Resident-led research in public housing to determine health needs and implement health improvements

Public housing resident leaders worked with staff from the DC Housing Authority to host a forum to examine the social determinants of health inequities and begin to educate, empower, and activate public housing residents. The forum was followed by focus groups that made it clear residents wanted to be included in decision-making for designing and implementing health interventions. Resident leaders and representatives from the DC Housing Authority staff, community health and public health organizations, began meeting monthly as the Citywide Advisory Board Health Planning Committee, including representatives from every public housing development in DC. With assistance from academics and health professionals, resident leaders designed a questionnaire to assess health status, health needs, and preferences for health interventions, and distributed it to all public housing households. Personal contacts, assured anonymity, and multiple opportunities for submission led to the collection of more than 1000 completed questionnaires. Analysis of the responses was supplemented by additional qualitative research. Top concerns expressed by residents included violence, environmental problems including roaches and polluted air inside and around public housing units, and limited access to good health care, especially for elderly and disabled residents. Asthma and mental health also ranked high among resident concerns. Throughout the process, membership on the Health Planning Committee expanded under the clear agreement that public housing residents would maintain the lead on research, advocacy, and program implementation. The project empowered residents and served as the foundation for continued collaboration with health and public health professionals to reduce health disparities in Washington, DC.