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Housing Affordability and Health Leadership

Over the past two decades, BARHII has been supporting Bay Area public health departments to address health inequities through a range of initiatives towards healthy communities.  The critical housing challenges has demanded BARHII engagement in an assessment of the issue and the development of broad public health partnerships for strategic solutions.  Reflecting upon the scale, strength and knowledge of the health sector, we are exploring regional housing solutions driven by the leadership of our health agencies and hospitals.


Housing Affordability

In February of 2016, BARHII dove deep into the housing issues that are re-shaping the Bay Area. We created BARHII’s first brief on Housing Affordability, Displacement, and Health with the goal of shaping a housing future that promotes health equity.

When housing costs require increasingly high percentages of a family’s budget, families are forced to make choices that create unhealthy tradeoffs. Families forego medical care or prescriptions, live in substandard or overcrowded housing, or move farther and farther away from the Bay Area’s job centers. More information about all the mental and physical health impacts of long commutes, financial stress, and displacement are included in the brief itself.

3Ps: Protection, Preservation, Production

Access to affordable housing is a task for which the Bay Area has reached consensus across many sectors.  We need to Protect people from displacement, Preserve existing affordable housing and Produce new affordable housing. Towards that end, we have many organizations, public agencies and developers working to address this task in a wide range of efforts ranging from new designs of accessory dwelling units, new local housing bonds, policies to retain existing affordability, or developers’ contributions to navigation centers.  Most residents are willing to contribute to the solutions.  However, the solutions are not matching the scale of the problem in the Bay Area. We need $400 million per year to Protect 300,000 low-income renter households; $500 million per year to preserve 65,000 affordable homes; and $1.4 billion per year to build 13,00 new homes. (Ending the Bay Area Housing Crisis, CASA)

Health Sector Strengths

The health sector has a grounded approach to the housing insecurity impact on health and is well positioned to elevate housing solutions at a regional scale given its current strengths:

                  +Economic Strength: Professional services, Transportation and Utilities, and Health and Education are the largest sectors in our regional economy. Out of those three Health and Education have shown the highest and most consistent job growth.

                  +Comprehensive Development Approach: The health sector has already engaged in various initiatives that recognizes housing solutions as an essential dimension of healthy communities.

                  +Equity Practices: The health sector has developed a matured platform on social equity that addresses the needs of our disadvantage communities and the challenges of our middle-income families.

                  +Knowledge and Innovation: The health sector has been a source of new knowledge that has high social value. This knowledge is now being expanded to incorporate access to housing as part of the Whole Care Person pilots or the Corporate Supportive Housing.

Building Collective Housing Solutions

As a coalition of Public Health Departments, BARHII has been building a foundation based on community participation in regional housing policies, communities of practice for integrating housing and health, trainings on race and equity trainings, and implementation of anchor institution strategies.  Through these learning processes and partnerships, BARHII has identified three potential complementary paths to contribute to healthy living conditions, institutional practices, and social equity at a regional scale:

Economic Opportunity

Policies and other interventions that increase economic opportunity can help improve physical and economic health:

Raise Wages: Increase minimum wages to meet costs of living, and pass living wage ordinances which set wage and benefit standards for government employees and firms that benefit from public contracts, subsidies, or resources.

Improve Working Conditions: Pass policies that include paid family leave for new parents, paid sick time beyond the state mandated three days, minimum standards for fair hiring, benefits, predictable scheduling, protection for organizing, and health and safe working conditions, with a focus on low-wage workers. Increase enforcement of labor laws – in particular to prevent wage theft, where workers do not receive the full wages and benefits they are legally entitled to.

Expand Education and Pathways to Middle Wage Jobs: Ensure equal access to quality childcare, preschool, and education through high school graduation for all students. Advocate for school disciplinary policies, such as restorative justice, that aim to keep students in school vs. suspensions and expulsions, in order to increase graduation rates and decrease the educational achievement gap. Support industries that provide middle-wage jobs by increasing coordination among jurisdictions and by zoning to preserve industrial zones in appropriate locations. Support lower-skill workers to fill middle-wage jobs through educational agencies and job-specific training programs. Ensure that projects relying on public land, facilities, or dollars provide training programs, living wages, and local/targeted hiring.

Remove Barriers to Employment: Pass policies that provide access to job opportunities for people who have been formerly incarcerated in order to reduce recidivism, improve incomes, and benefit overall community health. “Banning the Box” so past convictions are not included on job applications and targeted job training and placement programs can all help formerly incarcerated people, low-income communities, communities of color, and youth in foster-care systems find employment.

Help Families Keep What They Earn and Build Wealth: Limit predatory financial services (like check cashing, payday loans, and sub-prime loans) and provide lower income areas increased access to more stable, community-owned, financial services with low interest rates, public ownership, and/or local reinvestment. Support financial coaching and other programs to help families escape debt and build wealth.

Invest in Communities and Local Business: Provide adequate funding for health promoting public services and amenities like schools, libraries, health care, transportation, social safety-net programs, housing, parks, etc., while passing policies to limit displacement in at-risk neighborhoods. Promote small businesses in local planning processes, and identify opportunities and tools for retaining small businesses – such as proactive multi-lingual enforcement, small business coaching, and assistance with long-term leases and code compliance.