Nurse Leaders are Housing Advocates

Housing affordability has markedly worsened over the past 15 years, and more American families than ever are struggling to pay the rent and make ends meet. For those at the bottom of the income scale, the problem is most acute: roughly 10 million households with extremely low incomes are either homeless or pay unaffordable rents that force many of them to make untenable choices between paying the rent and paying for other necessities like nutritious food, transportation, and medications.

Out of over 3,000 counties in the nation, there are only 28 counties where a full-time worker earning minimum wage can afford a modest one-bedroom rental home, and there are none where they can afford a modest two-bedroom. A full-time worker earning the federal minimum wage of $7.25 needs to work approximately 127 hours per week for all 52 weeks of the year to afford a two-bedroom rental home at the national average fair market rent. The number of households with “worst-case housing needs” – that is, households with very low incomes that either pay more than half their income for rent or live in severely substandard housing and receive no aid – has risen by 66% since 2001. Nationally, there are only 37 affordable and available homes for every 100 extremely low-income renter households. According to a recent public opinion poll, 60% of Americans say housing affordability is a “serious problem” where they live, which is up an astounding 21 points since 2016 — and that includes majorities in cities, suburbs, and rural areas.

Decades of research demonstrate that stable, affordable homes are linked with better health outcomes across the lifespan (e.g., fewer child hospitalizations, ER visits, developmental delays, asthma cases, and mental health challenges; more preventative care visits; lower Medicaid costs; etc.). Unfortunately, today, millions of people experience housing circumstances that damage their health and, consequently, increase unnecessary health care utilization. These experiences include living in dilapidated/unsafe homes; residential instability such as “couch surfing” or doubling-up with family or friends; struggling to pay rent; living in housing that is located in low-opportunity neighborhoods that lack resources, job opportunities, and strong schools; and experiencing eviction and homelessness. Children’s HealthWatch found that unstable housing among families with children will cost the nation $111 billion in avoidable health-related expenditures over the next 10 years.

Every day, nurse leaders see first-hand the harmful health impacts of unstable and unaffordable housing on their patients. Therefore, they are uniquely positioned to weigh in on housing policy issues and join in the advocacy to make homes affordable for low-income people. Housing advocates and healthcare professionals must recognize that their fates are intertwined and work shoulder-to-shoulder to advance research-based housing solutions. That is exactly what we are doing through Opportunity Starts at Home, an unprecedented campaign that is bringing together leading organizations from housing, health, education, civil rights, food security, criminal justice, and more to urge Congress to finally tackle the housing crisis. The National Nurse-Led Care Consortium certainly understands that good housing is good health, and we are so pleased that it participates on the campaign’s Roundtable alongside so many other powerhouse organizations.

Failures of both public policy and the private market have contributed to today’s crisis, and many public and private institutions must play a role in developing solutions. But among these institutions, the federal government is key. Federal investments in affordable housing have been declining for decades and, today, only one in four households eligible for federal housing assistance receive it due to chronic underfunding. Without action from the federal government, quality affordable homes for the lowest-income people cannot be consistently built, operated, and maintained. The Opportunity Starts at Home campaign has outlined a set of federal policy strategies that are necessary to solve the affordable housing crisis facing America’s poorest households:

While the situation is dire, there is reason to be encouraged. In recent months, several of these ambitious policy concepts have been introduced in congressional legislation. In several cases, such as the Eviction Crisis Act and the Family Stability and Opportunity Vouchers Act, the legislation has been bipartisan, which demonstrates the growing recognition in both parties that housing is inextricably linked to nearly every measure of having a quality life. The political momentum is growing, and powerful new constituencies are forming to ensure that everyone has access to stable, affordable homes.