To Improve Public Health, Make Housing a Human Right
Where we live dictates so much of our daily lives.
Does the availability, stability, and quality of housing impact an individual’s or a community’s health? Intuitively we should all say yes. And data and research support this lived experience.
Observational studies have shown that being without a stable home is detrimental to one’s health. People who are chronically unhoused face substantially higher morbidity in terms of both physical and mental health, and experience increased mortality. People who are not chronically without housing but who face housing instability (whether moving frequently, falling behind on rent, or couch surfing) are also more likely to experience poor health in comparison to their stably housed peers.
The housing crisis facing this country is also a public health emergency. The alarm bells have been ringing for decades. Now the Covid-19 pandemic has intensified its dangers. Evictions between the beginning of the pandemic and the institution of a since-lapsed national eviction moratorium in September 2020 led to 433,700 excess Covid-19 cases and 10,700 additional deaths.
Can the expansion of housing make a positive dent in addressing poor health outcomes? I wish we could test this question. Unfortunately, the United States is experiencing an extreme shortage of housing of all kinds: first-time buyer houses, affordable housing, trade-up properties, rental properties, two- and three-family properties, and multifamily buildings. According to a recent National Association of Realtors study, the supply of homes in the U.S. is more than five million homes short of demand, and builders are only on track to build 1.5 million homes per year.
Source: Census
As a consequence of this low housing stock inventory, the median price for an existing home had climbed to an all-time high of $363,300 in June (up 23 percent over the previous year).
This housing crisis is felt most intensely in Black, Indigenous, and People of Color (BIPOC) communities which have experienced a well-documented history of racial discrimination in securing, stabilizing, and maintaining quality housing. Court decisions and government policies have long tacitly or explicitly supported this discrimination. For example:
In 1926, the Supreme Court decision in Village of Euclid v. Ambler Realty Co. provided support and a rationale for what later became known as not-in-my-backyard opposition to affordable housing.
In 1934, the Federal Housing Administration was created to insure home mortgages for financial institutions, but rather than providing equal access to people of color, the agency’s underwriting manual explicitly directed personnel not to insure homes where there were “inharmonious racial groups” or if there was a possibility of “invasions” by such groups.
At its inception, the federal public housing program established in 1937 was largely limited to White households. But when this housing subsequently came to be occupied predominantly by households of color, funding for modernization and repairs proved inadequate, contributing to the stereotypically negative images of the program.
Today, as Covid-19 continues to impact cost-burdened renters, BIPOC renters are the most at risk of eviction due to the increased likelihood of missing rent payments due to higher rates of lost employment.
Before Covid-19 reached the concrete shores of New York City, one in five adults in the city, and one in five children -- more than 1.5 million people combined -- experienced poverty. Nearly 60 percent of Black and Latinx adults experienced poverty for at least one year between 2016 and 2019. Since the onset of Covid-19, more than a quarter of all New Yorkers have missed at least one rent payment. While Federal and State eviction moratoria have helped to prevent a massive rise in evictions and people without homes, the Federal protections have now expired and the State moratorium is temporary and not a long-term solution.
Public housing residents and the city’s unhoused communities (those unable to call regular places home) have been hit especially hard by the pandemic. The City Department of Health and Mental Hygiene recently reported that while New York City Housing Authority (NYCHA) tenants are roughly four percent of the city’s population, they’ve accounted for some seven percent of Covid-19 deaths. The impact of COVID-19 on New York City’s unhoused community has been severely understated. Within their community 613 New Yorkers died between July 2019 and June 2020. This marks a 52 percent increase compared to the prior year, with the largest rise occurring April-June 2020, when Covid-19 first began to bear down on the city.
New York City’s inability to address its housing crisis impacting its BIPOC communities did exacerbate COVID-19’s overall impact. This housing reality will continue to impact BIPOC New Yorkers without action. With one swift stroke of the pen the incoming Mayor of New York City can adopt a “Housing as a Human Right” agenda. In partnership with the City Council, the next mayor can take bold steps for community healing.
There are many actions to this agenda and many communities that need involvement in its development, but here are some actions that can be started on day one:
Value resident lived experience as legitimate knowledge for decision making through community-based participatory policy design.
Provide $15-$20 million in funding to the City’s existing Community Land Trust (CLT) initiative, which is designed to curb housing speculation and gentrification and stop displacement of low-income residents.
Identify underused public land as sites for permanent housing or New York City’s unhoused communities, and incentivize conversion of underutilized private commercial properties for affordable housing.
Implement a Universal Income Program for all New Yorkers struggling to attain a living wage.
Expand the City’s Emergency Repair Program (ERP), which funds essential repairs in landlord-neglected properties (and collects repayments from the owners).
Intensify the Alternative Enforcement Program (AEP), which identifies and steps up inspection and monitoring of buildings with extensive Housing Code violations.
Establish an agreement with the State that ensures Congress’s Build Back Better Act public housing funds address the estimated $50 billion+ in essential repairs needed to put NYCHA properties in good repair.
Ensure that rezonings of high-income, resource-rich neighborhoods, like those for SoHo/NoHo and Gowanus now undergoing the public review and approval process, maximize affordable housing development and prevent displacement.
I know New Yorkers think we are the best at everything. But Covid-19 has taught all of us that this is not the time to beat our chest and say “We got this.” It is instead time to learn and respond.
New York City should look at Vermont’s housing response to Covid-19 for inspiration. That state enacted one of the country’s most comprehensive eviction moratoriums, provided rent relief for landlords, expanded its existing motel voucher program to rehouse the unhoused from shelters to motels, and instituted a moratorium on utility shut-offs. In the Maple State, investments in housing are critical for addressing the pandemic (current) but have also been seen as catalytic in responding to persistent health inequities in the state.
There is a Nigerian proverb that says, “In the moment of crisis, the wise build bridges, and the foolish build dams.” New York City can start this process of building by announcing its commitment to leading a “Housing as a Human Right” agenda.
A former assistant commissioner for health equity at New York City’s Department of Health and Mental Hygiene, Javier Lopez is the founder and principal of Real Time Response, Inc. a BIPOC-led consultancy specializing in management, organizational strategy, and executive coaching.
Photo by: wikimedia
As New York City rebuilds from the pandemic, the next mayor and City Council will need to consider a comprehensive policy agenda that recognizes the historical collective traumas that Black and Latinx communities face. This article is part of an Urban Matters series bringing together perspectives on forming such a community healing agenda and building long-term strength, vitality, and wholeness for Black and Latinx New Yorkers.