PORTLAND, Ore. – La atención de la salud no termina cuando una persona sale del consultorio médico. Varios factores externos del esquema tradicional de atención, como la vivienda, juegan un papel primordial en la salud general de una persona. Michael Mellick, administrador de casos de vivienda en CareOregon, dice que cualquier persona que experimente una falta crónica de vivienda, seguramente experimenta también otros problemas.

“Puede asumirse que caerán en problemas de dependencia de substancias, y tratamos de ayudarles con eso. Y seguido aparecen problemas de salud mental. Hay problemas de antecedentes criminales que deben ser resueltos.”

Enfrentar las determinantes sociales como una vivienda adecuada es obligatorio para las Organizaciones Coordinadas de Atención (“Coordinated Care Organizations”), que manejan el Plan de Salud de Oregon (“Oregon Health Plan”) en las comunidades locales. En Portland, seis organizaciones de salud –incluyendo “CareOregon" y “Kaiser Permanente”, lanzaron en 2016 la iniciativa La Vivienda es Salud (“Housing is Health”). Los fondos de ésta han sostenido dos desarrollos para propietarios de bajos ingresos, y otro proyecto está programado para abrir sus puertas este verano.

“Housing is Health” es parte de la respuesta de CareOregon a los problemas de vivienda. Los administradores del caso como Mellick ayudan a los clientes no residenciales a buscar soluciones para sus necesidades específicas. Describe a un cliente que había vivido en las calles durante dos años con una enfermedad pulmonar crónica. Dice que el hombre es viejo y está en una posición vulnerable, y que la vivienda le está ayudando a extender su vida.

“Sigue involucrándose en conductas que no necesariamente son las más saludables para él, pero su utilización y el costo de su atención decrecieron drásticamente por el simple hecho de que ahora duerme en un lugar cálido y seguro.”

Mellick dice que una amenaza frecuente para los clientes es el sentimiento de aislamiento. Puede venir de una variedad de fuentes, como un trauma en una edad temprana, o los efectos del racismo o la pobreza. Agrega que tratar esto podría contribuir a una sociedad mejor.

“No estás nada más acabando en el individuo – estás viendo su relación individual con la comunidad. Alivio, recuperación, renovación. Esto va hasta el concepto de las relaciones y el lugar de una persona en la comunidad.”

Half of Nevada voters feel their political leaders are ignoring the housing crisis.

Recent polling conducted by the Center for Popular Democracy and the Right to the City Alliance showed voters are growing more concerned about the housing issues plaguing Nevada.

Cinthia Moore, a Democratic candidate for Nevada Assembly from East Las Vegas who previously led the Nevada Environmental Justice Coalition, said Nevada attracts investors because the state does not have adequate protections in place for renters.

"As I am knocking on doors, a lot of people are doing month to month leases as a way to get more money out of our hardworking families," Moore observed. "That needs to stop."

Moore pointed out many longtime renters no longer have year-leases and their landlords have transitioned them to month-to-month agreements. She argued the move has allowed landlords to raise prices considerably, a practice she has vowed to put an end to if elected.

The poll found almost half of Nevada voters in the survey said they would vote for a candidate supporting government funding for affordable housing. Just over half said they would support a candidate who supports rent stabilization practices.

Sen. Edgar Flores, D-Las Vegas, said when it comes to the cost of housing, many in Nevada are making the difficult decisions to pay rent or make a mortgage payment rather than buying groceries or putting gas in their car. Nevada has made progress, including the passage of a law allocating funds for rental assistance in Clark, Reno and Sparks counties.

Flores said more needs to be done and lawmakers leading these housing-related legislative efforts should better understand the burden it places on families.

"There are people that are making laws that revolve around housing every single day that don't understand what a week means for a family, don't understand what it is to have to go and talk to somebody to just give you a little bit of an extra break," Flores emphasized. "I'm not saying that their families are wrong for that."

Flores stressed because of the lack of lived experience, lawmakers could be shortsighted or disconnected from the effects of policies on the most vulnerable. Flores added it is unfair wages and salaries have not grown in proportion to housing costs, making it a tough issue for Nevadans to grapple with on a daily basis.

Colorado remains the eighth-least affordable state in the nation for housing, according to a new report from the National Low Income Housing Coalition.

Even as state and municipal minimum wages have increased, up to $18.29 an hour in Denver, Coloradans must earn nearly $38 an hour to afford a modest apartment.

Cathy Alderman, chief communications and public policy officer at the Colorado Coalition for the Homeless, said it is clear wages will not be able to keep up with rising housing costs.

"Colorado has a very robust minimum wage compared to the federal minimum wage, and many other states, and we're still falling behind in terms of housing costs," Alderman pointed out. "We have to think about policies that can bring the cost of housing down."

A full-time worker earning the state's minimum wage can only afford to pay $750 a month in rent. A Social Security recipient can only afford to pay $294. Boulder, Eagle and Summit counties top the list of the most expensive areas in Colorado, where service and other low-wage workers have to travel for hours each day because they cannot afford to live where they work.

Thousands of new housing units have been popping up along the Front Range for years but are offered at price points better suited for hedge funds and other investors than average working families. Alderman argued the housing crisis will not be resolved by market forces alone.

"In the Denver metro area, we have more than 20,000 units of luxury and market-rate housing sitting vacant because people can't afford it," Alderman observed. "There is no incentive to lower the rent to make it accessible."

The federal government stopped investing in housing decades ago, but the "Housing Crisis Response Act" working its way through Congress aims to create nearly 1.4 million affordable homes and help nearly 300,000 households afford their rent.

Alderman believes the federal government, which can tap many more revenue sources than state and local governments, needs to play a role.

"State and local governments have been trying to invest more in housing," Alderman acknowledged. "But if they can't leverage federal dollars, they just can't get very far. And so I think it's time for the federal government to see this as a nationwide crisis, not just as a local crisis."

New Mexico advocacy groups are calling on New Mexico Gov. Michelle Lujan Grisham to cancel next week's special session where lawmakers are scheduled to debate public safety legislation. The coalition, which includes progressive-leaning groups that support the governor on many issues, wants community experts consulted before laws are passed.

Marshall Martinez, Equality New Mexico's executive director, said the proposals on next week's agenda are rushed - and would present complicated policy changes to behavioral healthcare, addiction treatment and homelessness.

"We're talking about the ability of the state to force someone into an inpatient treatment center without their consent, and we're talking about things like criminalizing panhandling," Martinez said.

In addition to Equality New Mexico, the coalition that sent a letter to the governor on Tuesday includes the ACLU of New Mexico, the Center for Civic Policy, Common Cause New Mexico and the New Mexico Conference of Churches. On Wednesday, a spokesperson for the Governor said calling off the special session is not an option.

Martinez believes advice from community experts who provide mental health and other public safety-related services should have been sought by the governor's office prior to the session being scheduled to ensure legislation provides lasting solutions.

"You have to come to the table with community-based organizations, like those of us who've been working on these issues for years, and engage us in a conversation about what will work," he continued. "Good policy isn't made in a vacuum on the 4th floor of the State Capitol building."

He also noted an obvious lack of consensus between Democratic and Republican lawmakers on the legislative proposals, and said the short session does not include opportunities for community feedback.