This is the time of year to reflect on our blessings and think about the struggles of those who are less fortunate. As housing costs in Miami-Dade continue to skyrocket, too many around us are unable to find quality, affordable housing. It’s a challenge that exposes them to health hazards and limits their ability to meet other basic needs, including access to healthcare.
While most of us can imagine the immediate trauma of not having a place to call home, it can be harder to grasp the long-term consequences of homelessness and housing instability on people’s lives. Yet these issues affect a large number of families and children in Miami-Dade County, where close to 9,000 students in the school district are homeless or considered “unstably housed.” It’s a number that has increased by 50 percent in just two years. In fact, some estimate the number could be as high as 14,000. This has serious implications not just for academic achievement and cognitive development, but for the health of these children., too.
The evidence linking access to housing and health is clear. According the American Hospital Association, socioeconomic factors and physical environment, including income, housing quality, exposure to pollution, together determine half of health outcomes. When a household spends more than a half of its income on rent, the family will struggle to afford groceries, prescription medicines and trips to the doctor.
As the Miami Herald recently reported, 62.7 percent of renters Miami-Dade and Broward counties and in West Palm Beach spend more than a third of their income on rent, while 33.8 percent of renters in the region spend more than half of their income on rent. According to FIU’s 2016 Properity Feasibility Study, the average household in Miami-Dade County pays 62 percent of its income on housing and transportation, one of the highest ratios in the country.
In real life, this looks like a mother being forced to choose between paying rent or buying food for her children. It looks like a man with diabetes who waits to fill his insulin prescription because it is the end of the month and his rent is due.
People experiencing homelessness are most likely to go to the emergency room for expensive treatment for serious conditions. Homelessness and housing insecurity prevent people from seeking preventive care or managing chronic conditions.These housing challenges result in increased demand for emergency healthcare services that overburden our healthcare system and lead to higher costs for everyone.
In order to bring down these costs and improve health outcomes across the community, elected officials must invest in innovative strategies that address the root causes of poor health, particularly for the more than 500,000 households that either are living in poverty or are at risk of poverty.
Preserving and rehabilitating subsidized and low-cost, market-rate housing is a strategy that recognizes how health outcomes are directly correlated to housing security. Indeed, according to data from the University of Florida’s Shimberg Center for Housing Studies, Miami-Dade has lost 8,000 of units of subsidized housing in the past 15 years.
Looking forward, 95 properties in our county — like Stanley Axlrod Towers on Brickell Avenue in Miami — are slated to lose their subsidy contracts in the next 10 years. If those contracts are not renewed and the building maintenance not kept up, then about 9,700 households stand to have nowhere else locally that they can afford to live. Protecting and expanding the housing supply for people of the most modest means ultimately saves spending on social services later down the line. Furthermore, housing is an efficient platform for providing healthcare services that can save costs and improve health outcomes for residents.
Too often, we imagine homelessness and housing insecurity as a one-dimensional problem, which keeps us from reaching a systemic understanding and finding solutions for the problem. Breaking down entrenched silos is not easy, but we need policymakers, city leaders, and health and housing providers to work together to address housing as a social determinant of health. Once we have that understanding, we can work together on the solutions that reduce healthcare costs and make people healthier and our communities more livable.
Annie Lord is executive director at Miami Homes for All. Janisse Schoepp, Ph.D., is vice president of operations and strategy at the Health Foundation of South Florida. Sara Haas, is senior program director at Enterprise Community Partners, Inc.