Fix Housing as a Step to Fixing Health, Inequality

Data at the home level can serve to improve health, community service, education, and social mobility--a boon to local economics.

3 MIN READ

Now, here’s a concept.

A new analysis concludes that housing–if it’s accessible to people in a community–is a form of local economic accupuncture.

This study, “Housing as a hub for health, community services, and upward mobility” from Brookings Institution economists Stuart M. Butler and Marcela Cabelo, reaches a conclusion some of us may have suspected all along.

“Housing […] is increasingly understood to be an important determinant of success in life, affecting health, access to education, and the opportunity for upward mobility.

The condition and location of a family’s home can affect such things as respiratory health and “toxic stress” among children, which can have lasting effects on individuals throughout their lives. The availability of good social services, positive social networks, and job opportunities can determine whether a family achieves the American Dream or not.”

No small irony, then, in the fact that in more and more communities, it’s harder and harder to develop, redevelop, or do anything that improves housing in those neighborhoods that need it.

This Wall Street Journal story from staffer Laura Kusisto, who’s on a run of dark-lining-on-silver-clouds stories about the 2018 housing market, addresses the enormous and growing level of difficulty most market-rate home builders and residential developers encounter as they try to add new housing stock to communities in dire need of it. Although Kusisto is not alone in her take on the choke-hold costs, waste, and regulation burdens place on affordable new-home construction, she writes:

A combination of tightened housing regulations, a lack of construction labor and a land shortage in highly prized areas is driving the crisis, according to industry experts.

Even during the deep recession of the mid-1970s and the downturn in the early 2000s, builders put up significantly more homes per U.S. household than they are constructing now, in the ninth year of an economic expansion. Only at the bottom of the 1981 and 1991 economic downturns were per-household construction levels near what they are now, according to Jordan Rappaport, an economist at the Kansas City Fed. He says the only period when the U.S. might have built fewer homes by population was during World War II.

Meanwhile, back to the Brookings study. Its authors propose that policy-makers and planners leverage local housing as levers to improved individual well-being by doing the following:

  • Improve data collection, sharing, and evaluation. Housing-based hubs and other community collaborations are hampered by their capacity to develop and share data, as well as weaknesses in techniques for measuring effectiveness. Improving techniques and processes could help ameliorate these obstacles.
  • Improve budgetary coordination and funding experimentation. Maximizing the return on investments in housing-based initiatives requires flexible budgeting, as well as planning and coordination across agencies. This requires political leadership and policy reforms at the federal, state, city, and local levels.
  • Experiment with different models to organize and manage housing-based services. Establishing and operating multisector programs within a hub puts great responsibilities on the management staff. Depending on the community and the stage of development of the housing hub, different models of management to link home and services might be most appropriate.
  • Strengthen housing-health partnerships. Several hospital systems have undertaken significant housing-health partnerships. Some could be described as responses to financial “sticks,” such as using housing initiatives to comply with community benefit requirements on nonprofit hospitals. Others are “good citizen” philanthropic examples of the hospital assisting its local community. And others are creative new business models. These partnerships could have a number of benefits to the community, and governments should consider how best to expand and support them.


The multiplier effect of housing on local and regional economics has been clear forever. Now, evidence is piling up to show that housing can solve for two of society’s other chronically and ever-more-intensely challenging problems: healthcare and educational costs.

The talk-track of opposition to new housing development is now a broken record–more infrastructure cost, more pollution, traffic, crime, and stress on local services.

The narrative that housing is actually a solution to problems worse than all of those is only just beginning.

About the Author

John McManus

John McManus is an award-winning editorial and digital content director for the Residential Group at Hanley Wood in Washington, DC. In addition to the Builder digital, print, and in-person editorial and programming portfolio, his accountability for the group includes strategic content direction for Affordable Housing Finance, Aquatics International, Big Builder, Custom Home, the Journal of Light Construction, Multifamily Executive, Pool & Spa News, Professional Deck Builder, ProSales, Remodeling, Replacement Contractor, and Tools of the Trade.

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