What’s Bad for your Wallet Might Be Bad for your Health: The Negative Health Consequences of Spending Too Much on Housing

by Martha Fedorowicz

In May 2018, Kaiser Permanente, the largest private integrated care system in the US, announced that it would invest $200 million through its Thriving Communities Fund to address the affordable housing crisis in California’s Bay Area. Then in 2019, Kaiser announced that it used the fund to purchase an apartment building in a diverse but quickly gentrifying neighborhood in Oakland with the express purpose of making repairs and upgrades to improve health in the building and to ensure affordability to current residents. If Kaiser wanted to improve health, why wouldn’t it focus solely on housing upgrades, which research shows can produce positive health outcomes (PDF)? Why would it include maintaining affordability in its mandate?

Although we’ve known that poor housing quality can have negative impacts on a person’s health, a growing body of evidence also ties housing unaffordability to negative health outcomes. A few hospitals and health systems are reorienting their investments around this new evidence by funding affordable housing, hoping to improve outcomes of the people and communities they serve.

While Kaiser’s large housing affordability investments may seem far removed from its health focus, it is part of a growing movement by hospitals, health systems, and other anchor institutions to invest in improving social determinants of health—like housing and neighborhoods—by rehabilitating housing and by increasing the supply of below-market rents.

So how does unaffordable housing affect health?

This growing body of evidence linking unaffordable and poor-quality housing and negative health outcomes is shifting how hospitals and health systems see their roles in improving community health. Not only are more hospitals starting to invest in housing, they are also looking beyond housing rehab and upgrades to maintaining affordability for low-income residents.

For more information on what hospitals and health systems can do to invest in housing, stay tuned for the Urban Institute’s forthcoming Health Systems, Hospitals, and Housing Investment Toolkit to be released summer 2019.

Photo by Wondervisuals/Shutterstock