Where you live has a profound impact on health outcomes; and Connecticut has some of the nation’s most compelling racial and ethnic inequities when it comes to health outcomes. Designing, planning and developing healthy, affordable homes in neighborhoods of opportunity can dramatically improve health outcomes and promote health equity – all while boosting the local economy.
But improving the built environment requires strategic collaborations between local public health departments, town planners, municipal leaders and other town officials, state policymakers and agencies, developers and builders, and citizens. As such, The Connecticut Association of Directors of Health (CADH) released a policy brief called Housing and Planning for a Healthy Public: Land use, Design and Development to Promote Health Equity.
The brief makes the case for formalizing planning-public health partnerships at the municipal level in Connecticut and identifies potential policy strategies that such partnerships could advance to improve conditions to promote health and health equity – one community at a time.
- Local health departments should routinely analyze and share data on the relationship between community conditions and health outcomes and assess health impacts of development;
- Municipal planners should review health data to inform development, integrate public health and health equity-related goals into town plans of conservation and development, update zoning language and adopt ordinances to promote health, engage in transit-oriented development and revitalize urban cores;
- Municipal leaders should formalize public health-planning partnerships by requiring and facilitating quarterly meetings and, where possible, appointing public health officials to planning and zoning commissions;
- Housing and community advocacy organizations should engage local health departments, municipal planners, and elected officials to support them in advancing policy solutions that create more affordable housing in neighborhoods of opportunity; and
- Transportation officials should engage in development-oriented transit.
The policy brief also focuses on transforming the built environment and community design—including the creation of more affordable housing in neighborhoods of opportunity to promote health.
Racial residential segregation and concentrated poverty are tied in direct and indirect ways to adverse health outcomes. A long history of segregation-promoting policies has disproportionately concentrated people of color in unhealthy places. For example, five of Connecticut’s largest cities, where the majority of Connecticut’s racial and ethnic minorities are concentrated, account for 42.1% of all asthma hospitalizations statewide.
Lack of access to affordable housing also affects health and disproportionately impacts minorities. The home ownership rate among White households in Connecticut is 76.5%, compared with 36.9% for households of color. Among the 50 states and Washington D.C., Connecticut ranks 3rd worst in the nation on racially based equity in home ownership.
The affordability of housing is increasingly being recognized as a public health problem. Though through strategic partnerships and thoughtful local policy-making, local public health departments and municipal planners can create communities that grow the local economy, protect the environment, increase social cohesion, and above all, promote equal opportunities for good health for all Connecticut residents.
Aaliyah Stephens is a Health Program Associate at the Connecticut Association of Directors of Health. For questions, please email Alyssa at anorwood <at> cadh <dot> org
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I couldn’t agree more about the importance of housing’s impact on health. Housing has been called a social determinant of health, but I believe (and think you’d agree) that this characterization somewhat understates housing’s role in affecting health. As you rightly note, one’s home and where one lives affect one’s health in so many ways, not to mention the community to which one belongs, the environmental conditions to which one is exposed, what school one attends, what one is able to eat, whether one drives, walks or rides a bike to work, etc. In this way, I think housing is perhaps the most important social determinant of health since it in fact determines all other social determinants of health. Perhaps housing should be known as the FOUNDATION for health.
Nowhere is housing’s role in health more apparent than for people who go without a home for long stretches of time. For people experiencing homelessness, the lack of a home exacerbates complex and chronic health conditions, increases exposure to high-risk behaviors and violence, and prevents connection to coordinated care. As a result, so many people experiencing homelessness wind up on a revolving door of emergency rooms, inpatient hospitalizations, detox programs, not to mention shelters, jails, prisons. My organization, the Corporation for Supportive Housing, is advancing an initiative to provide affordable housing connected to primary and behavioral health care for people with chronic conditions experiencing homelessness who are the highest-cost users of emergency rooms, hospitals, and other crisis health services. You can read more about our initiative athttp://www.csh.org/sif.
Thank you, Richard, for your insights and the pioneering work of your organization. As we also note in our policy brief, homelessness exacerbates any health problem and makes medical treatment and follow-up nearly impossible. Looking forward to exciting possibilities on the horizon of integrating health care services into models for supportive housing!
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