Housing is Health Care with Teresa Nguyen and Isaac Haney-Owens

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ISAAC HANEY-OWENS: Hello, this is Isaac Haney-Owens, and you’re listening to the Leaders for Inclusive Community Podcast, hosted by The Kelsey, covering topics related to housing and disability. Welcome! Thanks for listening. Each episode, I’ll meet with different community leaders to learn about what they do and ask them questions about how their work can make housing and communities more inclusive of people with disabilities. 

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TERESA NGUYEN: So, I think we have a big choice, and we have a big opportunity as humans, as people who build these built environments, to really improve the health of those around us. We have a responsibility for that. 

ISAAC: Today, we’re interviewing Teresa Nguyen at Colorado Employment First, where she develops training and curriculum for youth and families in employment and health. 

So, it’s nice to meet you. 

TERESA: Yeah, nice to meet you, too, Isaac. 

ISAAC: Yes. 

TERESA: Thanks for having me. 

ISAAC: Yeah. This is a topic that you’re gonna talk about is something that I don’t really have any, that I’m not really, that I’m unfamiliar with how housing, how health and housing go together because I have a hard time seeing that, seeing that connection. 

TERESA: Yeah. Yeah. They seem really disconnected. You know, housing doesn’t really have anything to do with your body or your health in a way that you can see. And so, it’s hard to, I think, harder to think about, but it definitely does. And yeah, I’m excited to share more on that and how they go together. 

ISAAC: So, the first question is, how was it like growing up with a disability? 

TERESA: So, yeah. Just to give everybody some context, I was born with a genetic disorder called osteogenesis imperfecta or OI for short, which really just means I have brittle bones. They break really easily and more often than the average person. For me, I use a power wheelchair to get around, and I have been using a wheelchair since I was five years old, I believe. And so, for a lot of my life that really impacted the way I experienced things. So, that meant for first and foremost, I had to be able to move around my house where I was living pretty easily. As a kid, that wasn’t really possible. We had a three-story house with stairs, and so we had to come up with other ways for me to kind of still be independent, but also move around, like live in the house that we were in that was not completely accessible for a power wheelchair. So, that meant was most of my childhood, I would not actually have my wheelchair inside my house. So, even though I mainly use a power wheelchair now, as a child, I used a walker because that was a little bit lighter and can fit into more spaces, including a three-story house. So, I used that often, or I just kind of scooted myself around on the floor in my house. And so, that kind of impacted, right, what I could do and what I couldn’t do inside my own home. 

For example, I didn’t have great balance. And so, using a walker just kind of prevented me to do a lot of things because I had to focus on walking instead of doing other things, such as, I don’t know, setting the table for dinner or using the kitchen to my own independent ability. So, I really wasn’t able to do many tasks that help people live independently until I was able to use a wheelchair inside of the house. And that came much later in my life. So, I think that really impacted the way I learned things and experienced things world. And so, that was kind of what it was like going up a disability in the context of housing and mobility, if that makes sense.

ISAAC: And it’s great to see that you don’t let your disability control your life. 

TERESA: Yeah, I try not to. I mean, I’ve had great role models that kind of helped expand my world. And my parents really helped empower me to really just kind of explore my boundaries and my independence. So, yeah, I’m really grateful for that. 

ISAAC: So, what made you decide to go into the healthcare field? 

TERESA: Well, having a disability, like I talked about, I was really somebody who basically grew up in the healthcare setting in and out of doctors’ offices and hospitals. And I saw kind of both the positives and the negatives of the healthcare system. I saw the challenges that the system posed on my parents who are immigrants from Vietnam. And I thought a lot about how I could improve the systems as an English-speaking first-generation Asian American. Like, how could I bridge that gap for those who don’t know the American culture and know the American healthcare system? So, I wanted to tackle that challenge. 

But then on the flip side, I also saw how my own health outcomes—which I think are positive for the most part—they were impacted by certain parts of the healthcare system that were really great, including really educated and passionate medical doctors who have dedicated their lives into just kind of tackling those disability components of healthcare and barriers. And so, I wanted to be kind of a part of that change as well and contribute positively to the health outcomes of other people with disabilities. And so, those two things, kind of addressing the challenges that come with the healthcare system that currently exists, and then also just being a part of that change, those are the two things that motivated me to go into the healthcare field. 

ISAAC: It’s great to see that you’re doing something good for this community. 

TERESA: Oh, thank you. 

ISAAC: What does it mean when you say understanding the importance of building environments and health outcome? 

TERESA: Well, I mean, I think there are so many things that impact our health. There are the places where people live: that impacts health. Where people learn, the conditions and where people work and play and hang out: those are all things that affect a wide range of health risks and health outcomes. And these are known as the social determinants of health. And so, kind of examples of that are things like housing, education, employment, and of course, the environment. And all of these factors are mainly a part of our built environment. These systems, these buildings are designed by people in our society. And so, I think we have a big choice and we have a big opportunity as humans, as people who build these built environments, to really improve the health of those around us. We have a responsibility for that. 

ISAAC: How does housing impact people’s health? 

TERESA: Oh, gosh! In so many ways. When we think about how much housing costs, right? If we don’t have access to affordable housing, to cheap housing, people will have to make a choice between what they need to spend their money on. So, if they spend half or more of their paycheck on their housing, then they have to make cuts to other spending in their lives, such as spend less money on groceries. So, what quality and what kind of food are they spending money on that contributes to their health? Or they will have to spend less money on their actual medical care, right? Are they going to go to the doctor when they need to, or are they gonna skip that appointment because it’s too expensive, and they would rather live in a house or an apartment before they take care of those needs? So, housing costs contribute to health. 

