The Affordable City: Strategies for Putting Housing within Reach (And Keeping It There)

McKinlay, Anna

doi:10.1080/08111146.2021.1938934

Cited by 3 publications

(7 citation statements)

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“…19 To generate findings relevant to the health care sector, we considered associations of health outcomes with (1) health system-partnered, structural primary prevention to promote housing affordability and stability as contextual conditions associated with the distribution of population risk 20 and (2) targeted primary prevention to help at-risk households remain stably and affordably housed via short-term (<1 year) and long-term (Ն1 year) interventions. Key intervention examples, informed by the public health and urban planning literature, 11,12,21,22 are defined in Table 1.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…In the US, such subsidies are mostly sponsored by the Department of Housing and Urban Development and can be tenant based (ie, vouchers) or unit based (ie, public or multifamily housing) (Table 1). 11,12,21,22 Four of 15 articles comparing long-term subsidies with usual care described the Family Options Study (FOS), a multisite, multigroup trial that randomized families in emergency shelters to receive longterm subsidies or usual care (rapid rehousing and transitional housing study groups were excluded from this review). [32][33][34][35] No studies evaluated health associations of rent stabilization.…”

Section: Targeted Primary Prevention: Long-term Strategiesmentioning

confidence: 99%

“…Finally, our study highlights openings for research on the health outcomes of policies guaranteeing legal counsel to low-income tenants in eviction courts, stabilizing rents, and reforming municipal zoning. 22…”

Section: Jama Network Open | Public Healthmentioning

confidence: 99%

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Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

et al. 2022

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ImportanceHousing insecurity—that is, difficulty with housing affordability and stability—is prevalent and results in increased risk for both homelessness and poor health. However, whether interventions that prevent housing insecurity upstream of homelessness improve health remains uncertain.ObjectiveTo review evidence characterizing associations of primary prevention strategies for housing insecurity with adult physical health, mental health, health-related behaviors, health care use, and health care access.Evidence ReviewPairs of independent reviewers systematically searched PubMed, Web of Science, EconLit, and the Social Interventions Research and Evaluation Network for quantitative studies published from 2005 to 2021 that evaluated interventions intended to directly improve housing affordability and/or stability either by supporting at-risk households (targeted primary prevention) or by enhancing community-level housing supply and affordability in partnership with the health sector (structural primary prevention). Risk of bias was appraised using validated tools, and the evidence was synthesized using modified Grading of Recommendations Assessment, Development, and Evaluation criteria.FindingsA total of 26 articles describing 3 randomized trials and 20 observational studies (16 longitudinal designs and 4 cross-sectional quasi–waiting list control designs) were included. Existing interventions have focused primarily on mitigating housing insecurity for the most vulnerable individuals rather than preventing housing insecurity outright. Moderate-certainty evidence was found that eviction moratoriums were associated with reduced COVID-19 cases and deaths. Certainty of evidence was low or very low for health associations of other targeted primary prevention interventions, including emergency rent assistance, legal assistance with waiting list priority for public housing, long-term rent subsidies, and homeownership assistance. No studies evaluated health system–partnered structural primary prevention strategies.Conclusions and RelevanceThis systematic review found mixed and mostly low-certainty evidence that interventions that promote housing affordability and stability were associated with improved adult health outcomes. Existing interventions may need to be paired with other efforts to address the structural determinants of health. As health care systems and insurers respond to increasing opportunities to invest in housing as a determinant of health, further research is needed to clarify where along the housing insecurity pathway interventions should focus for the most effective and equitable health impact.

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Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Targeted Primary Prevention: Long-term Strategiesmentioning

confidence: 99%

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Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

et al. 2022

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“…[58][59][60] Laws to guarantee that renters with low income have access to lawyers and are protected against unjust evictions, landlord harassment, and source-of-income discrimination could also help prevent displacement. 59,61 Such efforts likely need to be accompanied by policies to enhance income stability, such as through expanded access to unemployment insurance, the earned income tax credit, 62 and the child tax credit. 63 In addition, improved access to health care, such as…”

Section: Discussionmentioning

confidence: 99%

“…Potential approaches to mitigate excessive housing costs include emergency rental assistance, longer-term rent subsidies, rent stabilization policies, affordable housing development incentives, social housing models, and revisions to zoning constraints on housing supply (especially if implemented in high-opportunity exclusionary neighborhoods and in conjunction with increased tenant protections). [58][59][60] Laws to guarantee that renters with low income have access to lawyers and are protected against unjust evictions, landlord harassment, and source-of-income discrimination could also help prevent displacement. 59,61 Such efforts likely need to be accompanied by policies to enhance income stability, such as through expanded access to unemployment insurance, the earned income tax credit, 62 and the child tax credit.…”

