Affordable Housing Finance

SPECIAL FOCUS

AMERICA’S HOUSING IMBALANCE

Housing as the Best Cure

AFFORDABLE HOUSING FINANCE • September 2008

BY DONNA KIMURA

The best medicine for many illnesses is often an affordable home, according to Dr. Megan Sandel. She would know. A pediatrician at the Boston Medical Center, she has seen the links between good affordable housing and health.

Sandel first noticed the connection in her first year of residency. “A group of doctors in my class and I talked about what we were seeing among patients. We were talking about medical issues, but they really derived from housing,” she said.

Sandel provided some of the most compelling testimony last year when the House Committee on Financial Services held a hearing on the National Affordable Housing Trust Fund. Joining the usual housing advocates in support of the trust fund, she served as a powerful new messenger.

Q: You’ve said “a safe, decent, affordable home is like a vaccine.” Please explain.

A: Often when we talk about housing, we talk about the negative effects. If you are homeless, you are more likely to potentially have mental health issues, or if you are paying too much for heat, you may have malnutrition issues. Often, we don’t talk enough about how there are health benefits if you provide safe, decent affordable housing.

For me, a safe decent home is like a vaccine because it can keep kids healthier. Like a vaccine, it prevents disease.

Q: You have looked at the relationship between housing and health. Share with us a few of your findings.

A: I came to housing from a housing-quality perspective, particularly the conditions that make kids sick.

There’s an excellent study out of the hospital where I work, Boston Medical Center, and C-SNAP, the Children’s Sentinel Nutrition Assessment Program. The study shows that if you are a child in a food-insecure household that is eligible for a housing subsidy and doesn’t get one, you are twice as likely to have stunted growth. You are very vulnerable. If you receive a housing subsidy, you are less likely to be stunted or have malnutrition that affects the ability for children to grow. Clearly, a housing subsidy is a powerful benefit. It literally grows bodies and brains.

Q: Share with us a first-hand experience of working with a homeless family or a family in need of affordable housing.

A: I was taking care of a child I met when her family was homeless. She was about 9 months old, and she was suffering from a failure to thrive. She wasn’t growing well. She was homeless and had difficulty getting enough food. She also had some swallowing problems. I put her in a rehab hospital, but when she returned back to a homeless shelter she began to lose weight again.

Through some help from lawyers, we were able to get her family priority status and into public housing. When she got her own apartment, she started to do well.

Despite thousands of dollars of tests and medial attention, that was the thing that made her better. She’s going to kindergarten in the fall. She’s reading. In many ways, this is a save. Getting her that housing really saved her.

Q: If the production of affordable housing falls further behind, what would be the impact?

A: We talk about the budget tradeoffs that families are forced to make. For families, the three biggest bills are food, energy, and housing. In a world where food and energy costs are up 20 to 25 percent just in the last year, you can imagine the squeeze on many families. The demand outstrips supply now. We will only see more families in those tight budget tradeoffs. At my hospital, we refer to it as the perfect storm. Families are going to have to figure out how to weather the perfect storm of rising fuel costs, rising food costs, and the lack of affordable housing.

We also refer to young kids as the canary in the coalmine. They are the most vulnerable, the ones to see the most effects. Typically, they will have trouble with growth or developmental issues. There’s no doubt we are already seeing huge increases.

Boston Medical Center has a food pantry on site. We have traditionally given out 50,000 bags of food a year. We are already seeing a 20 percent increase at the monthly level this year.

When people are hungry, food is an important intervention. By giving them a bag of food, it is putting a Band-Aid on the problem. You are not treating the underlying issue. For many, the underlying issue is a lack of affordable housing.

Q: What can the affordable housing industry do to improve the health of residents?

A: First and foremost, as a doctor I want to thank the affordable housing industry for providing what I call the best intervention—a safe, decent affordable home. It’s a prescription that I can’t write on my own. I say thank you to the industry. Many are focusing on what they can do to improve the quality of housing. That’s really important for reducing pest infestation, getting rid of mold, providing families with safe homes.

I would encourage working together with medical and public health officials to increase the affordable housing supply through efforts like the Affordable Housing Trust Fund that will not be tied to the whims of the budget, [and allocating] more set-aside funds that can be relied on to create and sustain affordable housing.