Housing America, Part Three: Making the Connection between Housing, Health, and Racial Equity

Last month, NOAAH hosted a three-day health and housing conference that sought to highlight the importance of thoughtful housing development, homeownership opportunities, rental housing planning and its management. Further, the conference identified issues, highlighted best practices, and strengthened the partnerships between housing and community advocates. Additionally, healthcare providers developed a vision and a goal for creating fair, sustainable, healthy communities.

Health impact assessments and research have consistently demonstrated the strong link between housing and health. Building quality housing that is safe, well-maintained, ventilated, and free from pests and contaminants such as lead, and radon can reduce the incidence of injuries, disease, and poor mental health.

Developing equitable and environmentally sustainable communities is key to improving health outcomes. Non-segregated neighborhoods without concentrated poverty that have a strong network of supportive services reduce crime and foster civic engagement. Ensuring that neighborhoods have easy access to transportation, parks and recreation, good jobs, healthy foods, and medical care can improve the physical and mental health of its residents. Black, Indigenous People of Color (BIPOC) and segregated neighborhoods also deserve the amenities to maintain healthy outcomes.

Creating income-restricted affordable housing limits the rent-burden on a household to 30% of their household income, allowing families to pay for other basic needs such as food, medical care, and savings. Addressing these other social determinants of health reduces negative health outcomes. Providing ways for low-income families to purchase homes establishes the opportunity to build equity, wealth, and creates neighborhood stability which adds value to the community.

What We Learned

Healthy homes and neighborhoods make for healthy residents. Even before we are born, housing conditions affect our health. But not everyone has equal access to quality, accessible, and affordable housing.

Because of structural racism, people of color have faced barriers (PDF) to both quality health care and housing for generations. Long-standing racial inequities in the social determinants of health have caused stark racial health disparities. This research roundup demonstrates how decent, affordable housing can lead to better health outcomes among people of color. With this information, policymakers, advocates, and housing professionals can promote racial equity and avoid perpetuating health and housing disparities.

How housing location affects health

  • Black and Hispanic hospital-based pediatric primary care patients* are more likely than white patients to live in census block groups with high violent crime rates. 
  • People living in neighborhoods with higher levels of deprivation — an index of neighborhood quality based on households experiencing crowding or severe housing cost burden, the poverty
    rate, median home value, educational attainment, and unemployment rate — face higher risk of heart failure, independent of individual socioeconomic and health factors. This study also found that participants living in the most deprived neighborhoods were more likely to be Black.
  • In most states and counties, people of color are more likely to live near pollution emitting facilities, placing them at greater risk of contracting respiratory and cardiovascular diseases and premature death than white people. Pollution-emitting facilities, placing residents at greater risk of contracting respiratory and cardiovascular diseases and experiencing premature death than white people.
  • Compared with white people, Black people are 52 percent more likely to live in census block groups with heat risk-related land cover conditions, such as impervious surfaces and little green space, placing residents at greater risk for heat-related deaths and illnesses.

How housing segregation affects health 

  • Residential segregation increases the incidence of cardiovascular disease among Black adults.
  • Among Black women, living in a highly segregated metropolitan area long-term is associated with the development of obesity.
  • Neighborhoods in the Detroit metropolitan area with larger Black populations are more likely to have more residents with disabilities and higher rates of mortality. Higher homeownership rates within these neighborhoods reduce the association between Black residents
    and mortality.

How housing affordability and stability affect health 

  • A study of urban Illinois census tracts found high correlations between both eviction rates and eviction-filing rates with five negative health-related behaviors.
  • Compared with white and Hispanic households, Black, non-Hispanic households have a significantly higher average eviction filing rate and higher rates of smoking, obesity, lack of leisure time and physical activity, and sleeping fewer than seven hours. Middle-age Black people are more at risk for heart attacks and strokes if they have experienced foreclosure.
  • Black and Latino renters are more likely to experience housing instability than their white counterparts. And housing instability is associated with adverse health outcomes for caregivers and children. 
  • A study conducted by the American Heart Association found Latino residential areas at higher risk for foreclosure have higher rates of hypertension and hypercholesterolemia than areas at lower
    foreclosure risk.  
  • Public housing residents, the majority whom are Black and Hispanic (PDF), are more likely than the general community to have poor health.
  • Latino public housing residents in the Bronx are more likely to experience diabetes, heart attacks, and hypertension than Latino Section 8 voucher holders or low-income Latinx families without
    housing assistance.

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