CDM Corner: Housing’s contribution to health and well-being

By Racquel Reddie, Managing Director of Community Development

Housing’s contribution to health and well-being

Researchers on health have long recognized that factors beyond access to doctors and hospitals and heredity have an impact on how healthy people are.  Factors like education, income, food insecurity, and unemployment all have an impact the health of individuals and are collectively referred to as “social determinants of health.”  While there is no single list of factors in the research literature, affordable housing is widely recognized as an important social determinant of health.  It makes a lot of intuitive sense that not having a safe, secure place to sleep every night takes a toll on people, and that exposure to mold, lead and other toxins in substandard housing also causes illness.   Safe and affordable housing can reduce health care expenditures and improve quality of life for residents.  For example, affordable housing for senior citizens with appropriate supports has been shown to reduce hospital admissions and nursing home use.

For these reasons, housing developers have developed many partnerships that reflect the insight that housing quality impacts health.  The Center for Community Investment (CCI) at the Lincoln Institute of Land Policy announced the launch of Accelerating Investments for Healthy Communities (AIHC), and named Nationwide Children’s Hospital as one of six participants for its Healthy Neighborhoods Healthy Families (HNHF) initiative.

NCST Developers’ Perspective

Many of NCST’s longtime partners have recognized and addressed the housing and health priorities in their local communities.  To learn more, we spent some time talking with Deborah Robb from the Greater Cincinnati Port Authority/Homesteading and Urban Redevelopment Corporation (HURC).  Over the years, the HURC program has provided homes to families which had previously been living in sub-standard housing.  For parents in particular, sub-standard housing adds a dimension of stress from fear for the safety of their children.  To be sure, these fears stem from lead, asbestos and other environmental concerns, but also concerns that their children would be harmed in kitchens with faulty stove handles or getting into cabinets where the fixtures hadn’t been properly installed or maintained. 

With these concerns in mind, the HURC program intentionally undertakes their home renovations by adding modern amenities and replacing all fixtures.  Those simple improvements mean the difference of being able to ensure that cabinets can be child-proofed or that the hot water is reliably working.  According to Deborah Robb, “…we had acquired a property in part of town that needs some help.  A real estate agent indicated that they had a woman with four kids, and a guardian on the mortgage.  But the priority was to move from a dangerous living situation to a stable situation for the household.  And this impacts everyone including the children when you consider the social determinants of health: they are not sick as often, they are attending school, reduction in stress, etc.”

In Memphis, Tennessee, another NCST partner is working to bring not just awareness but also affordable housing units to help replace the blight and distress that some neighborhoods are confronted with.  In partnership with the Tennessee Housing Development Agency (THDA), United Housing Inc. (UHI) was successful in applying for and obtaining Blight Remediation funds to support the demolition of vacant and abandoned homes that often times pose health and safety risks in neighborhoods, which are also important aspects of the social determinants of health. 

As an important partner of NCST’s Project ReClaim in Memphis, UHI was able to leverage blight remediation funds as well as competitive grant funds with highly distressed assets that the Trust’s subsidiary CRC was able to convey as donations.  Two of the six properties that were conveyed with the ReClaim program are now providing UHI with infill lots for new construction geared towards active military and veteran families for affordable rental opportunities.  United Housing is on a mission to build all their new homes with energy efficiency and accessibility features.  These military families will also have wrap around services to help them be successful.  

National Intermediaries’ Efforts

National intermediaries such as Enterprise Community Partners and LISC are active in this space as well.   In January 2019, Enterprise launched a new national initiative, Health Begins with Home. Working with a broad group of partners and guided by data-driven insights, Health Begins with Home will put $250 million to work over five years to promote health as a top priority in the development and preservation of affordable homes and to elevate homes as an essential tool for improving resident and community health.   For both children and adults, the quality, affordability, stability and location of home are seen not just as important factors but as foundational to health and well-being.  Through the Healthy Futures Fund, LISC is developing innovative ways to bring community health centers to underserved areas as well as affordable housing that incorporates health services for low-income residents. 

HUD, US EPA and others have put in place requirements to deal with the negative health effects as they relate to housing and rehabilitation standards (lead, zero VOC paint, asbestos).   Both Enterprise Community Partners and LISC have green sustainable building guidelines. Trainings are offered to members and affiliates through NeighborWorks America and NACEDA.  Recognizing the deep tie between community development and health, NeighborWorks America combines its investments and strategies in health, affordable housing, community building, financial capability and economic development to support health and well-being at each critical stage of life. 

Through grants, training and technical assistance, NeighborWorks supports the efforts of its network and the community development field to develop healthy homes and communities.  NACEDA has offered trainings such as Advancing Health Through Mixed-Income Communities; Intersection of Community Development and Community Health; Integrating Health Funding to Pay for Services in Supportive Housing; and Holistic Approaches for Neighborhood Health and others.  In addition to trainings, other important players in raising awareness of this issue are industry news organizations like Shelterforce and NonProfit Quarterly.

The issue of health and housing has a long history and has taken many forms throughout the years.  As NeigborWorks America so aptly coined the phrase “Home Matters”, it reminds us all how important home is to the health and success of our families and the diverse communities we serve.