Section: Discussionmentioning

confidence: 99%

Association of Cost-Driven Residential Moves With Health-Related Outcomes Among California Renters

et al. 2023

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ImportanceUnaffordable housing is associated with adverse health-related outcomes, but little is known about the associations between moving due to unaffordable housing and health-related outcomes.ObjectiveTo characterize the association of recent cost-driven residential moves with health-related outcomes.Design, Setting, and ParticipantsThis cross-sectional study involved a weighted multivariable regression analysis of California Health Interview Survey data from January 1, 2011, to December 31, 2017. A population-based sample of 52 646 adult renters and other nonhomeowners in California were included. Data were analyzed from March 2, 2021, to January 6, 2023.ExposureCost-driven moves in the past 3 years relative to no move and to non–cost-driven moves.Main Outcomes and MeasuresFive outcomes were assessed: psychological distress (low, moderate, or severe, as categorized by the 6-item Kessler Psychological Distress Scale), emergency department [ED] visits in the past year (any vs none), preventive care visits in the past year (any vs none), general health (poor or fair vs good, very good, or excellent), and walking for leisure in the past 7 days (in minutes).ResultsAmong 52 646 adult renters and other nonhomeowners, 50.3% were female, 85.2% were younger than 60 years, 45.3% were Hispanic, and 55.1% had income lower than 200% of the federal poverty level. Overall, 8.9% of renters reported making a recent cost-driven move, with higher prevalence among Hispanic (9.9%) and non-Hispanic Black (11.3%) renters compared with non-Hispanic White renters (7.2%). In multivariable models, compared with not moving, cost-driven moving was associated with a 4.2 (95% CI, 2.6-5.7) percentage point higher probability of experiencing moderate psychological distress; a 3.2 (95% CI, 1.9-4.5) percentage point higher probability of experiencing severe psychological distress; a 2.5 (95% CI, 0-4.9) percentage point higher probability of ED visits; a 5.1 (95% CI, 1.6-8.6) percentage point lower probability of having preventive care visits; a 3.7 (95% CI, 1.2-6.2) percentage point lower probability of having good, very good, or excellent general health; and 16.8 (95% CI, 6.9-26.6) fewer minutes of walking for leisure. General health, psychological distress, and walking for leisure were also worse with cost-driven moves relative to non–cost-driven moves, with a 3.2 (95% CI, 1.7-4.7) percentage point higher probability of experiencing moderate psychological distress; a 2.5 (95% CI, 1.2-3.9) percentage point higher probability of experiencing severe psychological distress; a 4.6 (95% CI, 2.1-7.2) percentage point lower probability of having good, very good, or excellent general health; and 13.0 (95% CI, 4.0-21.9) fewer minutes of walking for leisure. However, the incidence of preventive care and ED visits did not differ between those who made cost-driven vs non–cost-driven moves.Conclusions and RelevanceIn this study, cost-driven moves were associated with adverse health-related outcomes relative to not moving and to non–cost-driven moves. These findings suggest that policies to improve housing affordability, prevent displacement, and increase access to health care for groups vulnerable to cost-driven moves may have the potential to improve population health equity, especially during the current national housing affordability crisis.

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Urban densification considering sense of place and environmental justice – or not

Shahrad

2024

Acta Universitatis Agriculturae Sueciae

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Rapid urbanisation is a major transformative driving force of continuous and contested changes in socio-spatial urban structure. Such changes can lead to sociospatial injustice especially when they involve marginalised populations. Managing rapid urbanisation thus requires goal-oriented inclusive urban planning and policies to secure sustainable development. The theory of environmental justice, as distributive justice, recognition justice, and procedural justice, has been developed in urban planning literature. The experience of justice – or the lack thereof – also affects sense of place, which in relation to urban change includes how people experience, relate to and create meaning in urban spaces. This thesis aims to deepen the understanding of the interplay between sense of place and issues of environmental justice in relation to urban densification in Swedish stigmatised neighbourhoods. The thesis is based on a case study with multiple sampling techniques: document analysis, visual discourse analysis, photo elicitation, and interviews with residents, planners and stakeholders. The first paper focuses on the role of media in creating discourses concerning e.g. safety and security and how these discourses impact the creation of socio-spatial injustice. The second paper concentrates on the impact of an urban densification project to shed light on issues of environmental justice and public participation. In the third paper, the concept of sense of densification is introduced, and it examines how densification projects affect residents’ lives, both in outcomes and as processes. The thesis concludes that the combined knowledge about sense of place and environmental justice research from an urban planning standpoint can provide a greater understanding of how to motivate residents to act collectively to improve their community and participate in local planning processes. This is important for planners and stakeholders, in order to strengthen a sustainable planning and design process by understanding and honouring the value of local meanings of places.

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The Affordable City: Strategies for Putting Housing within Reach (And Keeping It There)

Cited by 3 publications

References 0 publications

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

Association of Cost-Driven Residential Moves With Health-Related Outcomes Among California Renters

Urban densification considering sense of place and environmental justice – or not

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