Housing is crucial for good health, but it's not just what's inside the home that matters.
Since 2018, I can often be found at our local community center—listening, learning, sharing, and strategizing around the table with community members on ways to push the city for more affordable housing and prevent the displacement of neighborhood residents.
Dorchester Not for Sale in the annual neighborhood parade, June 2019 (Credit: Cristina Eduardo, Dorchester Post)
Credit: Dorchester Not for Sale, @DotNot4Sale
Credit: Dorchester Not for Sale, @DotNot4Sale
Inequality and evictions<p>The impacts of institutional racism prevail today in Boston, where the median <a href="http://apps.bostonglobe.com/spotlight/boston-racism-image-reality/series/image/?p1=Spotlight_Race_FooterNav&p1=Article_Inline_Text_Link" target="_blank">net worth</a> of Black households is $8 compared to $247,500 for White households.</p><p>Dorchester, one of Boston's neighborhoods that experienced <a href="https://www.dotnews.com/columns/2019/how-redlining-dashed-dreams-hurt-neighborhoods#:~:text=in%20Dorchester.,were%20then%2Dpredominantly%20white%20neighborhoods." target="_blank">redlining</a>, is home to<a href="http://www.bostonplans.org/getattachment/8349ada7-6cc4-4d0a-a5d8-d2fb966ea4fe" target="_blank"> a diverse and working class community</a> with the highest number of immigrants and non-English speaking households in the city. About two-thirds of residents are renters, and the average income for workers is $41,000 a year. The increase in large-scale and luxury housing developments throughout the city and the speculation of development have driven up housing prices and living costs. As of right now, the <a href="https://www.bostonmagazine.com/property/dorchester-neighborhood-guide/" target="_blank">average rent</a> in Dorchester is $2,894 per month—or $34,728 a year.</p><p>Residents are feeling the harm. </p><p>One DotNot4Sale member shared with me (translated from Vietnamese): <em>I like this neighborhood; I like living here. Low-income people here live very peacefully—don't disturb anyone and keep the city safe. If there is new development, there will be no benefits for people like me—there will be more traffic, rents will increase, and more displacement. These developments will only benefit landlords, developers, and those that have a lot of money.</em></p><p>Many residents have already left. Since 2011, the number of <a href="https://static1.squarespace.com/static/5c61afb8c2ff616264f89964/t/5cba6802e4966ba200a5d899/1555720195217/2014-Housing-Court-Report-Summary.pdf" target="_blank">eviction cases filed to the Boston Housing Court</a> was approximately 5,200 per year, or 14 cases per day. While alarming, we know this number is likely underestimated. Many families that are displaced don't make it to housing court out of fear of retaliation from their landlord and/or lack of legal support.</p>
“I get sick a lot”<p>In areas of high housing demand, several community residents have shared that landlords have ignored making housing repairs in order to drive tenants out more quickly and resell or re-lease the property for a higher profit.</p> <p>As one DotNot4Sale member shared with me (translated from Vietnamese): <em>I call my landlord to fix the hole above my sink, but he ignores me. Water is leaking from the upstairs kitchen into mine. There is no heat in the main living areas of my apartment. I get sick a lot.</em></p> <p>Imagine you are a single parent of two children, making $40,000 a year and paying $1,600 a month, or almost 50% of your income a year, for a one-bedroom. With the surge of luxury condos in your neighborhood, there are few places that you could afford in decent enough condition for your children. </p> <p>You worry about making ends meet in the short-term, like paying for groceries, daycare, utilities, and bus passes. </p> <p>Your apartment is owned by a slum lord who has not repaired the holes in the walls, the broken windows, nor addressed the mold and pest issues that were there when you moved in. Money-strapped and not able to take time off work, you cannot make these repairs on your own. </p> <p>You are afraid to ask your landlord to fix these issues for fear they may increase the rent or kick you out and find other tenants. </p> <p>These unaffordable and unsafe living conditions are causing you stress and taking a toll on yours and your children's mental and physical health- their ability to focus in school, your ability to sleep.</p> <p>You and your children live in constant fear of having to move again. </p> <p>Now take a deep breath. </p> <p>While this may be an exercise for you, millions of Americans are in this situation right now.</p>
