Creating change in housing and health equity

Today’s guest blogger is Kelly Hilovsky, a policy fellow with APHA and the Bloomberg American Health Initiative, focused on advancing policy solutions to key public health issues. She shares about the new Center for Public Health Policy report, “Creating the Healthiest Nation: Housing and Health Equity.” 

While this year's tragic events have elevated the public discourse on racism in this country, discriminatory acts have been the status quo in America since its founding. In particular, structural racism in housing has been endemic since the mid-twentieth century. This history is the foundation of APHA’s Center for Public Health Policy report, “Creating the Healthiest Nation: Housing and Health Equity.” 

As the report outlines, practices such as exclusionary zoning, redlining and discriminatory mortgage lending practices are just a few of the efforts used to keep people of color restricted from certain neighborhoods. Despite some of these practices being deemed illegal, the long-term consequences are still felt by low-income communities and people of color. 

Communities that were previously redlined continue to have less access to job opportunities, limited transportation options, poor-quality housing and limited basic services. A primary consequence of discrimination in housing is an enduring wealth gap between communities of color and those of whites.  Lack of wealth has definite health and social consequences for a family and, over time, these impacts compound. 

Homeownership is a key contributor to the wealth disparity. Observing gaps in homeownership rates among racial groups is another way to identify the economic impacts of racism in housing. This APHA report highlights a review by the Urban Institute of homeownership data from 1976 to 2016, which demonstrated the substantial and consistent gap between white communities and those of color. 

As a result of these gaps caused by racism in housing policies, health disparities such as those exposed by the COVID-19 pandemic are a blatant reminder of structural racism in our society. This report looks at housing affordability, quality, safety, neighborhoods and stability and measures the impact of housing factors on the health of various groups. 

While understanding the history and the economic and health impacts is crucial to engaging in work in this space, knowledge alone will not lead to change. Sharing best practices, tools and guidelines for public health professionals to engage in policy and advocacy, cross-sector partnerships and community engagement and education, is a primary goal of this report. 

For example, one way to increase homeownership rates in low income communities is through establishing Community Land Trusts. The report highlights this approach and a tool to get practitioners started. Another example comes from Boston, MA, in which community members developed a Healthy Neighborhoods Equity Fund to support low-income populations in increasing affordability of quality housing options. 

Advancing racial equity through housing – or any other factor – involves acknowledging, as individuals, the position of either privilege or resilience in the face of racism. To authentically participate in this work requires humble attitudes, courage and open ears so that, ultimately, the voices of impacted communities lead the way in shaping equitable solutions. 

Broad disenfranchisement and overt racism led to the current state of housing and health inequity, and only an inclusive, ethnically diverse, community-led approach will deliver just and desirable solutions. Thankfully, public health practitioners are well positioned to serve as a dynamic link between communities and decisionmakers. We hope that this report empowers you to stand with communities to advance equity through housing.  

To learn more about the topic, register now for the next webinar in APHA’s Advancing Racial Equity series, “Housing is a Human Right,” held on Oct. 14 from 12:30-2 pm EDT.