It is difficult to overstate the impact that access to safe, stable housing has on health. Housing is one of the most well-researched social determinants of health and, among other social factors, influences the health of families across the nation.[1] Those who pay too much for housing, live in inadequate conditions, or lack access to housing altogether are at an increased risk of experiencing negative health outcomes, such as mental health conditions, poor maternal and infant health, chronic disease, and premature death. This is especially evident for those experiencing homelessness, who are often forced to utilize costly emergency room services to meet their elevated health needs.[2] While the complexity of addressing housing as a social determinant of health remains apparent, innovation in the financing and implementation of housing and health services has led to meaningful solutions in communities around the country. Additionally, affordable housing created by the Housing Credit helps ensure that fewer people experience the negative health impacts of all degrees of housing instability – an umbrella term encompassing a range of circumstances from doubling up with another family to experiencing unsheltered homelessness.[3]
Affordable housing developments financed using the Housing Credit often do more than provide a physical home for people seeking safe, stable housing – they often incorporate services to meet the holistic health and social needs of residents. One way the Housing Credit does this is through its use as a financing tool for permanent supportive housing developments, which serve the complex needs of people experiencing chronic homelessness and are critical components of homeless services systems across the nation. Affordable housing produced using the Housing Credit supports the health of all residents regardless of the degree of housing instability they have experienced. Research shows that frequent involuntary moving places people at increased risk of experiencing severe mental distress; experiencing homelessness or housing instability at all elevates the risk of adverse birth outcomes; and children who lack access to safe, stable housing have higher risks of chronic disease.[4] [5] [6] When affordable homes are developed in communities, these negative health outcomes can be mitigated for residents.
Increasing investments in affordable housing can improve the health of rural, urban, and suburban communities alike. Hospitals and health systems recognize this and continue to invest millions of dollars in Housing Credit developments to improve the health of the communities they serve and reduce health care spending.[7][8] As the nation continues to face an unprecedented affordable housing crisis, increasing resources for the Housing Credit is critical to mitigating the health impacts of housing instability on our communities.
The AHTCC continues to advocate to strengthen and expand the Housing Credit in the 118th Congress. The Affordable Housing Credit Improvement Act (H.R.3238/S.1557) would increase resources to supply nearly 2 million more affordable homes than otherwise possible. It also contains several provisions that would provide “basis boosts,” or additional Housing Credit equity, to certain types of developments if needed for financial feasibility. For developments providing supportive and health services, these additional resources are often needed.
The Housing Credit’s impact on population health emphasizes the importance of strengthening and expanding the program at a time when the need for housing is greater than ever. To learn more about the connection between housing and health, see the AHTCC’s new Health and Housing one page resource by clicking the link below.
[1] “Housing And Health: An Overview Of The Literature, ” Health Affairs Health Policy Brief, June 7, 2018. DOI: 10.1377/hpb20180313.396577
[2] Feldman BJ, Calogero CG, Elsayed KS, Abbasi OZ, Enyart J, Friel TJ, Abunamous YH, Dusza SW, Greenberg MR. Prevalence of Homelessness in the Emergency Department Setting. West J Emerg Med. 2017 Apr;18(3):366-372. doi: 10.5811/westjem.2017.1.33054. Epub 2017 Mar 7. PMID: 28435486; PMCID: PMC5391885.
[3] Frederick, T.J., Chwalek, M., Hughes, J., Karabanow, J., & Kidd, S. (2014). How stable is stable? Defining and measuring housing stability. Journal of Community Psychology, 42(8), 964–979. doi: 10.1002/jcop.21665
[4] St Martin BS, Spiegel AM, Sie L, Leonard SA, Seidman D, Girsen AI, Shaw GM, El-Sayed YY. Homelessness in pregnancy: perinatal outcomes. J Perinatol. 2021 Dec;41(12):2742-2748. doi: 10.1038/s41372-021-01187-3. Epub 2021 Aug 17. PMID: 34404925; PMCID: PMC9507167.
[5] Chen KL, Wisk LE, Nuckols TK, et al. Association of Cost-Driven Residential Moves With Health-Related Outcomes Among California Renters. JAMA Netw Open. 2023;6(3):e232990. doi:10.1001/jamanetworkopen.2023.2990
[6] Busacker, A., Kasehagen, L. Association of Residential Mobility with Child Health: An Analysis of the 2007 National Survey of Children’s Health. Matern Child Health J 16 (Suppl 1), 78–87 (2012). https://doi.org/10.1007/s10995-012-0997-8
[7] Velasquez DE, Sandel M. Housing Investment Strategies by Healthcare Payers and Systems: Paving the Road Ahead. J Gen Intern Med. 2023 Apr;38(5):1296-1298. doi: 10.1007/s11606-022-08009-y. Epub 2023 Jan 10. PMID: 36627524; PMCID: PMC9831367.
[8] Enterprise Community Partners. Housing in Health: Exploring the Intersection Between Housing and Health Care. 2016. https://www.enterprisecommunity.org/sites/default/files/2021-06/Health%20in%20Housing%20Exploring%20the%20Intersection%20between%20Housing%20and%20Healthcare.pdf
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