Economics Students Research Efficiency of Social Services Programs at Camden Housing Complex

By Tom McLaughlin

In socioeconomically underprivileged cities, research shows that residents commonly face barriers to receiving proper medical care, including a lack of health insurance and health literacy.

In cities such as Camden, social services programs have been adopted to help residents overcome these obstacles. But just how do we know which programs represent the most efficient use of the costs incurred?

That’s the critical question currently being asked by a team of Rutgers University–Camden economics students.

Under the direction of Tetsuji Yamada, a professor of health economics and chair of the Department of Economics at Rutgers–Camden, students John Lancaster, Christopher Krol, and Ling-Cai Yuan are studying the impacts of implemented social services programs upon residents at the Northgate II housing complex in North Camden.

Developed by the nonprofit Fair Share Housing Development (FSHD) to revitalize the neighborhood, Northgate II consists of 402 affordable rental units, divided into a 23-story high rise with 308 apartments for elderly and disabled residents on one block, and 94 family units in 14 garden apartment buildings covering two blocks.

According to the Rutgers–Camden students’ review, a past report had shown that, between 2002 and 2008, 615 Northgate II residents visited emergency rooms and hospitals 3,901 times at a total cost of $83 million to taxpayers.

“It was such a hotspot for emergency room usage compared to other parts of Camden, so that became one of the biggest motivators for Fair Share Housing Development to provide these health interventions,” explains Lancaster.

As the students explain, FSHD would go on to partner with the Camden Coalition of Healthcare Providers to conduct focus groups with residents, in which the community’s key characteristics, values, needs, attitudes, social norms, health behaviors, and priorities were identified.

Yamada notes that, with more than 200 variables, the researchers need to find out influential factors before drawing conclusions

Based on these discussions, in 2012, the organizations adopted a population health management approach that encouraged social services staff to bring multiple interventions, such as service coordination/care management, wellness programming, nutrition, and mental health programming, directly to where the residents live.

However, the program facilitators initially found that their health interventions weren’t reaching the highest-cost patients, prompting further inquiry, explains Krol.

“They wanted to determine the extent of the impact that these programs were having,” he says. “They were asking questions like, ‘How sick does a patient have to be before they are beyond the helpful reach of these programs?’”

To that end, explains Yuan, he and his fellow Rutgers–Camden students set out to design an evaluation program that will assess the efficiency and effectiveness of these programs which influence the residents’ health outcomes and expenditures.

With the assistance of Chia-Ching Chen, a professor of epidemiology and community health at New York Medical College and an expert on program planning and evaluation, they are currently translating some qualitative data gleaned from the ongoing, day-to-day social workers’ interactions with the residents into workable, consistent, quantitative data.

“For example, social characteristics and behavioral risk factors, such as smoking, all need to translate into data so that they can be used in our statistical analysis,” explains Lancaster.

Yamada echoed the sentiment, adding, “With more than 200 variables, we also need to find out influential factors before drawing conclusions.”

According to the Rutgers–Camden students, their preliminary results show that the health interventions from August 2013 to February 2017 are having a negative effect on emergency room and hospital utilization; they view two or more emergency room utilizations as a proxy for the risk to “aging in place” – the ability to live safely and independently in one’s home.

Furthermore, Yuan notes, they are gathering as much information as possible on the residents’ behaviors and the programs’ effects on these behaviors, as well as any changes in the residents’ health literacy before and after these health interventions.

The students add that the research project affords many opportunities for further inquiry.

“Some correlations may be stronger for certain segments of the population,” says Krol, “so those are further hypotheses that can be tested.”

The research team says that it will continue to monitor and work to improve the health and quality of life of Northgate II residents.

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