Amanda Andere, Chief Executive Officer, Funders Together to End Homelessness
Jeanne Fekade-Sellassie, Executive Director, Funders for Housing and Opportunity
Having a stable, safe, and affordable place to call home impacts our ability to be healthy. But because America’s foundational housing policies and systems intentionally excluded Black, Indigenous, and other people of color, far too many people in our nation are at risk of poorer health because a home is out of reach.
We believe housing justice means that everyone has safe, accessible, secure, affordable, and dignified living conditions with equitable access to what one needs to thrive. When we have an affordable place to live, we have money left after paying rent to spend on things like foods and prescriptions. We can confidently plan for the future and we’re not worried about being evicted. When we have agency over the neighborhoods in which we live, we can access vital resources, such as transportation, schools, health institutions, jobs, food, and social services.
Housing is health—and because of historic and persisting systemic inequities, they are both inextricable from racial justice. To end the racialized experience of homelessness and housing insecurity that affects communities of color and to repair its devastating health effects, we must center racial justice in our linked philanthropic approaches to health and housing.
Longstanding Inequities and Racism in Housing
A stable, safe, and affordable home is not accessible to everyone equally in the United States, largely because structural racism has created and exacerbated inequities in housing. For decades, our housing policies meant only some families, mainly white families, could rent or own homes in thriving neighborhoods without fear of displacement. Although many policies like redlining are outlawed, they persist in new forms, and we continue to see communities deeply segregated along racial lines. Millions of people have been relegated to inadequate housing, with few pathways for advancement or protection in times of crisis.
These historical and ongoing injustices have made homelessness and housing instability racialized experiences. Disproportionate numbers of Black, Hispanic, and Indigenous people experience homelessness (National Alliance to End Homelessness 2022). Blacks and Hispanics are more likely than whites to be rent burdened or behind on rent payments and to be evicted from their homes (Joint Center for Housing Studies of Harvard University 2021; Himmelstein and Desmond 2021).
Because of the deep interconnection between housing and health (Opportunity Starts at Home 2022; Pollack, Griffin, and Lynch 2010; Taylor 2018), it follows that housing inequities’ health effects disproportionately impact households of color and marginalized communities.
Eviction is a prime example of how housing inequities exacerbate health disparities and racial injustices. As Gracie Himmelstein and Matthew Desmond write, “Because eviction in general disproportionately affects low-income people of color, the health consequences of eviction likely widen both racial and socioeconomic disparities in health” (Himmelstein and Desmond 2021).
What’s more, it is projected that we will spend more than $111 billion over the next 10 years on avoidable health care costs due to housing instability and insecurity (Children’s Health Watch 2017). This number doesn’t just represent money— it represents health care issues that people unnecessarily experience because they do not have a stable home.
Better Housing, Better Health: A Road to Racial Justice and Liberation
Health outcomes and access to quality health care are directly tied to a safe affordable home. In fact, affordable housing can reduce emergency room visits by 18 percent, increase primary physician visits by 20 percent, and decrease overall medical expenses by 12 percent (Opportunity Starts at Home 2022). If we are committed to health equity and racial justice and want to continue to improve health outcomes, then housing justice must be central to this work. Advancing housing justice creates health equity for communities of color disproportionately affected by housing instability and homelessness. Ultimately, housing justice advances racial justice and starts us on a path towards liberation.
Many health-focused funders, including two groups we lead, are pooling resources and expertise and advocating collectively for housing justice, health equity, and racial justice.
Funders for Housing and Opportunity (FHO) is a group of national funders working to change systems so renters can access safe, stable homes they can afford in communities that support health, economic mobility, and access to good jobs and schools, free from the barriers and harms of systemic racism. Many FHO members primarily work outside housing—they joined because this basic need is essential to the other outcomes their foundations seek to advance.
FHO models a cross-sector, collaborative funding structure focused on racial equity and prioritizes projects that give power to those most affected by housing and health inequities. For example, FHO has supported Portland, Oregon’s Welcome Home Coalition, which nurtures leadership and advocacy skills among people directly affected by Portland’s regional housing crisis. The coalition worked closely with a leadership circle of Somali women and with the residents of an affordable housing organization serving the Latino community. They created culturally-specific housing advocacy trainings and public forums that enable Black, Indigenous, and People of Color (BIPOC) community members to speak out and influence the local public response to COVID-19 and housing policy and funding decisions.
Funders Together to End Homelessness is a national network of funders working to achieve housing and racial justice. Its Health Systems Funders for Housing Justice network centers on the inextricable link between health care and homelessness systems and the belief that housing is health care. The network’s members — health systems and hospitals — have narrowed their focus to several evidence-based strategies for linking homelessness prevention and hospital care: medical respite, recuperative care, and medical legal partnership. Aiming for racial justice, members of the network are also advocating for policies that address homelessness and housing insecurity. And they are acting on opportunities for private philanthropy to partner with local and federal governments to promote housing justice and support individual and community wellbeing.
The network has acknowledged the challenge of working within a historically inequitable system and believes hospitals must bridge the work they are doing with that of trusted community partners. For example, one member, Cedars-Sinai, is partnering with the UniHealth Foundation to link the health and housing sectors and build nonprofit capacity through projects like recuperative and respite care, case management, and navigation services and by fostering cross-sector partnerships. Cedars-Sinai and UniHealth are also moving beyond simply funding key programs. They are also hosting convenings to engage local philanthropy in supporting people experiencing housing instabilities.
In a nation still recovering from the COVID-19 pandemic and grappling with the unjust disproportionate loss of lives and health among communities of color and people experiencing homelessness, we see even more how interconnected we all are (Wood 2020; Leifheit 2021). Once every American has a safe, affordable place to call home, we will truly live in healthy and just communities.
Himmelstein, Gracie, and Desmond, Matthew. Eviction and Health: A Vicious Cycle Exacerbated by a Pandemic. Health Affairs/RWJF Health Policy Brief, April 1, 2021.
Joint Center for Housing Studies of Harvard University. The State of the Nation’s Housing 2021. June 16, 2021.
Leifheit, Kathryn, et al. “Elevated Mortality Among People Experiencing Homelessness With COVID-19.” Open Forum Infectious Diseases. Volume 8, Issue 7 (July 2021).
National Alliance to End Homelessness. State of Homelessness: 2021 Edition. Accessed April 11, 2022.
National Low Income Housing Coalition. A Place to Call Home: The Case for Increased Federal Investments in Affordable Housing. Campaign for Housing and Community Development Funding, 2017.
Opportunity Starts at Home. Good Housing is Good Health: Fact Sheet. Accessed April 11, 2022.
Pollack, Craig Evan, Griffin, Beth Ann, Lynch, Julia. “Housing Affordability and Health Among Homeowners and Renters.” American Journal of Preventive Medicine, Volume 39, Issue 6, 515-521 (2010).
Taylor, Lauren. “Housing and Health: An Overview of the Literature.” Health Affairs, June 7, 2018.
Wood, Daniel. “As Pandemic Deaths Add Up, Racial Disparities Persist — And In Some Cases Worsen.” NPR Shots, September 23, 2020.