Dr. Laura Gultekin, Ph.D., FNP-BC, is a Clinical Assistant Professor in the Department of Health Behavior and Biological Sciences at The University of Michigan's School of Nursing. She has spent the past several years partnering with community agencies to develop and implement research aimed at improving the health and well-being of families experiencing homelessness and housing instability. Through qualitative, multidisciplinary, community-engaged research, Laura is working to develop, implement, and measure community-sustainable programs that positively impact housing stability and the life circumstances, specifically exposures to trauma and violence, that contribute to family homelessness.
Q1: Can you describe how your current research or practice intersects with housing and health?
I am working clinically in two different areas that are relevant to housing and health. As a clinician, I practice at Hope Clinic in Ypsilanti, and I am the Nurse Navigator at Marygrove Early Education Center in Detroit. Hope Clinic serves patients who have no health insurance. Every day, the patients at Hope are making decisions about how to use their precious resources. They are balancing choices such as whether to pay utility bills or put gas in the car, pay for a prescription medication or buy groceries. These choices can put them in financial peril and move them from a position of stable housing to unstable housing. Hope Clinic provides one of the few integrated health centers in the area, providing free access to behavioral health, medical care, dental care, farm stand and food pantry items, laundry services, and social work support to identify employment support and insurance/Medicaid/Medicare options.
My role as Nurse Navigator provides me access to families with a range of resources, supporting them as they navigate the intersection between educational systems and health. Supporting families in accessing Head Start and Early Head Start education programs can help identify children at risk for learning disruptions from a range of challenges, whether from a developmental delay, a chronic health condition, or a family in need of housing and food security. I’m currently working with a DNP student, Stacy Dear, to evaluate policy regarding sick dismissal policies in the aftermath of COVID. Sick dismissals not only impact a child’s engagement in school, they also impact a parent’s or guardian’s ability to maintain stable employment.
Q2: From your research and practice, what have you found are some of the best ways practitioners and policymakers can intervene to prevent family homelessness? What are essential aspects to consider when creating these interventions?
This is a great question, in part because it merges two aspects of this work that have to act in harmony: practice and policy. Interventions and policies need to involve and understand the community they are intended to impact. Engaging with service organizations, talking directly with service recipients, and completing needs assessments to ensure proposed interventions and policies are likely to produce a needed and intended outcome are essential steps in working with families experiencing homelessness or at risk for it. We need to reach families before they are in crisis and focusing on basic survival needs to impact the range of traumas and adversities that contribute to a trajectory of housing instability. Our work must have a trauma-informed, equity-focused lens in order to make a difference.
Q3: What do you see as the role of healthcare institutions and clinics in the prevention of housing instability?
All clinicians have a role in preventing trajectories into housing instability and homelessness. We need to consistently assess patients across the lifespan for adverse childhood experiences (ACEs) and access to basic essentials such as food and housing. And more importantly, we need to act on those assessments and connect families directly with available resources. Creating medical homes that offer integrated models of care can really aid in connecting patients directly with needed support services. If we can identify folks who are experiencing instability in multiple aspects of their life, such as employment, foundational relationships, and educational access, we can help with problem solving and resource acquisition that can move a life trajectory away from housing instability.
Q4: How has your research engaged community organizations and drawn on community-level expertise?
I have partnered with organizations including Community and Home Supports (CHS) and Coalition on Temporary Shelter/Creating Opportunities to Succeed (COTS) in Detroit over the past several years. My work relies on the expertise of social workers and family service workers, as well as mothers receiving services from these agencies who have been generous in sharing their time and their experience to inform my work. They help me to understand that the needs of families experiencing homelessness are difficult, if not impossible, to capture in a quantitative manner. Without their wisdom, my efforts would have focused on creating redundant, unnecessary resources that families were not seeking.
Q5: Is there anything else you would like to describe about your research on housing and health?
We need to be better at recognizing risk-patterns before they create crisis for families. Reaching children and families at risk for future housing instability means investing in childcare and education for our youngest community members, as well as securing access to basics like clean water, healthy food, housing and healthcare. When families have to focus on meeting basic survival needs, they cannot put energy into learning and thriving so we need to ensure those basic needs are met before we can make significant progress in addressing the underlying causes of family homelessness.