Opinion: Why Housing is Key to Addressing the Public Health Crisis of Racism

 ‘Expanding supportive and affordable housing for homeless families in New York City would immediately save lives and dramatically improve health outcomes for families of color in the long-term.’

Last month’s resolution from the New York City Board of Health declaring racism a public health crisis was a welcome commitment by the city to address the vast racial disparities that were only heightened by the COVID-19 pandemic, but one word was conspicuously absent from the declaration and subsequent coverage—homelessness.

While the resolution notes housing as one of several determinants of health that will be assessed, the issue of homelessness specifically must have a central role in this conversation.  In order to fully address racial disparities in healthcare, expanding permanent housing for homeless individuals and families must be a central plank of the Health Department’s response. 

Homelessness, and family homelessness in particular, is itself an indictment of racial disparities in the city. Families of color account for a disproportionate share of homeless families here. And in the city’s domestic violence shelter system, in which families account for 88 percent of the population, 89 percent of the residents are Black or Latinx.

Homelessness and housing insecurity are strongly correlated with negative physical and mental health outcomes. Even before the pandemic, rent-burdened individuals and households were often forced to make ends meet by rolling back spending on other essentials like food, healthcare, and clothing.

Further, we know that housing insecurity in the critical early childhood years has devastating, life-long consequences. In a 2005 study looking at nutritional outcomes for children in low-income families, children under 3 whose families did not receive housing subsidies were more than twice as likely to experience growth delays compared to children in households receiving housing subsidies.

And of course, housing insecurity leads to tremendous stress, anxiety, and depression, which can trigger onset of a number of physical ailments and create extensive barriers to children’s development and learning. A 2016 study from the U.S. Department of Housing and Urban Development (HUD) found that children ages 5 to 17 living in homes with permanent housing subsidies were 25 percent less likely to have school conduct problems than children in families that accessed emergency shelter and other programs that did not provide them with a place to live.

For homeless families, the health risks are compounded by the fact that domestic violence is the number one cause of family homelessness in New York City. With domestic violence accounting for 1 in 6 murders in the city, having safe, permanent housing is truly a life-or-death issue. 

Permanent housing is an essential tool to arrest the intersecting cycles of homelessness and health disparities in communities of color. The success story of the Department of Health’s own supportive housing initiatives, which provide housing assistance paired with on-site support services for homeless New Yorkers living with mental illness, HIV/AIDS, and other serious health problems, speaks to the positive impacts of housing on individual and community health outcomes.

As the Department of Health begins to assess structural racism across a range of health determinants and make subsequent policy and funding recommendations, we remind them that housing is healthcare, especially in communities of color that have been targeted by systemic injustices. Expanding supportive and affordable housing for homeless families in New York City would immediately save lives and dramatically improve health outcomes for families of color in the long-term. 

Nicole Branca is the executive director of New Destiny Housing, a New York City nonprofit founded in 1994 to provide housing and services to one of the City’s most vulnerable homeless populations—victims of domestic violence and their children.