Guest Post from the Louisiana Public Health Institute: Affordable Housing Is a Health Issue

This year marked the 49th anniversary of the passage of the Fair Housing Act. Yet, the idea that affordable housing access is a health issue has only begun to gain traction within the past two decades. While programs addressing housing are typically not within the mission and scope of most public health agencies and organizations (outside of those serving people living with HIV/ AIDS who have been long time housing advocates for their clients), housing has a tremendous impact on population health.

Housing costs that put undue strain on a family’s or an individual’s finances can cause chronic stress and result in limited access to neighborhoods that promote healthy choices and community spaces for social cohesion. The impact social and economic factors have on health is so significant that in 2016 the U.S. Centers for Disease Prevention and Control developed their Health Impact in 5 Years (HI-5) initiative, which highlights 14 evidence-based community-wide approaches that are known to demonstrate positive health impacts within five years and generate cost savings over time.

For many families, the cost of housing is one of their largest living expenses. According to the U.S. Census Bureau, the median gross monthly rent is around $924 in New Orleans. The cost of renting takes on even more significance when one considers that over 50 percent of renters report that what they pay in rent consumes 30 percent or more of their household income.[1] Unfortunately, some residents experience very little value in return for their hard-earned pay. Many of these rental units are unhealthy and unsafe, where tenants are exposed to mold, lead, vermin, or lack of heat or running water.

Sadly this issue may be more common than we realize. This year’s County Health Rankings ranks Orleans Parish the worst parish in the state for “severe housing problems,” with 28 percent of households reporting at least 1 of 4 housing problems: overcrowding, high housing costs (when monthly housing costs, including utilities, exceed 50 percent of monthly income), or lack of complete kitchen or complete plumbing facilities.[2] Recently, fair housing advocates, the City of New Orleans, the Housing Authority of New Orleans (HANO), and others have taken steps to assess the city’s housing stock and set goals to improve conditions.

The creation of a rental registry is a potential strategy for addressing these issues. Compliant-based processes that put the onus of reporting housing violations on tenants is not enough, as tenants can be vulnerable to retaliation and eviction. The risk of landlord retaliation is very real, with many tenants and tenants’ rights organizations sharing their experiences during Community Development Committee and City Council meetings earlier this year. Like mold and lead, research has shown that eviction can also have long-term, negative consequences to health. In a Harvard and Rice study looking at longitudinal data from the Fragile Families and Child Wellbeing Study (FFCWS), researchers found that mothers who were evicted the previous year experienced higher levels of material hardship, stress, and were more likely to suffer from depression. They were also more likely to self-report poor health for both themselves and their children, and their poor health, including episodes of depression, persisted at least two years after the eviction took place.

The evidence is clear: access to affordable housing can lead to better health outcomes. As public health advocates, we should do more to support these endeavors, too. In Louisiana and elsewhere the risk to affordable housing efforts remains high. Just last month, the Louisiana state legislature was contemplating a bill prohibiting local governments from considering inclusionary zoning for housing. Thankfully this bill was killed in committee, but we must remain vigilant against these types of legislation. We can stand alongside our fair housing colleagues and give voice to the myriad of ways unaffordable, poor quality housing impacts the communities we serve.  Some ways include:

[1] U.S. Census Bureau; 2011-2015 American Community Survey 5-Year Estimates; generated by Sandra V. Serna; using American FactFinder; <http://factfinder2.census.gov&gt;; (13 July 2017).

[2] See http://www.countyhealthrankings.org/app/louisiana/2017/measure/factors/136/map

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