Maryland’s Shady Grove Station is just 30 minutes from Union Station on Washington’s Metro Red Line, but when it comes to the health of these communities, the distance is worlds apart.
Residents near Shady Grove can expect to live nine years longer than those living near Union Station. The differences are shaped by many factors, but most have little to do with medical care. In fact, health and longevity are more strongly influenced by social, economic and physical environments than by what happens in the doctor’s office.
Housing and Urban Development Secretary Shaun Donovan underscored the critical role of neighborhoods and communities in health — and the need for action — at a recent conference in Detroit, noting, “You can predict the life expectancy of a child by the ZIP code in which they grow up. This is wrong.”
Policymakers have spent years improving access to care. And rightly so. But we now know that the social, economic and physical factors that shape our everyday lives are even more important. A critical factor is affordable housing in good neighborhoods. As the research group Children’s HealthWatch aptly states: “A safe, decent, affordable home is like a vaccine — it literally keeps children healthy.”
HUD’s Moving to Opportunity demonstration project, intended to uncover the effects of neighborhoods on a range of measures, recently published findings in the New England Journal of Medicine showing that poor women who were given the opportunity to live in safer, more affluent neighborhoods had lower rates of obesity, diabetes, psychological distress and major depression than those who did not take that opportunity. This suggests long-term investments in improving neighborhoods may help improve the health outcomes of poor families.
Another study, conducted in Southwest Baltimore and published in Health Affairs, found that racial differences in hypertension, diabetes and obesity among women either vanished or substantially narrowed when researchers took into account where people lived. Neighborhoods matter.
For years, the health and affordable housing sectors have worked on parallel but separate tracks to improve the lives of low-income people. The affordable housing sector focused on improving neighborhoods suffering from poverty, overcrowded housing and high unemployment. The health sector focused on combating poor health, including high rates of obesity, asthma and chronic disease. We worked side by side in many of the same neighborhoods but have rarely collaborated.
If real progress is to be made toward improving the health and quality of life for millions of Americans, this must change. The evidence makes one point clear: Housing policy is health policy. The affordable housing and health sectors must stop working in silos and work together. We have begun this journey.
Until recently, HUD did not focus on the potential health benefits of its programs, but it now considers improved health outcomes a strategic goal and is creating initiatives designed to transform social, economic and environmental conditions. Signature efforts such as the Neighborhood Revitalization Initiative, Choice Neighborhoods, and Strong Cities, Strong Communities seek to improve places where people live.
Others, including the Housing Choice Voucher and Housing Opportunities for Persons with AIDS, create links between housing, quality educational opportunities and jobs, safer streets and quality health care to help ensure that housing inoculates as many people as possible.
Terri Henderson, 6, center, whose mother is El Salvador, attends a rally with members of Congress at Union Station's Columbus Circle to announce the Restore Opportunity, Strengthen, and Improve the Economy (ROSIE) Act on July 29, 2014. The legislation provides incentives for government contractors to pay a living wage and other benefits that would help low-income workers.