Editorial

It is stating the obvious to say that housing policy intersects with many other policy domains, though the nature and implications of these intersections are fortunately now receiving more attention. This issue of Housing Policy Debate features articles at two particular intersections: housing and health, and housing and transportation.

First, the issue collects five articles that draw broad connections between housing, neighborhoods, and health. In “Racial Disparities in COVID-19 Case Positivity and Social Context,” Lowell et al. (2024) link PCR testing data from the Duke University Health System with local property data to show that housing and neighborhood characteristics explained an important share of the region’s Black-White disparity in COVID-19 infections (while health insurance status was a more important contributor to the disproportionate positivity rate among Hispanic residents). Next, in their article titled “Exchanging Housing Dollars for Health Care Savings,” Brennan et al. (2024) translate the health-housing into dollars and cents, finding that participating in a Housing First program in Massachusetts resulted in more than $10,000 of savings in Medicaid claims per year, which is the cost of almost a year’s worth of rent outside of Boston. What’s more, the authors’ research design helps rule out the idea that these savings are merely a result of “natural stabilization,” i.e., the idea that homeless individuals are likely enrolled in Housing First when their health needs are peaking, and that any kind of support would reduce their healthcare costs.

Another article drawing a direct (monetary) link between health and housing comes from Smith et al. (2024). In “Do publicly funded neighborhood investments impact individual level health-related outcomes?” they present their research tracking residents of two Pittsburgh neighborhoods that received significant commercial and residential investments between 2011 and 2018. Their study suggests that every $1 million invested in neighborhoods generates significant improvements in residents’ food security, sense of safety, and neighborhood satisfaction—but they did not find statistically significant decreases in stress or dietary quality.

Next, in “Does Poor Health Influence Residential Selection?” Osypuk et al. (2024) return to the Moving to Opportunity (MTO) study to pose a new question: how did the health of households participating in the experiment affect their locational outcomes? Osypuk et al. find that households with baseline health challenges (disabilities, child behavioral or learning problems, medical conditions, etc.), if given a Section 8 voucher with no other supports, did not end up in neighborhoods with higher levels of opportunity. Their results suggest that mobility counseling is important for these families, who may have to prioritize proximity to healthcare services, face health-related housing obstacles, or simply have less time or bandwidth for a housing search.

In a final health-housing article, “Health and Healthcare Access Among Adults Living in Affordable Housing,” Gensheimer et al. (2023) investigate how residents of affordable housing financed by the Low Income Housing Tax Credit (LIHTC) compare to similar individuals in non-LIHTC housing in terms of their health. Their findings—that LIHTC residents fare worse across a range of health indicators, but are also more likely to be insured and have a regular source of care—are useful in themselves but also set up an array of questions about the drivers of these outcomes and how LIHTC policy might respond.

The issue closes with two articles at the intersection of housing and transportation. Collishaw et al. (2023), in “Does Subsidized Housing Facilitate More Sustainable Commute Patterns?” take advantage of a unique variable in Canada’s 2016 census that captured residence in subsidized housing. They find that in Toronto, Montreal, and Vancouver, subsidized residents tend to have shorter and less auto-oriented commutes to work than similar individuals in non-subsidized housing, suggesting that subsidized housing is a key source of affordability in amenity-rich and transit-accessible areas in those cities. Next, in “Do Long Commutes Discourage Fertility Intentions Among Young Public Housing Renters in Guangzhou, China?,” Du et al. (2024) explore how the creation of public housing, that is occurring mainly in the suburbs, affect fertility intentions. The authors find that, at least for those who drive themselves to a job in the private sector, long commutes do decrease their likelihood of reporting that they intend to have children within the next five years.

Collectively these articles suggest just how intricately our homes are linked with other fundamental aspects of life, ranging from our how we eat, how safe or how stressed we feel, how we navigate the city, how often we visit the emergency room, and even whether we intend to have children. More deeply understanding these connections is critical to crafting holistic housing policy that promotes wellbeing for individuals, households, and communities.