Health Starts at Home

Mom and baby photo

Health Starts at Home is an initiative hosted by the Boston Foundation that brings together housing and health-care organizations to support work that focuses on the positive benefits of stable, affordable housing on children’s health outcomes.

Over the last 10 years, researchers have found that instability in housing, driven in large part by unaffordable rents, profoundly negatively impacts a child’s mental, behavioral, and physical health, resulting in higher health-care costs and increasing the burdens on homeless systems and providers. This four-year initiative supports partnerships among housing and health care organizations with the goal of:

  • highlighting the importance of affordable housing in children’s health outcomes;
  • identifying promising new and existing models for partnership that can be brought to scale to improve children’s health outcomes;
  • decreasing health care costs; and
  • decreasing costs related to homelessness.

Health Starts at Home logoPHASE I: Planning Grant Competition

In the winter of 2014, the Boston Foundation received 12 applications representing collaborations among over 50 organizations. Following rigorous review by a 10-person panel of both internal and external reviewers, four 9-month planning grants were awarded. During this planning period, in addition to refining their interventions, each partnership will work with the competition’s evaluation consultants, Health Resources in Action and the Urban Institute, to ensure that the systems are in place to collect data on savings to the housing and health-care systems as a result of the grants, and on improved housing and health outcomes. The partnerships supported in Phase I with $40,000 planning grants are highlighted below.


Building Bridges to Better Health

Partners: Metropolitan Boston Housing Partnership, Boston Health Care for the Homeless Program, Urban Edge

Model: Close to 2,000 families are currently sheltered in motels across Massachusetts. In addition to the stress of homelessness, these families are isolated from their home communities, endure cramped and unhealthy conditions, and lack amenities such as access to cooking facilities and healthy food. This pilot will focus on homeless children and their families currently living in one such motel where health and housing providers will coordinate on-site service delivery to improve access to health care, employment support, decent affordable homes and stabilization services. The partners will focus on integrating existing services, connecting families to routine health care, finding appropriate, stable housing and screening families for benefits eligibility. 


Chelsea Homes for Health

Partners: The Neighborhood Developers, MGH Chelsea HealthCare Center, CONNECT, Metropolitan Boston Housing Partnership, Roca

Model: This partnership includes major institutions in Chelsea, a mid-size city just north of Boston with a largely immigrant population. MGH Chelsea, which serves the majority of households in the community, will be the entry point for clients into the Chelsea Homes for Health program. In addition to routine screening for medical conditions, families receiving care in both the Pediatric and Obstetrical departments at MGH Chelsea will be screened for housing instability. The screening will provide MGH Chelsea with the knowledge and capacity to refer families to existing, robust services including benefits screening, financial counseling, workforce development, peer support for young mothers and housing assistance provided by Chelsea Homes for Health partner organizations.


Designing and Stocking the Housing Pharmacy: Pairing Health Care and Housing Dollars to Improve Stability and Health

Partners: Children’s HealthWatch, BMC HealthNet Plan, Boston Public Health Commission, Madison Park Development Corporation, Nuestra Comunidad Development Corporation, Boston Housing Authority, Tohn Environmental Strategies, Medical-Legal Partnership Boston, Vital Village Network, Project Hope and social service and community engagement advocates

Model: Based at Boston Medical Center, this partnership includes organizations that represent a wide range of players in the housing and health care sectors in Boston. Together they will create a seamless system of services for children under the age of four who receive medical services at Boston Medical Center.  Medical staff often do not ask about a family’s housing situation because they can offer no “treatment.”  This model will build on the existing Children’s HealthWatch interview protocol, enabling trained interviewers to ask the right questions and link families to the broad array of services that already exist in their community to help them find, retain, and improve their housing. 


Mortar Between the Bricks: Building a Foundation for Child Health Through an Integrated Network of Support, Prevention & Intervention

Partners: Massachusetts Law Reform Institute, Boston Children’s Hospital, Horizons for Homeless Children, LIFT-Boston

Model: This partnership includes a nationally-recognized medical provider, poverty law experts focused on policy reform and high-capacity direct service providers. Together they will identify at-risk, housing insecure and homeless Boston Children’s Hospital patients. They will provide interventions and services to stabilize families through an integrated cross-referral system and access to peer support. This model intentionally focuses both on services to the adults, as well as to the children based on a two-generation framework.


PHASE II: Implementation

At the completion of the nine-month planning phase, grantee partnerships will submit a proposal for implementation funding that includes details about their refined model, outcomes and partnership roles. This phase of the competition may also be open to partnerships that were not awarded a planning grant by invitation only. Following a second panel review, successful partnerships will receive three years of support totaling up to $200,000/year to implement their program models and evaluation plans.

SUPPORT: Join the Boston Foundation in supporting the implementation of promising projects developed through Health Starts at Home. Learn more about Health Starts at Home by contacting Lucy Ellis, Program Assistant, at 617.338.1608 or To explore making a gift or grant to this initiative, please contact Laura McConaghy, Philanthropic Partnerships Officer, at 617.338.1612 or