How High Housing Costs Impact Health Care

Enterprise Community Partners Inc. surveyed renters across the nation and found that more than half have delayed medical attention because they were forced to choose between paying their rent and paying their health care.
Laurel Blatchford, President, Enterprise Community Partners Inc. Image courtesy of Enterprise Community Partners Inc. 

A new national report commissioned by Enterprise Community Partners Inc. as part of its Health Begins with Home initiative found that more than half of renters surveyed delayed health care because they couldn’t afford it.

The survey revealed renters who are paying a high percentage of their income for housing—particularly those paying more than 50 percent of their monthly income—routinely make difficult decisions between paying for rent and health care. Of that group, 83 percent said they prioritize paying rent before anything else, compared with 1 percent that prioritized healthcare costs. Nearly half (45 percent) said they have not followed a treatment plan from health care professionals because they couldn’t afford it, compared with 34 percent of all renter respondents. And nearly one-third (31 percent) of severely rent-burdened respondents said they delayed a routine checkup because they couldn’t afford it, compared to 23 percent of all renter respondents.

“No one should have to choose between paying rent and paying for health care,” Laurel Blatchford, Enterprise president, said in a prepared statement. “And yet, thousands of people make that difficult trade-off every day. That’s wrong. By working closely with health care organizations, we’re creating ways for renters to afford the health care they need.”

The survey, the first to examine renters’ ability to afford health care and medical professionals’ perception of those challenges, also found that every one of the 500 medical professionals surveyed reported at least some of their patients have expressed concerns about affordable housing. Thirty-one percent of those professionals reported at least a quarter of their patients said they had concerns about affordable housing. That number increased to 42 percent among those professionals who treat a large number of lower-income patients. Forty-four percent stated they believe a lack of accessible health care hinders the health of lower-income communities.

“This survey is the first to carefully document how these challenges affect both renters and medical professionals, and will help both the health and the housing sectors collaborate to save lives. This interdependence between health and housing must remain at the forefront of our collective health equity efforts,” Brian Rahmer, vice president, Health and Housing, at Enterprise, said in prepared remarks.

Partnerships and Collaboration are Key

The Columbia, Md.-based national affordable housing non-profit is working with a broad group of partners to promote health as a top priority in the development and preservation of affordable housing and is deploying $250 million over five years to spur more collaboration through the Health Begins at Home initiative launched in January. One of the groups Enterprise is working with is Kaiser Permanente, which had announced a joint Enterprise-managed $85 million Housing for Health fund in the San Francisco Bay Area and a $100 million national loan fund.

Rahmer told Multi-Housing News the survey results, while not surprising to those who work in the affordable housing and public health sectors, “give us some additional points to stand on as we bring on new partners in different regions across the country.”

He said the survey findings would help Enterprise and others “shine more light on that connection” between housing and health outcomes.

“The accumulation of data and information continues to grow about people’s health outcomes and the trajectory of those outcomes, particularly in the United States,” Rahmer said in an interview, shortly after the survey was released Wednesday morning.

The survey also showed that respondents had lower satisfaction rates with housing-related factors that impact their health, including adequate access to outdoor spaces (47 percent), lack of exposure to indoor toxins (48 percent) and air quality (38 percent).

Mental Health Impacts   

Brian Rahmer, Vice President, Health and Housing, Enterprise Community Partners Inc. Image courtesy of Enterprise Community Partners Inc. 

Perhaps just as important, Rahmer noted information gleaned from the report also revealed how the economic burdens of high housing costs impact renters’ mental health too, causing ongoing stress.

“This chronic stress has a wearing effect, a weathering effect,” he said. “That is not good for anybody.”

Inadequate medical care and family stress also affects children’s health and well being, starting with their readiness for kindergarten and elementary school and continuing to have a dramatic impact throughout their lives, commented Rahmer.

Providing quality, stable and safe affordable housing is key to creating better outcomes, he stated.

When Enterprise introduced its Health Begins with Home Initiative in January, executives said it would focus on four key areas: conducting research; awarding grants to nonprofits to fund housing and community health programs and increase partnerships between housing and healthcare organizations; providing technical assistance and connecting capital from healthcare organizations, institutional investors and social impact funds to develop and preserve affordable, healthy and well-designed homes.

Rahmer told MHN Enterprise will be putting that $250 million to work with current partners but will also be working on creating new partnerships to invest in capital programs, health equity funds and loan funds.