‘Living in despair and hopelessness’: Lack of affordable housing can put people’s health at risk

KHN
—
When Louana Joseph’s son had a seizure with an upper respiratory infection in July, she abandoned the apartment her family had called home for nearly three years.
She suspected that the gray and brown stains spreading through the apartment were mold and had caused her son’s illness. Mold can trigger and exacerbate lung diseases such as asthma and has been linked to upper respiratory conditions.
But leaving the two-bedroom apartment in Atlanta meant giving up a home that rented for less than $1,000 a month, a price increasingly hard to find even in the poorest neighborhoods of the country.
« I’m looking everywhere, » said Joseph, who is 33. « At the moment, I can’t afford it. »
Since then, Joseph, his 3-year-old son and his granddaughter have been on the verge of homelessness. They oscillated between sleeping in an extended-stay motel and staying with relatives, not knowing when they could find permanent housing.
A national affordable housing crisis has taken a toll on the lives of low-income families, like Joseph’s, who are on the brink. Their struggle to stay ahead of homelessness is often invisible.
Rents have skyrocketed during the pandemic, worsening an already severe shortage of available housing in most US cities. The result will be growing numbers of people stuck in substandard housing, often with environmental hazards that put them at increased risk for asthma, lead poisoning and other medical conditions, according to academic researchers and health advocates. low income people. The stress level of these residents is increased by the difficulties they face in paying their rent.
« People are living in hopelessness and despair, » said Ma’ta Crawford, a member of the Human Relations Commission for Greenville County, South Carolina, who works with families living in extended-stay motels.
According to the Federal Office for Disease Prevention and Health Promotion, housing instability – such as having difficulty paying rent, living in overcrowded conditions or moving frequently – can have negative consequences on health.
In addition to potentially facing environmental risks, people struggling with housing insecurity postpone doctor visits, cannot afford food, and struggle to manage chronic illnesses.
The loss of a home can also trigger a mental health crisis. The suicide rate doubled from 2005 to 2010, when foreclosures, including those on rental properties, were historically high, according to a 2014 analysis, published in the American Journal of Public Health, that looked at 16 states.
Rents jumped 18% nationally between the first three months of 2021 and the start of 2022. And there is no county in the country where a minimum-wage worker could afford a rental home of two bedrooms, according to an August report from National Low Income Housing. Coalition. Across the country, only 36 affordable homes are available for 100 people in need, forcing many families to cobble together temporary shelter.
« It’s a vicious circle, » Crawford said. « Every motel here has a school bus stop. »
In the Southeast, evictions are more common than anywhere else in the country, according to an analysis published this year in the Proceedings of the National Academy of Sciences.
Georgia has 19 evictions per 100 renter households, according to data from Princeton University’s Eviction Lab. There are 23 evictions per 100 renter households in South Carolina, and Virginia has 15 evictions per 100 renter households. The national rate is about eight evictions per 100.
Despite President Joe Biden’s promises to address the affordable housing shortage, researchers and activists say inflation — and Democratic deals — are only making the threat to health worse.
Last year, the Biden administration included billions of dollars in the ‘Build Back Better’ bill to increase the number of housing choice vouchers – a hard-to-get benefit that helps low-income people pay their rent. Under the voucher program, also known as Section 8, recipients spend 30% of their income on rent and the federal government pays the rest. Currently, only 1 in 4 people who qualify receive the vouchers due to limited funding.
But lawmakers scrapped the provision that increased the number of vouchers, a compromise to pass the bill known as the Cut Inflation Act.
About 2.3 million households rely on the program to pay their rent. Joseph applied years ago but has yet to receive any benefits.
The day before his son was born in September 2019, Joseph moved into an apartment complex in Southwest Atlanta, one of the city’s poorest neighborhoods. A year later, she upgraded to a two-bedroom unit in the same complex that cost $861 a month, far less than the typical metro Atlanta apartment.
Recently, Joseph returned to the two-bedroom apartment to show KHN his condition. What appeared to be mold surfaced after a pipe burst and the air conditioning failed, but the resort owners did little to address the situation, Joseph said.
The gray and brown stains were on his mattress, couch, and other plastic-wrapped belongings. They covered boxes of diapers stacked on dressers, an Elmo doll lying face down, a toddler’s sneaker and pink onesies.

A property manager for Seven Courts Apartments, where Joseph lived, declined to comment when reached by phone. The management company did not respond to repeated requests for comment.
A few months after leaving the apartment, Joseph and his two children moved in with his sister in Orlando, Florida, with what they had left: a car and clothes.
A lack of affordable housing can force low-income families, like Joseph’s, to bear health risks such as mold, vermin and water leaks, said Alex Schwartz, housing expert at the New School of New York. And the trauma of evictions, foreclosures and homelessness can harm physical and mental well-being, Schwartz said.
For five years, Nancy Painter lived in an apartment in Greenville, South Carolina that had mold and cracks in the walls, ceiling and floor. Sometimes, Painter said, she carried a box of two-handed bug killer to ward off cockroaches.
An autoimmune disease makes her extremely susceptible to colds and other respiratory illnesses, and arthritis causes crippling pain. But she stayed in the apartment until last year because the rent was $325 a month. The painter moved only after the landlord planned to renovate the accommodation and raise the rent.
Painter, 64, now lives on about $1,100 in Social Security disability benefits. Her poor health prevented her from continuing to work in a fast food restaurant. She pays over 70% of her income for a room in a house she shares with other adults who cannot find affordable housing.
These renters should not spend more than 30% of their income on housing so that they have enough left over for other basic needs, according to federal government formulas. « My options are so slim, » Painter said. « All I want is a little place where I can have a garden. »

The problems are particularly acute among black people and other groups who have been denied good jobs, mortgages and opportunities well beyond the Jim Crow era, said Dr. Steven Woolf, professor of health at the Population and Health Equity at Virginia Commonwealth University. Life expectancy can vary by 15 to 20 years between different neighborhoods in the same city, he said.
Federal lawmakers routinely fail to prioritize the nearly 50-year-old housing voucher program, said Kirk McClure, professor emeritus of urban planning at the University of Kansas. The United States offers less housing assistance than other wealthy countries, such as the United Kingdom and Australia, where voucher programs allow anyone who meets the income requirements to get help , McClure said.
« In the richest society in the world, we could give every poor person a voucher, » McClure said. « It doesn’t require anything magical. »
Officials with the US Department of Housing and Urban Development, which oversees the voucher program, did not respond when asked if the administration plans to push for more housing vouchers.
Joseph’s prospects of finding another home remain dim as rents soar.
The fair market rent – which is determined each year by the federal government based on the size, type and location of a rental home – for a two-bedroom home in the United States has reached $1,194 per month, on average, in 2019, according to a 2020 report by the National Low Income Housing Coalition. A family of four living on a poverty-level income could afford $644 a month, according to the report. In the city of Atlanta, the median rent for apartments of all sizes is $2,200, up nearly 30% since January 2021, according to real estate site Zillow.
Lack of childcare services prevented Joseph from looking for full-time jobs. But she can’t qualify for a state child care assistance program because she doesn’t have a full-time job, and another state program she’s researched isn’t available. won’t open until next year.
She sued the owner of the Seven Courts Apartments in Small Claims Court in June for $5,219 to compensate her for the ruined property and the rent she already paid. A settlement could allow him to move into a new house.
« I’m stuck because I have nowhere to go, » Joseph said.
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