In 2015, the American Hospital Association and others joined to emphasize to the Internal Revenue Service that support for housing might constitute “community benefit” — both in plain language and in the language of the tax code — and that its Schedule H form and instructions on hospital facilities’ community benefit needed to be clarified.

“Since [2007], numerous studies and research in the public health area have clearly established that ‘housing is health care,’ ” the AHA, the Catholic Health Association and the Association of American Medical Colleges said in a letter.

A few months later, the IRS nodded in agreement. In December 2015, it announced that investments in clean and safe housing will be viewed as community benefit expenditures.

Priya Bathija, the AHA’s senior associate director of policy, said housing instability is one of the challenges identified by the association’s Task Force on Ensuring Access in Vulnerable Communities. The task force’s 29 members are examining integrated, comprehensive strategies to reform health care delivery in vulnerable communities. One strategy being considered would specifically address how the social determinants of health, including housing instability, utilities, food insecurity, interpersonal violence, lack of transportation and other factors, limit access to health care services in the community.

The task force's report recommends several different paths for addressing these challenges through enhanced clinical-community linkages. One path focuses on screening patients to identify housing instability or other barriers and to inform them of resources that might help. Another path allows hospitals to provide navigation services that connect their patients with the services they need — and also ways to partner with other organizations to address specific problems, such as lack of affordable housing, that affect residents’ health status.

In the area of housing, the task force discussed both housing instability and poor-quality housing, such as homes in which mold exacerbates asthma or causes allergic reactions.

“Hospitals are working to take whatever steps they need to take to improve the health of the population,” Bathija said.