# Aging in Place: A Cross-Sector Partnership of Housing and Health Care

> **NIH NIH R21** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $195,000

## Abstract

Abstract/Project Summary
Many older adults prefer to remain in their homes as they age. The ability to age in place is a balance between
the amount of cognitive and physical function, the physical environment, and the social environment available
to stay in their homes. Black older adults and the poor experience greater physical impairment and a higher
prevalence of Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRDs) than their
counterparts resulting in greater challenges to aging in place. Bold ideas to facilitate aging in place, particularly
among vulnerable populations, are needed.
To promote aging in place, we present the Unite care model, a community-initiated, academic supported, dual-
sector initiative that combines two sectors: housing and health care. The Unite care model co-locates a
Federally Qualified Health Center (FQHC) clinic on an older adult affordable housing campus, home to over
700 predominately Black older adults in Flint, Michigan. The Unite care model will promote aging in place by
optimizing: 1) medical care including onsite clinic and home visits; 2) the physical environment through
referrals for home safety evaluations and facilitating environmental modifications and; 3) the social
environment by community health worker led health behavior and social interventions. Overall, the Unite care
model will flip the paradigm that asks the most vulnerable older adults to seek out the medical safety net.
Instead, the Unite care model will bring the safety net to older adults to support aging in place.
The objective of this proposal is to assess how well the Unite care model is implemented, identify which older
adults utilize it, with particular emphasis on older adults with activity limitations or AD/ADRD, and whether the
model promotes aging in place. In aim 1, through a concurrent exploratory mixed methods design guided by
the Proctor implementation outcomes framework, we seek to determine how much and for whom (i.e.,
penetration) and how well (i.e., adoption and acceptability) the Unite care model is implemented. In aim 2, we
will determine which older adults utilize the Unite care model and assess whether the Unite care model
promotes aging in place through blood pressure reduction, a measure of medical care and an important
predictor of disability, and changes to the physical and social environment. We have worked in partnership with
the Flint community for over a decade and have specifically worked on this project with our housing and
healthcare partners for two years. This proposal will inform other communities contemplating new models of
care to promote aging in place among older adults living in poverty and older Black Americans and suggest
whether larger-scale testing of this model of care is warranted.
.

## Key facts

- **NIH application ID:** 10189162
- **Project number:** 1R21AG071796-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Lesli Elizabeth Skolarus
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $195,000
- **Award type:** 1
- **Project period:** 2021-04-15 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10189162

## Citation

> US National Institutes of Health, RePORTER application 10189162, Aging in Place: A Cross-Sector Partnership of Housing and Health Care (1R21AG071796-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10189162. Licensed CC0.

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