- The SW Washington Community Connections Initiative is an innovative research project exploring the relationships between outcomes across the education, housing, legal, and healthcare sectors.
- Providence CORE linked data across these sectors to study how people interact with multiple domains and inform more effective cross-sector interventions.
- Findings in a new CORE report show links between student mobility, health, and attendance; the impact of mental health and substance use in the legal system; and patterns of acute care use among individuals who experienced incarceration or housing instability.
Community health is shaped by the conditions in which community members live, learn, work, and play. These deeply interrelated factors, known as the Social Determinants of Health, are considered the major drivers of health and health inequities. However, studying the links between outcomes across the education, housing, legal, and healthcare sectors poses challenges, as each sector operates independently, collects different data, and uses different systems.
To bridge this gap, a group of organizations in Clark County, Washington, partnered with the Providence Center for Research Outcomes and Education (CORE) for the Community Connections Initiative. This innovative research project aimed to analyze the interconnectedness of outcomes across sectors and inform more effective interventions to meet the needs of the populations they serve. The partners included the Clark County Sheriff’s Office, Evergreen Public School District (EPS), Vancouver Public School District (VPS), Vancouver Housing Authority (VHA), and Southwest Accountable Community of Health (SWACH).
A new report from CORE describes numerous findings from the three-year study, showing links between student mobility, health, and attendance; impacts of mental healthcare and substance use treatment on interactions with the legal system; and patterns of acute care use among individuals experiencing incarceration or housing instability.
Read on for highlights from the report, or download the full report here.
Connecting the dots with fuzzy matching
To make this research possible, CORE utilized an innovative approach called fuzzy matching. Fuzzy matching allowed our team to link data across sectors, offering valuable insights into individuals’ interactions with multiple domains; for example, identifying a student enrolled in Evergreen Public School District (EPS) who also received housing support through Vancouver Housing Authority (VHA) and healthcare services under Medicaid.
Learn more about Fuzzy Matching in CORE’s 2022 white paper: Getting Clear About Fuzzy Matching.
Key findings
Links between student mobility, health, and attendance
Our team examined the characteristics and experiences of students to understand the relationships between student mobility, health, and chronic absenteeism. Key findings include:
- Students shared between the two school districts were three times more likely to seek housing assistance than students remaining in a single district.
- Students experiencing chronic absenteeism were two-thirds more likely to seek housing assistance than students present 90% of the time or more.
- Elementary school students who received housing through VHA saw a significant increase in their attendance rates.
- Students experiencing chronic absenteeism were more likely to have complex and non-complex chronic conditions than those present 90% of the time; most of the top chronic health conditions were behavioral health diagnoses.
Impact of mental health and substance use in the legal system
The study highlighted the strong connection between mental health, substance use, and interactions with the legal system. Key findings include:
- Adults who had been incarcerated were 70% more likely to have been diagnosed with a mental health condition and, even after accounting for age, gender, race/ethnicity, and language, were five times more likely to have a diagnosed substance use disorder compared to individuals who had not been incarcerated.
- Receiving outpatient mental health services within three months of leaving jail resulted in a decreased likelihood of recidivism.
- In addition to impacting the proportion of individuals who experienced recidivism, receiving outpatient mental health care increased the average time to rearrest.
Patterns of acute care use
Understanding acute care utilization – i.e., emergency department visits and inpatient stays – among individuals who experienced incarceration or housing instability offers valuable lessons for how cross-sector interventions can impact health outcomes. CORE’s findings in this area include the following:
- Adults who had been incarcerated were more likely to have chronic substance use and mental health conditions, while adults experiencing housing instability were more likely to have chronic physical and mental health conditions.
- Adults experiencing housing instability were over 50% more likely to have an emergency department visit and 30% more likely to have an inpatient stay than individuals not seeking housing support through VHA.
- Adults who had been incarcerated averaged nearly one more emergency department visit in the year following their involvement with the legal system than the general Medicaid population.
In conclusion, the Community Connections Initiative offers valuable insights into the interconnectedness of various sectors influencing community health. Moving forward, this initiative will continue to drive cross-sector collaboration, promote evidence-based interventions, and foster healthier communities in Southwest Washington.
To read the full report, click here.
