The Overhead Wire Daily | May 22nd, 2024 | The Biopsychosocial Model

May 22, 2024

The philanthropic wing of America’s largest Medicaid insurer has pledged $1B towards affordable housing by offering below market loans to a development partner. As noted in the Forbes article, 80% of health outcomes are driven by what happens outside the doctors office and are often referred to as the social determinants of health.

Dr. Mindy Fullilove has described this further as looking at place through the lens of the biopsychosocial model or the sociology of illness.  In this framework, we can see all of the social impacts on a persons life that lead up to an illness or medical emergency. Often this can be a fluctuating social network, unstable housing situation, or even a setback such as a loss of income or a loved one.

Yet governments don’t look deeper into the biopsychosocial model to determine whether they should increase housing production using housing money or give people more transportation options in order to reduce downstream medical impacts. So states are treating the illness by looking to use precious Medicaid monies on housing and transportation instead of sussing out root causes.

There’s definitely a direct benefit to the health care system in getting people housed who would otherwise spend too much time in an emergency room or getting people to appointments instead of missing them, but there are also bigger downstream impacts of improving housing and transportation that reduce health expenditures by reducing stress and improving quality of life.

Today, an article we linked in the LA Times discusses restaurants struggling to stay open amidst rising costs and inflation. Cost of living increases driven by housing seems to be a major culprit even if it’s not explicitly mentioned in the article. There’s also a discussion in Minneapolis of figuring out a way to lower child care costs that are stressing family budgets and creating disincentives to having a a bigger family or even just going out and doing fun things on the weekend.

This all can probably be filed into the housing theory of everything, but I want to give a plug for beginning to actually map it out in the biopsychosocial model Dr. Fullilove puts forward as a way of thinking about place. What are the problems we are seeing and how much are we focusing on them?  And how many resources would we have collectively for a lot of other important upstream things if we found that we weren’t focusing enough initially on key root issues. I suspect we’d improve our quality of life and our health exponentially.


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