Paying the Rent vs. Paying for Health Care: A Painful Tradeoff

The recently released annual County Health Rankings emphasizes the undeniable connection between health and housing: How long and how well we live depends on where we live.
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Severe housing cost burden affects health and is linked to barriers to living long and well, according to the 2019 County Health Rankings, an annual report that ranks the health of counties nationwide. The ranking was recently released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute and measures vital health factors to provide a snapshot of how where we live, work and play influences our health. 

This year’s report highlights an important factor that shapes how well and how long we live: Secure, affordable housing. The ranking’s key findings provide a closer look into housing as an element that affects people’s health. For example, in Oregon, Hood River and Wasco counties are in the top five as the most expensive. People earning the minimum wage would have to work nearly two full-time jobs in order to afford rent and basic needs. When they prioritize paying rent or mortgage, it’s harder and harder for people to afford going to the doctor, cover other bills or pay for transportation to go to work or school. In time, this leads to serious health problems.  

The report helps to compare and establish if health in a county has improved. According to Thrive Allen County, a rural health advocacy organization in Kansas, Allen County moved up from #84 to #38 in a year. The county now has a new critical-access hospital and the organization helped reduce the county’s uninsured rate from 21 percent to just 9 percent. All these and other measures led to the dramatic jump of 46 places. 

On a national level, the report found that 11 percent of households spend more than 50 percent of their income on housing, which makes them severely cost burdened. The issue is particularly poignant in more segregated counties. In general, African Americans face greater barriers to opportunity and health than Caucasians. Nearly a quarter of African American households spend more than half of their income on housing. 

By analyzing the data, factors of concern in a certain area can be identified and changes can be made. The 2019 County Health Rankings suggests several solutions to improve residents’ health. Communities need to be more inclusive and connected, with policies and programs more responsive to the specific needs of each county. 

Immediate action needed

An encouraging finding of the ranking was that among those who own a home, housing cost burden has decreased in the past decade, but there has been no improvement in the rates among renters. To a large extent, housing cost burden continues to be higher among renters than owners, particularly for households with low incomes. 

Another national survey on the connection between homes and health from Enterprise Community Partners found that almost all lower-income renters consider rent their most important bill.

“When incomes don’t rise as fast as rents, expensive housing pushes more people into poverty and poor people die earlier than wealthy people, particularly in this country. At the same time, health care in America is becoming a wedge of inequality. Without interventions to decouple income and wealth from health, or to reduce inequalities in income and wealth, we might see the emergence of a 21st century health-poverty trap and the further widening and hardening of socioeconomic inequalities in health,” Enterprise Community Partners Vice President of Health and Housing Brian Rahmer told Multi-Housing News.