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Physician letter can help resolve housing problems

January 2, 2022

Most families’ housing conditions improved after they gave their landlords a letter from a physician outlining how the problems could harm health and urging them to make repairs, a recent study showed.

Exposure to roaches, rodents, lead, mold and other poor housing conditions can have a negative impact on child health. However, remedies such as relocating families or seeking legal assistance are costly and resource intensive.

Sending letters from physicians to landlords is a low-cost strategy used by medical-legal partnerships to address indoor environmental concerns. The authors of this study sought to determine whether such letters are effective.

They used a social determinants of health tool to screen patients seen at three pediatric primary care clinics in Brooklyn, N.Y., from April through December 2019. Those who answered yes to the following question were considered to have poor housing conditions: “Are you currently having any housing problems (overcrowding, roaches, rodents, utilities, mold, lead) that your landlord is not helping you with?”

Those with poor housing conditions were offered a letter from a physician urging the landlord to fix the problems. The letter, which was available through the electronic health record, also explained the health problems the housing conditions could cause.

Of the 2,480 families who were screened, 233 (9%) had poor housing conditions, and 127 of them asked for a letter.

A follow-up phone survey was completed by 96 families two to six months later. Thirty-five had given the landlord the letter, 31 said the landlord addressed the issue and 26 said the problem was resolved.

“Integrating the letter template into the electronic health record allows for a quick intervention, providing families with a simple way to attempt to remediate their housing conditions before resorting to more time-intensive solutions, such as moving or legal action,” the authors concluded. “Furthermore, most families who gave letters to their landlords reported that the process led to landlord action and improved housing conditions.”

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