Engaging Health Equity

For relevant background for this blog post – check out previous posts.

Health Literacy is Health Equity: in Blog 4, I wrote about the importance of considering health literacy as crucial to health equity processes and outcomes. Now, I want to drill down a bit. Let’s take housing and health. Housing is central to health. As such, rental assistance, particularly federal and local housing vouchers, is critical to helping everyone access safe and affordable housing. However, the process of getting and using housing assistance is rife with problems. Among them, a mismatch between adult literacy skills and system demands (i.e. what the process requires users to do and know). Navigating assistance processes are complicated. Recognizing this, many organizations offer help in figuring out the process and filling out related forms, whether for housing, food (WIC/SNAP) or health insurance.

Let’s consider the multi-step activities involved in a housing search. Each involves a unique set of literacy, numeracy and mobility skills. This is not an exhaustive inquiry; nevertheless, I hope that considering the literacy skills required for a Section 8 housing search reveals some of the facilitators and barriers – and therefore actions we can take to improve services and programs linked to optimal health.

Examples of Literacy & Mobility Skills Involved in the Section 8 Housing Search

This list is by no means exhaustive and doesn’t focus on all nuances of literacy. For example, graphic literacy is emerging as a literacy skill in its own right, and each of these listed skills have component parts as well.

• Aural Literacy Skills: Listening to, understanding, and implementing relevant information from a landlord or Public Housing Authority regarding terms of a lease or the application process or apartment availability.
• Oral Literacy Skills: Communicating housing needs, desired move-in date, or price range to real estate agent or potential landlord. Asking relevant questions related to Section 8 or family requirements. Communicating with potential landlords by phone.
• Reading Comprehension Skills: Searching on the internet or in newspapers for available units. Reading a map of housing locations. Reading public transportation schedules or maps to arrive at unit of interest, or Public Housing Authority, or related organization.
• Writing Skills: Filling out housing voucher and related forms. Writing down addresses and directions to potential housing units, taking notes on the housing units, and filling out rental applications. Communicating with potential landlords via email or text.
• Numeracy Skills: Calculating whether a monthly rent payment is within budget. Calculating total income. Determining how many days still available to submit the application and needed parts. Reading a bus or train schedule and calculating timing for visits to rental properties or Public Housing Authority.
• Mobility: Getting to apartments to view them, including the ability to travel with little advance notice when apartments are made available.

The table below identifies major stages and tasks required to use a Section 8 Housing Choice voucher, along with the literacy or mobility skills associated with each task. After exploring the following, an organizational health literacy assessment like The Health Literacy Environment Packet and the HLE2 and an information assessment focused on readability, usability, and actionability of documents, websites, videos, forms, etc. can all be useful next steps. From a health equity and organizational health literacy perspective, systems and organizations must use the following considerations about literacy to increase facilitators and reduce barriers to access and use of health and related systems.

All highlighted links in the chart below can be found in a list posted after the chart. Scroll down.