The conditions, in which people are live when they are born, brought up, work and age, are referred to as social determinants of health. It also encompasses a wider set of systems and forces that shape the setting of our daily life. These include improvement agendas, social policies, economic policies and systems, and political systems. Resource availability to cater for our everyday needs such as local food markets and housing, access to educational, job opportunities and economic, access to medical services and the quality of vocational training and education are all examples of the social determinants of health. People often conceptualize socioeconomic status as the class of an individual or a group of persons. This course is measured as a combination of income, occupation, and education ( Alperstein, Rappaport and Flanigan, 1988).
Social determinants of health have weight when it comes to the cause and course of illness such as diabetes, cancer, and heart diseases. The same goes for HIV/ AIDS. These determinants of health may be a starker to HIVAIDS due to its communicable nature. Community’s access to crucial resources such as education, healthcare and housing are influenced by residential segregation. It also plays a part in determining which frequency and on what conditions people interrelate with one another. In the case of the exposure to HIV/ AIDS, severe and persistent stress that comes from racism, sexism, poverty, resource and power disparities have profound health effects. Therefore, trying to fight aids through attitude and behavior change alone is ineffective and incomplete ( Culhane, Metraux and Hadley, 2002). This may be misleading and increase chances of isolation as it suggests that a person’s poor decisions are reliable for their poor health.
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Government officials have focused on enhancing daily living conditions of HIV patients by providing proper housing among other activities such as equal distribution of resources and power as well as measuring and understanding the consequence of these interventions to improve health as asserted by Metraux, Marcus and Culhane (2003).
NYS program, the HIV/ AIDS Services Administration (HASA), was created in the 1957 in the realization of the fact that persons living with AIDS and the symptomatic HIV illness have unique requirements in assessing and retaining their government payback. Previously, this organization has had several names such as the Division of AIDS service and income support. This division offers benefits that are always available year in year out. These advantages include enhanced rent allowance while the full package of profits under HASA is only eligible to the New York beneficiaries. This whole package includes increased rent reduction, transportation, nutrition and intensive case management as well as housing assistance.
The Human Resources Administration (HRA) of the New York City is accountable for the administration of the HASA program. Recipients of HASA are eligible for a full display of beneficial programs. Some of these benefits are also obtainable to qualified individuals that are not members of HASA. Non- HASA members include SNAP, Medicaid, and Assistance rent arrear grants among others. Support for non- members is the similar as for any other HASA member.
Additional benefits under HASA
Scatter site and congregation housing
Benefactors of the HIV/ AIDS Services Administration may not qualify for congregate housing and scatter site which offers social services to qualified benefactors. However, they will still be entitled to these services.
Housing opportunities for people with AIDS (HOPWA)
This section provides supportive services and accommodation aid for low-income HIV-individuals infected and their families that are HIV/ AIDS Services Administration beneficiaries who are eligible for HOPWA.
Housing in NYC as the concerns and HRA
New policies are keeping people with AIDS from finding homes Survey shows that housing stability of the population living with AIDS is undermined by the new policies adopted by the NYS. Unstably poor New York aids patients, as a result of two policies that were approved by the HRA, significantly have harder time finding houses. This survey was carried out by case managers, and the above results were concluded ( Scally, 2013) . This study was released by analysis and advocacy group, the Shubert Botein Policy Associates in the New York.
Two long-standing policies that regard payment of fees on behalf of low-income earners that have been receiving rental help through HRA was changed in March by the HRA. First, the amount to be paid to a broker who usually works for the HRA on behalf of the client was halved. Second, the landlords who work with clients no longer receive cash receipts deposits from the HRA. Instead, owners are required to use vouchers given to them in place of the cash receipts to claim fund for the damages caused by the client.
Shubert Botein Policy Associates was commissioned to carry out a survey about the effects of HRA rules, to measure the impact of this regulation. 238 case managers were interviewed by Shurbet Boteinin may, who work with clients that receive housing subsidies through the HRAs HIV/ AIDS service administration. 95% of HASA clients according to the report admitted that these changes in policy pose as barriers.
Other findings showed that the brokers pay change is an obstacle to finding suitable housing. This is according to 94% of the respondents. This policy change as reported by 50% of the interviewees prevented housing for some clients. It takes longer to secure a house using HASA rental help program as compared to before the new policies were passed. This is according to case managers who account for 61% of the interviewees.
Many landlords and brokers have stopped working with have stopped working with HASA clients as per the survey, lengthening their dwell in bad, expensive housing. Some agents are asking customers of the on fixed incomes to settle part of the brokers pay, while landlords ask for security deposits from clients. To secure an apartment, consumers are risking finding quick money as reported by case managers these clients, therefore, have no other option other than to engage in risky and illegal act. They have retorted to sex work as reported by the program supervisor at village care for case management, Howard Haughton.
The lowest income new Yorkers living with HIV/ AIDS are HASA clients. 26,000 of these customers in approximation are subject to these policy changes as they receive cash assistance. Stable housing is important for these clients’ health and saves the city money as it gives them a chance to be productive in the society by removing them from emergency housing.
To reverse these HRA damaging policies, Housing Works are looking forward to working with the members of the city council and a coalition of accommodation providers. With HASA’s dream that aspires to get people to move closer to more independent existence, they find these policies are at odds ( Thompson, 1999).
A wide range of health conditions is associated with inadequate housing. These conditions include poor mental health, asthma, respiratory infections among others. Homelessness is attributed to some physical and psychological problems. This is evidenced from social and demographic research institute. This explains increased mental illness among HIV patients due to inadequate housing.
The government should work towards revising the new policies by the NYS that deprive the HIV patients from accessing adequate housing. This will reduce if not completely eradicate the problems that they experience due to this situation. As a result, their health is likely to improve greatly.
References
Alperstein, G., Rappaport, C., & Flanigan, J. M. (1988). Health problems of homeless children in New York City. American Journal of Public Health , 78 (9), 1232-1233.
Culhane, D. P., Metraux, S., & Hadley, T. (2002). Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing. Housing policy debate , 13 (1), 107-163.
Culhane, D. P., Metraux, S., & Hadley, T. R. (2002). The impact of supportive housing for homeless people with severe mental illness on the utilization of the public health, corrections, and emergency shelter systems: The New York-New York Initiative. Housing Policy Debate , 13 (1).
Metraux, S., Marcus, S. C., & Culhane, D. P. (2003). The New York-New York housing initiative and use of public shelters by persons with severe mental illness. Psychiatric services , 54 (1), 67-71.
Scally, C. P. (2013). The Nuances of NIMBY Context and Perceptions of Affordable Rental Housing Development. Urban Affairs Review , 49 (5), 718-747.
Thompson, P. (1999). Public housing in New York City. Housing and community development in New York City: Facing the future , 119-142.
