OpEd: Age-Specific Housing Improves Health Outcomes and Reduces Costs
by Kim Fitzgerald, CEO of Cathedral Square
Vermont has one of the oldest populations in the nation, a severe housing shortage, and rising healthcare costs. As the legislative session begins, new research offers evidence about an investment that addresses these realities: age-specific, affordable housing with supportive services for adults age 55 and older.
A recent study from NORC at the University of Chicago tracked older adults who moved into age-specific housing communities over a two-year period. Rather than experiencing the decline many assume comes with such life transitions, residents showed significant improvements in health, longevity, and quality of life.
Many people find these results surprising, but I don’t. At Cathedral Square, we've witnessed these transformations firsthand for nearly 50 years. Today we provide homes and services to over 1,300 people in 28 communities, and the pattern holds true. We've seen people arrive thinking they're nearing the end of their lives, only to become more healthy, happy and active once they settle in. We have residents who have lived with us for more than 40 years.
The report’s findings challenge a persistent misconception that moving later in life is inherently harmful. What we've learned is the opposite. When older Vermonters move into housing designed for their needs, with services that support independence, they thrive. They connect with neighbors. They belong to a community. They access health care before small problems become emergencies. They remain independent longer than they would have otherwise. A key part of this success is coordinated healthcare.
In 2009, Cathedral Square partnered with other housing and services organizations to create SASH® (Support and Services at Home), which has been available statewide to Medicare recipients free of charge since 2011. SASH celebrates its 15th anniversary this year, and it exemplifies what the research confirms: when healthcare coordination is built into housing, outcomes improve dramatically and the growth in healthcare expenditures decrease in a significant way.
This matters now because Vermont faces converging challenges. We have more Vermonters aging into their 70s and 80s each year. We have a housing affordability crisis that hits people on fixed incomes especially hard. And we have healthcare costs that spiral when people can't access preventive care or fall through gaps in coordination. SASH addresses these challenges head-on. Care coordination prevents health problems from becoming crises. People stay connected to their communities and support systems. And no one has to choose between paying rent or buying food and medications.
Here's something people don't always consider: when older adults move into affordable housing designed for their current and future needs, they free up housing in the community for individuals and families. Creating more age-specific housing helps address Vermont's broader housing shortage.
The economic case is clear. Every dollar invested in affordable housing with coordinated care and support services returns dividends through reduced emergency room visits, avoided hospitalizations, and longer independent living.
We have nearly 1,400 people on the waitlist for Cathedral Square apartments. The demand is real. The need is urgent.
As legislators consider appropriations for housing and healthcare, they should recognize that these aren't separate line items. For older Vermonters especially, housing IS healthcare. Stable, appropriate housing with coordinated services keeps people healthier, longer at lower cost to the healthcare system. SASH has proven this works.
The question isn't whether we can afford to invest in housing and coordinated care programs for older adults. With Vermont's rapidly aging population, the question is whether we can afford not to.