Why housing should be a top healthcare priority for healthcare systems, payers: RWJF

RWJF recently released the annual culture of health message linking housing to health and equity. (Pixabay)

Housing should be a top priority for healthcare systems and communities across the U.S., according to the 2019 annual Robert Wood Johnson Foundation (RWJF) report.

RWJF recently released the annual culture of health message linking housing to health and equity, stating that “In a Culture of Health, everyone has an opportunity to reside in an affordable, safe, stable home and a neighborhood that fosters well being.” 

It points specifically to the links between health and housing in four primary areas: neighborhood, affordability, quality and stability. For instance, the report says:

  • There has been a 45% increase in extremely poor neighborhoods from 2010 to 2014.
  • Nearly 50% of all U.S. households pay more than half of their annual income to housing.
  • 4.6 million people living with asthma in the U.S. can attribute the disease to dampness and mold exposures in their homes.
  • 6,300 people are evicted from their homes daily.

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According to the report, the location where people live impacts their health through factors such as the quality of local schools and the availability of jobs, as well as their access to nutritious foods and green spaces to play and exercise.

In addition, if individuals are spending too much of their income on mortgage or rent, they have less money for transportation to work and school, medical care, utilities and food. In recent years, housing costs have outpaced local incomes in many communities. And today, as many as 38.1 million households in the U.S. are spending more than 30% of their annual income on housing.

“As more people experience the burden of severe housing costs, there are more children in poverty, more people who don’t know where their next meal will come from, and more people in poor health,” the report stated.

The median wealth of U.S. households in 2016 was $171,000 for white people, $64,700 for those of other or multiple race, $20,600 for Hispanics or Latinos, and $17,100 for black people.

Therefore, the RWJF encourages communities to address their most pressing needs as a key foundation of a culture of health.

According to the RWJF’s 2019 County Health Rankings & Roadmaps (CHR&R), among those who own their home, the burden of housing costs has actually decreased in the past 10 years. However, there is no improvement in the rates among renters, and housing cost burden remains substantially higher among renters than owners.

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The rate of severe housing cost burden among counties in the U.S. ranges from 1% to 31% of household incomes. On average, severe housing cost burden is highest in large urban metro counties and lowest in rural counties.

“Across these communities, with every increase in the share of households severely housing cost burdened, there are greater barriers to living long and well, such as more people who are food insecure, more children in poverty, and more people reporting poor or fair health,” the report stated.

Across counties, every 10% increase in the share of households with a cost burden is equal to 29,000 more children that live in poverty, 86,000 more people that are food insecure, and 84,000 more people that are in fair or poor health.

In addition, the CHR&R shows that more segregated counties have higher rates of severe cost burdens for both white and black households. However, black residents face greater barriers to opportunity and healthcare than white residents. Nearly one in four black households spend more than half their income on housing.