Build public housing in the suburbs to improve population health

The Eastview Terrace II property in New Haven, operated by the New Haven Housing Authority.

The COVID-19 pandemic has brought renewed attention to a pre-existing and severe affordable rental housing crisis throughout the U.S. and here in Connecticut. Prior to the pandemic, there was no state in this country where a full-time minimum wage job was sufficient to affordably rent a one- bedroom apartment. Here in Connecticut, nearly two full-time jobs were needed.

Danya Keene and Andrew Fenelon

Today, after 11 months of pandemic related economic recession, renters are increasingly falling behind on rent. Furthermore, this affordable housing crisis has undoubtedly contributed to America’s COVID-19 epidemic, highlighting that adequate and affordable housing is critical to the health of our communities.

This session of the Connecticut General Assembly includes multiple bills to address this housing crisis. One of them, Senate Bill 487, seeks to expand the jurisdiction of housing authorities to build affordable housing in “higher opportunity” areas within a 15 mile radius. The bill recognizes that public housing (federally subsidized housing operated by local housing authorities) is an important tool to address the affordable housing crisis and to expand housing choices for low-income renters.

In addition to providing affordable housing, a growing body of research, including our own, indicates that such public housing may also have important health benefits.

By setting rent at 30% of a tenant’s income, both public housing and other rental subsidies such as tenant-based rental vouchers, can provide affordable housing that is not available in the private market. Indeed, data from the Urban Institute point to federally funded rental assistance as the only source of affordable housing available to extremely low-income renters in many U.S. counties. As a result, this resource is in high demand and short supply. Waiting lists average two years nationally and 27 months here in Connecticut.

In New Haven, these lists contain more than 10,000 individuals and are often closed to new applicants. In our recent interviews with some of these applicants, many describe rental assistance as a sort of golden ticket. And those who ultimately secure this coveted resource often describe significant health benefits.

With more affordable rents, they can redirect scarce resources to other health-related expenses. With access to stable housing, they can establish healthy routines and prioritize health-related goals. Many describe a significant reduction in stress. One participant describes receiving rental assistance as akin to having a truck lifted off of him.

While both public housing and rental vouchers can provide these health benefits, an emerging body of evidence suggests that health benefits are larger for public housing residents than voucher recipients. For instance, adults who live in public housing are less likely to report that they are in poor health or experience psychological distress than those waiting to enter public housing. Likewise, children who live in public housing experience fewer mental health symptoms and are less likely to visit the emergency room for an asthma attack than those waiting to enter. Similar health benefits are not seen for those receiving rental vouchers, even though vouchers may provide recipients with more housing and neighborhood choice.

One reason for this increased benefit of public housing may be the added stability that it affords. Public housing is particularly effective at reducing housing cost burden and preventing eviction, and public housing residents on average have longer tenancy that voucher holders. The community level stability that public housing supports can create a foundation for health promoting social support networks. Indeed, research finds that public housing residents report greater access to local social ties than their voucher assisted counterparts.

To be sure, public housing isn’t perfect. After decades of underfunding, much of the nation’s public housing stock is in desperate need of resources to facilitate upgrades and maintenance. However, it is important to note that the conditions in public housing are often superior to those that tenants can access in the private market and tenants’ organizations within public housing developments can provide residents with unique opportunities to collectively advocate for their housing needs.

Additionally, public housing is often criticized for its role in furthering racial and economic segregation. Indeed, public housing developments are disproportionately located in higher poverty urban areas. Perhaps for these reasons, attempts to address housing segregation have emphasized an expansion of voucher-based assistance that can provide access to opportunity areas and tenant choice.

However, public housing can also be a tool to address these age-old, noxious and health harming patterns of residential segregation. Public housing can anchor affordable housing in gentrifying urban areas and suburban communities that would otherwise be difficult for low-income tenants to access. But, efforts to diversify the location of public and other subsidized housing, nationally and here in Connecticut, are often stymied by exclusionary zoning regulations and local resistance.

Senate Bill 487 begins to address these issues. Coupled with challenges to exclusionary zoning this proposed legislation can help remediate significant shortages of affordable housing in high opportunity areas.  While 32% of rental units in New Haven are affordable, all but two of its surrounding communities meet the Connecticut statute’s requirement of at least 10% affordable units. In many of these towns, less than 5% of units are affordable. Allowing the Housing Authority of New Haven (HANH) to build affordable housing in these areas would expand housing options for low-income renters, particularly for those who may face challenges finding a unit to lease with a rental voucher. This affordable housing is a critical resource for current residents of surrounding towns who make up close to one-third of HANH’s current waiting lists.

While an expansion of public housing alone is unlikely to address the current affordable rental crisis, Senate Bill 487 recognizes the important role it can play and echoes some recent calls for a national expansion of public housing programs. Our research suggests that in addition to expanding housing choice for low-income households, these investments in public housing are likely to have important benefits for population health.

Danya E. Keene is an Associate Professor of Social Behavioral Sciences at the Yale School of Public Health.  Andrew Fenelon is an Assistant Professor of Public Policy and Sociology at Pennsylvania State University.

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