BACKGROUND AND OBJECTIVE: There is a documented connection between the home environment and health. Medical-legal partnerships (MLPs) can address social and environmental determinants of health. Our objective was to describe a cluster of substandard housing identified and treated by an MLP based in a pediatric primary care setting. METHODS: Potential cases of poor-quality housing were identified during outpatient primary care. A case was defined as any rented housing unit with a reported unaddressed housing risk within a defined building portfolio (owned by a single developer) in which ≥ 1 child lived. An on-site MLP offered affected families legal services including ordinance enforcement and connection to resources. They also initiated portfolio-wide advocacy. Legal advocates reported case outcomes. Medical history and household demographics were collected from the medical record and compared with clinic-wide data by using Fisher's exact test or χ(2) statistics. RESULTS: After identification of a single case, an additional 15 cases were identified. Pest infestation was the most common initial risk identified. Of 14 units with outcome data, repairs were completed in 10 (71%). Of the 19 building complexes with the same owner, 11 received significant systemic repairs. Of the 45 children living within the 16 identified case units, 36% had asthma, 33% had developmental delay or behavioral disorder, and 9% had an elevated lead level. Affected children were more likely to have one of these diagnoses than the general clinic population (all P < .01). CONCLUSIONS: An MLP identified and improved home environmental conditions for children living in a cluster of substandard housing.
BACKGROUND AND OBJECTIVE: There is a documented connection between the home environment and health. Medical-legal partnerships (MLPs) can address social and environmental determinants of health. Our objective was to describe a cluster of substandard housing identified and treated by an MLP based in a pediatric primary care setting. METHODS: Potential cases of poor-quality housing were identified during outpatient primary care. A case was defined as any rented housing unit with a reported unaddressed housing risk within a defined building portfolio (owned by a single developer) in which ≥ 1 child lived. An on-site MLP offered affected families legal services including ordinance enforcement and connection to resources. They also initiated portfolio-wide advocacy. Legal advocates reported case outcomes. Medical history and household demographics were collected from the medical record and compared with clinic-wide data by using Fisher's exact test or χ(2) statistics. RESULTS: After identification of a single case, an additional 15 cases were identified. Pest infestation was the most common initial risk identified. Of 14 units with outcome data, repairs were completed in 10 (71%). Of the 19 building complexes with the same owner, 11 received significant systemic repairs. Of the 45 children living within the 16 identified case units, 36% had asthma, 33% had developmental delay or behavioral disorder, and 9% had an elevated lead level. Affected children were more likely to have one of these diagnoses than the general clinic population (all P < .01). CONCLUSIONS: An MLP identified and improved home environmental conditions for children living in a cluster of substandard housing.
Authors: Andrew F Beck; Alicia J Cohen; Jeffrey D Colvin; Caroline M Fichtenberg; Eric W Fleegler; Arvin Garg; Laura M Gottlieb; Matthew S Pantell; Megan T Sandel; Adam Schickedanz; Robert S Kahn Journal: Pediatr Res Date: 2018-05-23 Impact factor: 3.756
Authors: Katherine A Auger; Robert S Kahn; Jeffrey M Simmons; Bin Huang; Anita N Shah; Kristen Timmons; Andrew F Beck Journal: Acad Pediatr Date: 2016-07-09 Impact factor: 3.107
Authors: Andrew F Beck; Bin Huang; Kathryn Wheeler; Nikki R Lawson; Robert S Kahn; Carley L Riley Journal: J Pediatr Date: 2017-11 Impact factor: 4.406
Authors: Andrew F Beck; Bin Huang; Jeffrey M Simmons; Terri Moncrief; Hadley S Sauers; Chen Chen; Patrick H Ryan; Nicholas C Newman; Robert S Kahn Journal: Pediatrics Date: 2014-02-02 Impact factor: 7.124