Quality of housing also contributes to health, right? If there’s bad construction or poor air circulation, ventilation, if there are pests around the housing components, if there are accessibility barriers, those all can either cause injuries or illnesses or exacerbate them. So, things like long-term disability and asthma are often associated with poor quality of housing. And so, I think those are kind of the main components of how housing contributes to health. The cost and the quality really matter, and they affect people’s lives every day. 

ISAAC: How has COVID shown impact, important housing is for people with disabilities?

TERESA: It definitely has had impact on housing for people with disabilities. I currently work in an organization that is working on improving the employment system in Colorado for people with disabilities. So, one way I’ve seen it directly impact housing is, in the time of COVID, one of the first groups of people to be laid off or to be furloughed are people with disabilities. And so, in that way, people with disabilities are often let go of positions in a crisis. Which means that leaves a lot of questions to how they’re going to pay their bills, and the bills include housing. And so, I’ve seen a lot of folks lose housing because of the pandemic. That’s one way, and that’s related to their job and how they can keep that. 

Another example is, like when I talked about the quality of housing and the air ventilation or air circulation, I’ve seen that effect a lot of people with disabilities and their choice to leave an apartment setting where there are more people in that setting contributing to kind of the air quality and air ventilation that could be a little bit less helpful in the pandemic. And so, again, that starts kind of the process all over again for people with disabilities to search for accessible, affordable housing that now does not include shared environments such as apartments or condos. We don’t see many standalone houses or spaces that are accessible for people with disabilities. And so, just COVID has really narrowed down the options for people on where they can live safely. So, those are the two ways that it’s impacted, that I’ve seen in my life. 

ISAAC: And also homeless people are impacted by it, too, ‘cause they don’t have a home to go to in the first place. And then they’re affected, and then they’re more at risk of getting the disease. 

TERESA: Absolutely. Absolutely. Exactly right. 

ISAAC: And also in COVID, people have, I’ve been hearing on the news, that people have been not wanting to go to the hospital and get themselves seen by a doctor when they need to, because they’re worried about getting COVID from the hospital. 

TERESA: That’s right, yeah. And that’s another thing, right? That’s like in light of preventing COVID, folks will now not go for routine checkups or a different issue not related to COVID because of the high risk in the healthcare settings. And so, yeah, that’s definitely a big pattern that we’re seeing as well. 

ISAAC: What would you like to see in the future of healthcare? 

TERESA: Oh, gosh. In healthcare. I would like to see expanded access to healthcare, meaning lower cost: lower cost for everything. But really just medical care, I think is the hardest to access because of the cost of those things. And so, I would like to see a lower cost. I would like to see a better way that healthcare is communicated to many people in society. I don’t think our culture has valued health as a priority. And so, I would like to see that change to maybe prioritize health before economic status or health before independence. I think it just would change a lot of things and a lot of choices people make for themselves. And so, that’s a big culture shift. I don’t know if it’s gonna happen in my lifetime. But it’s just been very clear during COVID that we just are not good at talking about healthcare. We’re not good about that, and we’re not good at making it our number one priority. So, that’s, I think that’s the big thing that I would like to see change. 

ISAAC: What do you think has to happen to make healthcare available for everybody and not just those that can afford it? 

TERESA: Oh, gosh! Well, I think that it needs to be a priority of our leaders within the federal government, right? That really means having the right people in the Medicaid system, having the right people in Health and Human Services to really direct that kind of work. I think it really all comes down to leadership and the priorities of our country’s leaders. I think that will help expand healthcare. I think having people with disabilities as a part of the healthcare conversation will help expand access for many communities. But I think many people with disabilities experience a lot of barriers that other communities have experienced as well. But I think we can empower ourselves to be a part of that conversation and leadership to really speak up for those inequities. I think that’s how we expand access. And truly, if we did put health first as a country, as a priority, I think our budget would look different to expanding healthcare. And so, those are all just things to consider, and they’re all really hard change to make. 

ISAAC: And how is your organization working to make sure that minority communities know about the information that relates to healthcare? 

TERESA: My own organization is more employment-focused than healthcare. But I think we do just relationship building and targeted community partnerships to really help get our information out to the communities that are underrepresented, underserved, including people of color and minority communities. So, really just those targeted community partnerships and relationship building, I think is important. And they’ve done a really great job in making sure that the staff that they’ve hired in my organization are trusted in those communities. And so, when information comes, it comes from a well-known person who identifies with the minority community who can be trusted and who can bring that information to them. So, I do think it matters who you hire and how intentional you are about getting that information to the minority communities in a way that doesn’t seem random or unrelated. 

ISAAC: And also, advocating is the best, is one way to help, is advocating to save the systems so that later generations can benefit from them. 

TERESA: Yeah, absolutely. Yeah, I think advocacy is forever important in a lot of our work and specifically for minority communities. But I think it starts with empowering those communities to advocate, right? And I don’t know if we’ve done a really good job of that, so we need to continue.

ISAAC: Thanks for taking the time to talk to me. Is there anything you might want to add before we end the interview?

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TERESA: You know, I think that it’s so important that you all cover how health and housing intersect. I think, like I said in the beginning, many people don’t think about it that way because you can’t see it with your own eyes, like every day, how that would affect somebody’s health. But I see it in kind of the background, right, like when people have to make choices about where they spend their money and where they can be the most safe where they’re living. And so, I think it’s just important to kind of highlight these things that are not often talked about. And I’m grateful for you guys to be doing that.

ISAAC: Thanks for listening. For more information on The Kelsey or to check out more of my podcast episodes, visit TheKelsey.org. If you have a topic you’d like me to explore or a person to interview, email me at Isaac@TheKelsey.org. Goodbye.

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