This post was originally published on the Bill of Health blog of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. 

Florence Nightingale once said, “The connection between health and the dwellings of the population is one of the most important that exists” — a statement that is as true today as it was at the turn of the 20th century. A decent dwelling and diverse communities, where there is access to transportation, good schools, shops, parks, socioeconomic mixture, social capital and collective efficacy, and economic opportunity are all features necessary for both a high-level and equitable distribution of well-being.

The promise of healthy housing and communities, however, falls short in the United States. Much of the housing in the U.S. is expensive, unsafe, and inadequate in supply.

Almost one-in-three households in the US is cost-burdened, which is defined as paying more than 30 percent of annual income for housing. About half of those are severely cost-burdened, paying more than half of annual income for shelter, according to the Harvard University Joint Center for Housing Studies.

In 2018, the CDC estimated that 4 million households still had children exposed to high levels of lead, and reported elevated-blood lead levels in some 500,000 children in 2016. Prolonged residential exposure to radon is the second leading cause of lung cancer in the U.S.

According to an analysis conducted by the National Low Income Housing Coalition, there are only 35 affordable and available units for every 100 extremely low-income renter households. That translates to a shortage of more than 7.2 million units.

There are many explanations for the housing crisis in the U.S. One is that the law has never stopped promoting and preserving segregation, nor has it adequately supported the supply of enough affordable, safe, and stable housing for all citizens.

In a new article in the Northeastern University Law Review, we outline 23 legal mechanisms, or levers, that may impact health equity in housing in the U.S., and review the evidence base evaluating each lever. These levers include the Low-Income Housing Tax Credit program, nuisance property ordinances, inclusionary zoning laws, rent control, fair housing protections, and minimum wage laws, among others....

Read the full post on the Bill of Health blog


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