What has been done?<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjkzMTU4NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0OTA1MjU3Mn0.PsUoOv3x7SrW1BVVf-f2Dq8ouRxpi1yzZwSs9x9qLOA/img.jpg?width=980" id="eb202" class="rm-shortcode" data-rm-shortcode-id="e5d2440331e2b4ba26c2c3f1f5f2c81b" data-rm-shortcode-name="rebelmouse-image" alt="Dorchester art" data-width="750" data-height="937" />
"Community in Action: A Mural for Vietnamese Folks in Fields Corner", Fields Corner, Dorchester, MA. (Credit: Ngoc-Tran Vu )<p>Currently, there are three main forms of <a href="https://www.hud.gov/topics/rental_assistance" target="_blank">governmental housing assistance</a> in the U.S.: public housing, income-restricted units, and Section 8 housing vouchers. All are for low-income tenants and require a home inspection, but they vary in the type of housing, who manages them, and levels of income eligibility. Public housing is government-owned, while income-restricted units are privately-owned and rent is subsidized by the government. The Section 8 voucher program leaves it up to tenants to find their own housing that accepts vouchers.</p> <p>These programs are not enough. Some even fail to adequately protect residents. In 2017, only <a href="https://www.jchs.harvard.edu/sites/default/files/Harvard_JCHS_State_of_the_Nations_Housing_2019.pdf" target="_blank">37 percent</a> of the 11 million extremely low-income renters received housing assistance. The average <a href="https://archinect.com/news/article/150043421/a-look-at-the-alarmingly-long-wait-times-for-section-8-housing-in-u-s-cities" target="_blank">national wait time</a> to get a Section 8 voucher is two years. Many landlords also <a href="https://www.huduser.gov/portal/portal/sites/default/files/pdf/ExecSumm-Landlord-Acceptance-of-Housing-Choice-Vouchers.pdf" target="_blank">discriminate against renters with vouchers</a>. </p><p>Even with vouchers, renters are facing evictions. For example, in <a href="https://www.boston.gov/sites/default/files/file/2020/01/An_Action_Plan_to_Reduce_Evictions_in_Boston_%28report%29%20200109_1.pdf" target="_blank">Boston</a>, we still see many eviction cases involving tenants on housing assistance.</p> <p>As a country, we need a progressive affordable housing agenda and comprehensive policies and programs in both public and private sectors to make a dent in the housing crisis. </p> <p>In recent years, nonprofit, philanthropic and religious organizations, and hospitals have stepped up. Some case examples include:</p>
Going beyond physical hazards<p>It is time for the environmental health community to also step up and be at the forefront of addressing housing insecurity.</p><p>Traditional environmental health research and funding priorities have focused on making our buildings more energy efficient and/or specific physical or chemical hazards, such as air pollution, lead, pesticides, and mold.</p><p>While this research has led to major public health improvements—such as more stringent housing codes, a ban on lead-based paint, integrated pest management, and lowering energy costs—it can fall short of addressing the root causes of why low-income and communities of color continue to face homelessness, higher housing-cost burden, and poor housing conditions.</p>
"Homes For All" Assembly, Dorchester, MA, June 2019. (Credit: Lisa Thompson)<p>If we focus on just the physical and chemical hazards of the indoor environment, how can we adequately address and prevent the root causes of health problems associated with housing insecurity?</p><p>I believe that housing is a human right. My experience in the community has pushed me to expand my definition of environmental health and contextualize my research in the existing affordable housing crisis. It has shown me that housing insecurity is a core environmental public health issue.</p><p>Housing insecurity increases a household's risk of living in <a href="https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/housing-instability" target="_blank">unsafe and unhealthy conditions</a>, their risk of being displaced, which in turn perpetuates the cycle of housing insecurity. <a href="http://www.mapc.org/wp-content/uploads/2017/11/HIA_Just_Cause_final.pdf" target="_blank">Households experiencing evictions</a> report worse self-reported health, higher stress levels, depression, and material hardship. They also have a greater risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318323/pdf/AJPH.2014.301945.pdf" target="_blank">suicide</a>. For children, evictions and having to move frequently can lead to poor mental and physical health, disrupted schooling, and a <a href="https://scholar.harvard.edu/files/hendren/files/mto_paper.pdf" target="_blank">lower earning potential</a> in future jobs.</p><p>Knowing this, I cannot turn a blind eye to the urgency of the affordable housing crisis in my own community and across the country. I cannot turn a blind eye to my neighbors who are being evicted and/or moving away because they cannot afford rent.</p>