exists in many formats across the globe: council estates in the UK; projects or public housing in the US; social housing in Canada; social or public housing in Australia; and state housing in New Zealand.

MANY OLDER ADULTS LIVE IN SOCIAL HOUSING AND ARE VULNERABLE

In the US, it is predicted that, by 2035, one in three public housing units will be occupied by an individual aged ≥65 years,⁴ while in the UK that is already the situation.⁵ In Ontario, Canada alone, approximately 75 000 older adults live in social housing.⁶

Older adults on low incomes are a vulnerable population with increased risk of chronic disease, falls, social isolation,⁷ and poor outcomes from COVID-19. In-person restrictions have heightened the importance of internet-based solutions for access to health care, information, basic …