Addressing rising rates of homelessness and housing instability
By Marcia D. Gailes, MPH22, Epidemiology-Biostatistics
I was already familiar with my field organization prior to my Applied Learning Experience (ALE). I had previously helped organize an event, where the proceeds benefited several local non-profit organizations, including Mama’s Helping Hands, Inc (MHH). The organization’s mission, “to be the catalyst of change for women and children in need of a new beginning,” caught my interest, and after reaching out and obtaining further information, I knew I wanted to complete my ALE with MHH. I have always been passionate about projects and research addressing disparities amongst women, infants, and youth, with a particular emphasis on maternal and child health. To me, this ALE project was an opportunity to utilize my knowledge of women and youth health combined with the public health issues of homelessness and housing insecurity and apply it in a practicum setting.
Rising rates of homelessness and housing instability are significant public health crises, which cause and exacerbates health problems, decimates communities, and drives health inequities. Studies show that individuals who experience homelessness have a risk of mortality that is 1.5-11.5 times greater than the risk of the general population, with 171,575 people in families with children experiencing homelessness on a single night. Families and youths faced with housing insecurity have many physical and mental health challenges, and have been linked to higher rates of stress, depression, anxiety, and suicide. People of color are significantly over-represented among those experiencing homelessness and housing insecurity. Housing instability and the threat of homelessness via eviction affects Black and Hispanic women renters disproportionately at the national level. Additionally, youth transitioning from foster care are at greater risk of experiencing homelessness, with an estimated 20% of young adults not having housing upon emancipation and increasing to 40-50% within eighteen months of emancipation.
For my ALE, I conducted a formative program evaluation of Mama’s Helping Hands, Inc. (MHH), a start-up 501(c)3 non-profit organization, based in Bergen County, NJ. The target population of MHH are a diverse array of displaced women, families, and youth, including those who aged out of the foster care system. The organization assists by providing counseling and financial assistance on a short-term basis, offering resources to/establishing connections with participants, assisting with their long-term transition processes. MHH serves as a bridge for homeless and housing insecure women and youth to receive support from other organizations and agencies that cater to their specific needs. The overarching goal of the program is to reduce the rates of housing insecurity and homelessness in the target population, across MHH’s area of service.
The organization is in program planning phase of development, seeking to implement the best interventions to serve their clients. The objective of my ALE project was to formatively evaluate MHH programs using a mixed-method approach to identify the strengths and areas for improvement in organization planning and implementation, in order to recommend improvements in program organization and design.
I began my implementation semester with a review of Mama’s Helping Hands’ program outlines, current and potential resources, and purposed services. I then conducted a comprehensive literature review to assess the existing knowledge base around housing insecurity/homelessness and inequities amongst the target population. The information gained from the literature review and the review of Mama’s Helping Hands program planning informed the design, development, and content of a survey instrument and formative interview/focus group guide. Several interviews were conducted with members of the Mama’s Helping Hand’s team and key stakeholders via Zoom video conference. The interviews also guided the development the intake survey instrument that will be distributed to program participants upon program implementation.
The findings of both reviews and interviews unearthed several key areas of interest to be explored. The intake survey was developed to assesses several categories, namely demographics, current living arrangements, and the health and wellbeing of program participants—resulting in a database. The questionnaire serves multiple purposes: collecting quantitative and qualitative data for subsequent analysis and providing pertinent information that MHH case managers will use to accurately assist their clients. The focus groups, which have not yet been conducted due to timing and coordination setbacks, centers around participants’ experiences, assessing themes of defining homelessness/housing Insecurity, housing challenges, services, safety, and health. Approximately 15-30 participants across three cohorts (including homeless women, women facing housing insecurity, and homeless/housing insecure transitioned foster care youth), will be interviewed to gather evidence and gain multiple perspectives, contributing to recommendations for program development and design improvement.
A supplementary project responsibility I conducted throughout my ALE included making community-based connections with various Community–Based Organizations, county and state level agencies, local legislators, community advocates, and potential board members. This process fostered improved connections between the organization and much needed resources; as well as contributed to the needs assessment. Additionally, I assisted with the creation of an appointment interface that will be utilized upon implementation to better serve the clients of MHH.
The framework and program model purposed by Mama’s Helping Hands aligns well with the findings of the literature review, which indicates that the complex and multi-faceted issues of homelessness and housing insecurity require a multi-pronged approach, addressing the overall target population and subgroups within the target population. To improve programs offered by MHH, it would be beneficial to incorporate considerations for clients’ risk and factors in all aspects of program planning prior to implementation, continue the program evaluation upon implementation, and continue making community-based connections in order to expand awareness of the organization and services offered throughout the community.
Throughout the spring and summer semesters, I planned and implemented an evaluation project for a non-profit community-based program at such an integral stage of their development, with the assistance of my preceptor and ALE advisor. We certainly encountered various obstacles throughout the process but were able to overcome and rectify any issues we faced. This opportunity has taught me a great deal about patience, amenability, and persistence. I have always been a planner, especially in regard to work or school projects—maintaining a schedule and plan is crucial in achieving success. Realistically, plans don’t always pan out as expected. Things can be delayed; life goes on. It’s not about the setback, it’s about the response. Through this project, I found that with quick thinking, a little flexibility, and valuable input from my both preceptor and advisor, it was possible to meet the objectives of my ALE. The impact of my Applied Learning Experience has left an indelible mark; I have no doubt that these lessons will stay with me through my career. I am appreciative for the support and tutelage from my ALE advisor, Dr. Silas N. Pearman, and my preceptor Ms. Jonnine Deloatch, director of program planning and development at Mama’s Helping Hands, Inc.
- American Public Health Association. (2017, November 7). Housing and Homelessness as a Public Health Issue. Retrieved from APHA.
- David A. Sleet, e. (2021). Homelessness and Public Health: A Focus on Strategies and Solutions. The International Journal of Environmental Research and Public Health, 18-21.
- The Network of Public Health Law. (2021, April 21). The Public Health Implications of Housing Instability, Eviction, and Homelessness. Retrieved from The Network of Public Health Law.
- Yung Chun, e. (2020, December 3). Racial and Ethnic Disparities in Housing Instability during the COVID-19 Pandemic: The Role of Assets and Income Shocks. Retrieved from SSRN.
- National Foster Youth Institute. (2022). Housing & Homelessness. Retrieved from National Foster Youth Institute.