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Joshua Bamberger – We All Deserve to Have a Decent, Safe Place to Live

Family physician explains why he wants the health care sector to embrace the issue of housing

Joshua Bamberger in the Meierhof courtyard during Building Healthy Communities: The Role of Hospitals

Joshua Bamberger in the Meierhof courtyard during Building Healthy Communities: The Role of Hospitals

Mirva Villa | 15.12.2017

Joshua Bamberger has worked as a family physician for almost 30 years. While working in San Francisco, he has seen patients entering hospitals living in extreme levels of poverty. These patients are able to benefit from the hospital’s resources in the short term, but the difficult circumstances in which they live have often been far too powerful for his work to have a long-term impact.

“[It’s] as if I was treating people, and it was almost irrelevant to their wellbeing,” Bamberger says, speaking at the Salzburg Global Seminar session, Building Healthy Communities: The Role of Hospitals. “One thing that seems to help the people who I serve to feel better, live longer and have the quality of life that we all deserve is to have a decent, safe place to live.”

Bamberger has become a strong advocate of providing housing as the primary and most important aspect of improving people’s health. It has been his passion for the past 10 years.

“For people who don’t have a home it is the most important thing. Why? On the one hand, you can’t take your medications regularly unless you feel valuable. I can prescribe them to you, but if you don’t eat them, they don’t work. For many people who live on the streets, their sense of wellbeing, their sense of value is so low that the motivation to take the medication regularly is diminished.”

Having a place where you are safe and cared for helps increase a person’s sense of dignity and their willingness to take care of themselves, Bamberger argues. But it’s not just that: living on the streets is very disruptive to health.

Bamberger says, “Stress hormones that are constantly flowing through your body, they erode your ability to heal, to have a robust immune system, to battle cancer, to be able to function with a cardio-vascular disease. All the things that cause harm medically just don’t get better in an environment where your life is uncomfortable and stressful.”

Homelessness is a big issue in San Francisco area. According to the 2017 census provided by the Department of Homelessness and Supportive Housing in San Francisco, there were 7,499 individuals without homes, and little over half of them were living unsheltered, sleeping outdoors.

“It’s bad,” Bamberger says. “I’ve been doing this for 30 years and I’ve never seen it worse, it’s really disheartening.” He thinks the main driver for it is the ever-expanding U.S economy, which he suggests has created a lot of wealth but also pushed up the prices of commodities.

“If your finances are static at an incredibly low level and everything else is becoming more expensive, your buying power becomes less and less, particularly around housing. When I moved to San Francisco in 1989, the apartment I got was something like $400 a month on rent, and it was a nice apartment: one bedroom with a nice living room, it had a good view… You can’t get an apartment like that for less than $2,600-3,000 today,” says Bamberger.

The problem is obvious to him. Many people will never be able to afford to rent, let alone buy their own apartments. He says, “There’s no pathway to get off the streets unless the government pays for your housing.”

That’s why Bamberger hopes to see the health care sector embrace the issue of housing as something worth investing in. He hopes more people can see the benefit of reducing the expenditure on health care, and improving the quality of people’s lives by providing them with homes.

He can’t understand why people working in hospitals don’t feel like housing conditions of their patients are their responsibility. Bamberger feels there is a great disconnect between the “extraordinary investment financially and emotionally in health care, and the almost disregard of some of the basic conditions that make humans human.” 

Bamberger believes a hospital is responsible for assessing and improving the housing conditions of the people it treats. He recognizes hospitals want to be more responsive to community needs, but he suggests the threshold should be set higher to include the needs of individuals living on the streets. During this session, Bamberger’s questioned the practice of treating someone at hospital for a serious condition to only then send them back to living on the streets.

“I think most people here and elsewhere are able to somehow insulate themselves from the absurdity of making such a technologic investment, and then just having someone walk back to the sidewalk, sleep on the street… I can’t do that, so it’s a very uncomfortable place to be.”

Bamberger considers every workday a success. He’s already helped develop 2,000 housing units in San Francisco and is hoping to develop thousands more over the next five years with financial support from health care systems. Being able to move somebody indoors, hand them the key and welcome them to their new home is an unbelievable feeling, Bamberger says.

“They just totally glow, wondering how this happened to them. It’s sort of how I felt when I was offered to come here to Salzburg. Me? Coming to Salzburg, flying across the world? It’s an incredible excitement, and I can imagine that times a hundred when you move into a beautiful place to live after being on the streets for so many years. “

The session, Building Healthy Communities: The Role of Hospitals is part of Salzburg Global Seminar multi-year series Health and Health Care Innovation in the 21st Century. This year’s session is held in partnership with the Robert Wood Johnson Foundation. To keep up to date with the conversations taking place during the session, follow #SGShealth on Twitter and Instagram.

Mirva Villa