Where we live affects how long and how well we live. Data, research, and investments can support stable and equitable housing for all.
Each of us want a safe, stable home for our families and everyone in our community. Evidence supports this: affordable housing is foundational to vibrant communities and supports collective wellbeing. Where we live can determine whether have safe places to play and be active; quality jobs and schools; and transportation to get us where we need to go.
Yet millions of people in America live in substandard or overcrowded housing, temporary shelters, in cars, and on streets. Residential segregation isolates people from opportunities, and creates long-lasting disadvantages. For many, the inability to access quality housing compounds many other challenges and makes it much harder to be healthy and break out of poverty.
Policymakers and the public alike often overlook and misunderstand housing’s profound effect on health. To address this, in his Annual Message message, RWJF President and CEO Richard Besser, MD, discusses how safe and affordable housing supports positive outcomes across the lifespan—and how unsafe and insecure housing can deepen inequity.
He shares stories from housing initiatives across the country—from Boligee, Ala., to Chelsea, Mass., to San Antonio. These examples show that improving the quality and affordability of housing also improves health. Safe and affordable housing—an essential part of efforts to transform under resourced neighborhoods into thriving communities—is a pathway to helping communities thrive.
In this post, we share illustrations that reflect the lessons this important work has taught us. We also revisit past Voices blog posts in which experts explored the role of housing as a determinant of health. With a focus on housing as a key to health, we hope to unlock better health for all.
Safe, Affordable Housing
Home is where the heart is, but it’s also where our health is. The quality and stability of our homes shape our health, our communities, and our society. When we live in safe, quality homes that are: free of physical, chemical, and environmental hazards; are near decent jobs, good schools, reliable transportation, and safe play spaces, we can flourish. When we don’t have these opportunities, we can suffer—and so do our communities.
As Amy Gillman, a senior program officer at RWJF writes, “There is a strong and growing evidence base linking our homes to our health.”
But safe, stable, and quality housing is out of reach for millions of people in America—and that has profound implications for health. “Where we can afford to live impacts where we live,” Gillman writes, “and our neighborhood’s location can make it easier or harder: to get a quality education; to earn living wages; to afford and have access to nutritious food; and to enjoy active lifestyles.”
Housing Costs Can Undermine Health
The cost of housing in America is high—and getting higher in many places. Over the last two decades, rents have increased, while incomes have stayed flat. This takes an especially heavy toll on the 38 million “cost-burdened” families in America—more than half of whom spend over 50 percent of their incomes for the roofs over their heads.
To make ends meet, many families must live in unsafe or overcrowded housing. And many others—especially low-income families—after paying for housing, don’t have enough left over to cover necessities like nutritious food, health care, and transportation. As Gillman writes, “When we’re spending too much of our income on rent or a mortgage, that leaves little to pay for transportation to work or the doctor or to put healthy food on the table for our kids.”
Housing Discrimination
In America, not everyone has the opportunity to live in an affordable, stable, safe home in a neighborhood that fosters well-being.
Unequal access to affordable housing contributes to other inequities, according to Kerry Anne McGeary, a senior program officer at RWJF. “We know there is a direct line from opportunity to equity to health—with access to good schools; affordable housing; safe neighborhoods; and quality health care as some of the key stepping stones,” she writes. “When those resources are unevenly distributed across neighborhoods—and sometimes within the same few blocks...health outcomes are certain to be inequitable as well.”
End Discriminatory Housing Policies
“Not all discrimination is conscious,” writes David R. Williams, a professor of public health at Harvard University. Policies and practices sometimes create bias and imbalances where we live, learn, work, and play—all of which shape our health.
Over the last four centuries, the “land of the free” institutionalized slavery, forcibly removed Native Americans from their lands, implemented a system of legalized racial segregation, denied housing loans, and more.
The country has made progress, but racism and discrimination persist. Nearly half of black people, for example, say they have experienced discrimination when trying to rent or buy a house, limiting access to one of the most foundational needs for good health.
The result, says Sheri Johnson, director of the University of Wisconsin Population Health Institute, “has been an accumulation of disadvantage through decades and generations.”
Working Together to Create Healthier Places to Live
The evidence is clear that “where we live affects how long and how well we live”—including our home and all the essential resources to which our home connects us.
New and growing evidence demonstrate not only how housing policies created inequity, but also how we can correct those past mistakes. We can expand access to opportunities by investing in safe, affordable, and stable housing—as well as in surrounding neighborhoods. In turn, this helps families build not only homes, but a greater foundation for long-term health, generational wealth, and collective wellbeing.
Read Rich Besser’s 2019 Annual Message to understand how our homes are key to our health.
About the Author
Najaf Ahmad spreads vibrant stories about the Foundation’s work as managing editor of the RWJF Voices Blog.
Jessica Mark, strategic communications consultant, brought extensive experience to RWJF’s Healthy Communities theme.