USA: Healthy Communities of Opportunity
Introduction:
2015 was a historic year for healthy Communities and housing policy and for the convergence of the two. On the housing front, the Supreme Court voted to uphold the disparate impact doctrine of the Fair Housing Act and the Obama Administration released the long-awaited Affirmatively Furthering Fair Housing rule, both actions recognizing the continuing impact of racial discrimination, segregation, and disinvestment on the lives of too many people of color.
Housing is not only the single greatest expense for most families it is also a key determinant in whether or not household members have the resources to live healthy lives and achieve their full potential. Equitable housing must be more than affordable; it must also connect workers and residents to the jobs, schools, services, and community assets that will enable them to thrive and be healthy.
Housing discrimination has traditionally been defined and combated based on relatively narrow and specific terms of the denial of accommodations to individuals, and Healthcare financing has been the purview of a powerful array of interests mostly concerned with medical services and insurance.
The Relationship Between Healthy Communities and Housing in American Urban Policy:
Health and housing are inextricably connected:
Health and housing have a historical nexus that practitioners have recently sought to elevate and reconnect as a powerful tool for advancing equity and promoting health in all communities. In response to outbreaks of infectious diseases fueled by unsanitary and unhealthy conditions common in 19th century urban slums, a convergence of medical practitioners, social reformers, and philanthropists held up decent housing as a key tool to advancing public health.
Placing healthy housing in context:
“Healthy housing” is a home where the physical, mental, and socioeconomic environment supports household members in making healthy choices, achieving educational and economic success, and engaging in robust social and cultural networks. It is housing in a neighborhood connected to good employment and business opportunities in the region. It is a home free from toxins and threats from the built environment such as unsafe streets, violence, poor air quality, industrial chemical exposures, allergens, mold, or pests. It does not impose cost burdens that divert household income away from healthy food, medical care, or educational opportunities.
National Housing Trends and Their Implications for Health:
Impacts on low-income healthy communities and communities of color:
This section characterizes the current impacts of nationwide housing trends on low-income communities and communities of color; on renters and the housing market; and on the economy. Though racial disparities in housing security have a long history, these disparities accelerated during the Great Recession of 2008 and continue to worsen.
Economic impacts:
Housing costs are rising faster than wages, with 14.3 million households across America facing growing housing instability with increased housing costs, low wages, and diminishing affordable housing stock. Housing is considered unaffordable when the median rent prices exceed 30 percent of median pre-tax income. Nationwide, by this measure, fully 53 percent of renters are considered housing cost-burdened.
Connecting Opportunity, Healthy communities, and Housing Policy:
Promising Movements In The Field:
Since improving housing conditions can improve people’s health and, in the process, reduce the amounts spent on their medical care, an array of health financing strategies are being explored as ways to address housing problems ranging from homelessness to asthma triggered by poor indoor air quality. In an age of tightened government budgets, these explorations, which incorporate a range of incentives for public and private insurers, managed care organizations, hospitals, and other care providers to address problems on a population-health level, may offer some of the most promising sources of new support for housing.
Conclusion:
The links between healthy communities and housing inequities are unmistakable, and the challenges faced by vulnerable communities struggling to afford housing in opportunity-rich communities undermine our public health and collective prosperity. Prioritizing low-income communities and communities of color to receive new housing investments as a platform for expanding opportunity and improving health outcomes will secure our nation’s prosperous future.