Opinion: COVID-19 Taught Us That Housing is Healthcare—NYC Must Pass Intro 146

‘As we start to pick up the pieces from the last 15 months, we have the opportunity to build back better. We refuse to go back to normal, because normal was broken. We cannot continue to warehouse people in overcrowded shelters or police people in the streets with no plan to move them into permanent housing.’

There is an old adage that says, “those who fail to learn from the past are doomed to repeat it.”  If the COVID-19 pandemic showed us anything, it is that housing is healthcare, and housing and healthcare are racial justice issues. One look at the statistics and it is clear that these issues are inextricably linked to each other: People of color are disproportionately represented among the homeless population. Black people are 57 percent of the homeless population in New York City, despite being only 23 percent of the overall population.

The age-adjusted mortality rate among single adults in New York City shelters was nearly 50 percent higher than that of the general population. According to Coalition for Homeless, by the end of February 2021, the age-adjusted mortality rate for homeless single adults was 153 percent higher than the rate for white New Yorkers. Studies show that homeless people age at a rate faster than their housed, wealthier peers. This process, known as weathering, can age homeless individuals between 10-20 years beyond their chronological age. Additionally, homeless folks experience levels of chronic stress that affect morbidity and mortality rates, only exacerbated by the events of this year. These health disparities left people who are homeless extremely vulnerable to COVID-19’s worst symptoms, including death. Healthcare providers, who intimately know the effects of this load on their aging patients who experience homelessness, have repeatedly asked if this is how society has chosen to treat our most vulnerable and elderly population, as they witness patients presenting to their emergency rooms and admitted to inpatient wards. 

In the early months of the pandemic, we saw haunting pictures of men packed head to toe, sleeping on cold marble floors in the lobby of homeless shelters because they had nowhere else to go while the city was telling everyone else to stay home and socially distance. This unconscionable treatment of homeless people continued for months as the city dragged its feet on moving people into empty hotels to keep them safe from COVID-19. Healthcare providers witnessed this in real time and called for rapid safe housing as a public health measure early in the pandemic. And now, as if the mayor and his administration have learned nothing from the suffering and painful health disparities between wealthier white communities and communities of color, the mayor is telling people who are homeless that the move back to congregate shelter is imminent while offering no solutions to move people into permanent housing. 

There is another old adage that says, “in every tragedy, there is opportunity.” The loss of human life from COVID-19 has been devastating, and the pandemic has laid bare the inequalities and injustices that are embedded in our society. As we start to pick up the pieces from the last 15 months, we have the opportunity to build back better. We refuse to go back to normal, because normal was broken. We cannot continue to warehouse people in overcrowded shelters or police people in the streets with no plan to move them into permanent housing.

It is for this reason that we call on Mayor De Blasio and Speaker Corey Johnson to pass Intro 146 immediately.  Intro 146 is a bill that would raise the City’s only rental assistance voucher for single adults to Section 8 levels.  Currently, CityFHEPS pays as much as seven hundred dollars below fair market rent, essentially dooming CityFHEPS voucher recipients to permanent homelessness.  Data from New York City’s Department of Social Services shows that only 2% of CityFHEPS voucher recipients are able to secure housing and move out of shelter using their voucher each month. That is an abysmally low rate of success, one that will never end or even put a dent in the crisis of homelessness our city has struggled with for years.  

With $6 billion of federal stimulus money in New York City, now is the time for Mayor De Blasio and Speaker Johnson to pass this bill. StreetEasy reports that the number of vacant apartments in New York City at Section 8 levels increased by 142% in the second half of 2020 compared to 2019. If Intro 146 were passed, it would make approximately 89,000 additional units accessible for folks who are currently stuck in shelters. 

Intro 146 has been sitting in City Council for three years and has 39 co-sponsors. There is no reason to delay and continue to play politics with people’s lives. If we are to learn anything from the mistakes of the past year, the city must invest in permanent affordable housing for low-income and homeless New Yorkers. We cannot and need not wait for another crisis; Mayor De Blasio and Speaker Johnson can save lives by passing Intro 146 immediately. 

Amanda Ramsdell, M.D., is an Internal Medicine Physician at New York Presbyterian in New York City and Assistant Professor of Clinical Medicine at Weill Cornell Medical College. Amy Blumsack is the Director of Organizing & Policy at Neighbors Together, a community-based organization in Ocean-Hill, Brooklyn.