Housing policy is health policy (and education policy, and economic policy...)

Mar 29, 2018

As an urban planner working in the field of affordable housing and a HealthConnect Fellow, I’ve had the unique opportunity to observe new national trends in both housing and health over the past few years. What has been most interesting in my view is that both fields came to a similar realization at about the same time. They realized that their work is very interconnected – and those connections extend beyond housing and health to many other fields as well. As the national health conversation shifted toward “social determinants of health” and “health in all policies,” so too did housers begin a discussion of “housing as a platform.” What we all collectively realized is that our decisions have broader consequences, and that we must all work together to create real and lasting change for the people we serve.

Why the shift toward cross-sector collaboration? One reason might be dwindling public resources for both fields, sparking new conversations about shared funding. Another might be a growing evidence base that backs up these ideas with extensive research. If you’re reading this blog, you’re probably already familiar with social determinants of health. As your friendly neighborhood housing researcher and data wonk, allow me to introduce you to just a little of the evidence for “housing as a platform,” especially as it relates to children’s health and wellbeing.

I’ll start with housing and health, the focus of my fellowship and perhaps the most extensively studied connection thus far. Poor housing conditions are the most common driver of poor health outcomes, especially the well-documented connection between lead poisoning and neurological conditions. Other conditions like mold, moisture, and pests may cause asthma attacks. We have promising local data on this connection, as an initial evaluation of Healthy Homes Des Moines has shown that remediating these triggers and providing asthma education has produced 74% drop in emergency room visits among children who participated in the program. Finally, poor housing conditions are also a driver of parental stress, which has been linked to emotional and behavioral problems in children.

Because sick children miss more school, it’s easy to see how those same health outcomes could also affect a child’s educational achievement. However, housing instability is another key driver of poor educational outcomes, as documented in a recent series from The Oregonian in Portland. Low-income parents are at higher risk of eviction due to missed payments, and are thus forced to move frequently. These frequent moves have been linked to behavior and attention problems, increased absenteeism, and disruption of peer networks – all outcomes that contribute to a higher rate of dropouts. According to U.S. GAO research, children that changed schools two or more times between 8th and 12th grade are twice as likely to drop out of high school.

I could go on – I haven’t even discussed how the neighborhood a child lives in impacts their future earnings potential – but I think even this quick review of the research makes clear that safe, stable, and affordable homes are key to children’s success. Whether you call this “social determinants of health” or “housing as a platform,” we know now that siloed thinking hasn’t solved the wicked problems we work on every day. Whether we recognize it or not, we’re all health professionals, housers, educators, and economic developers, and the only way for us to make progress is to create systemic change that extends beyond a single field. That’s what my cohort of HealthConnect Fellows is working to achieve, and I hope you’ll join us.

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