Tiny Homes, Big Impact: MAHEC Addresses Housing Crisis for Residents

Photo: MAHEC

A new initiative launched by the Mountain Area Health Education Center (MAHEC), co-host of the WNC Health Policy Initiative, offers an innovative housing solution for medical residents serving in rural Western North Carolina - purpose-built, energy-efficient tiny homes placed exactly where they’re needed most.

The first four of these 350-square-foot tiny homes have been installed in Sylva, NC, a rural community nestled in in the Plott Balsam Mountains of Western North Carolina of Jackson County. They will host residents in a variety of health sciences on 2-to-4 week rotations, and are located close to clinical placement sites as well as Sylva’s downtown area. The first cohort of residents will move in later this month.

Rural Housing Challenges Lead to Rural Practice Shortages

The tiny home project is championed by Dr. Bryan Hodge, a family physician and Chief Academic Officer at MAHEC, in an effort to address a major challenge in recruiting and training healthcare workforce, especially in rural areas - the cost and scarcity of affordable housing.

As a recent study by the Journal of Graduate Medical Education (Housing Challenges and Opportunities for Rural Residency Development) found, the hurdles to finding affordable (or any) housing faced by medical students in rural residency programs can be significant:

Rural communities often have less available housing than urban communities. Rural housing is more likely to be owned (81%) than urban housing (60%), leading to a smaller rental market.12 Residents in all communities—regardless of rurality and housing inventory—need access to safe, secure, affordable, and good-quality housing that is convenient to the workplace.

This issue can result in residents having to settle for less optimal housing options. They may be forced to share a home with multiple other co-renters, with the resulting lack of privacy and distractions when doing coursework or reading. Alternately, residents may end up commuting long distances over sometimes treacherous mountain roads in order to secure outlying housing that doesn’t break the budget, an option that can add a burden of isolation to the mix as residents end up widely spread over the surrounding area with few fellow residents or other familiar faces nearby. This can be especially true for those trainees more familiar with population-dense and resource-rich urban areas.

Along with the financial burden of market-rate housing costs, these situations can become deciding factors in a resident’s decision to study in and/or return to practice in rural communities.

As MAHEC’s Rural Health Disparities In WNC webpage notes, WNC communities not only suffer from above-average rates of disease, provider shortages in the region are at a crisis point across multiple fields of practice:

● All 16 WNC counties are primary care health professional shortage areas

● Only 3 out of 5 adults in WNC had a dental visit in the past year

● 8 WNC counties have no practicing general psychiatrist

● 7 WNC counties have no practicing ob/gyns

A “Tiny” But Mighty Solution

These factors all make increased recruitment and retention of medical students a vital need. However, a study in the Journal of Graduate Medical Education looking at >12,000 family medicine physicians who completed residency training between 2008 and 2012 found that “[s]pending more than half of residency training months in rural areas was associated with substantially increased odds of rural practice.”

Thanks to this creative new approach to housing support, MAHEC’s residents now have a great opportunity to successfully undertake and complete residencies where they are needed most - and WNC’s rural areas will stand a higher chance of seeing those students return to practice as physicians.