Severe Housing Problems in Pennsylvania

Pennsylvania

Housing influences health and well-being. Those lacking at least one basic household necessity (bathtub/shower, sink with faucet, stove or refrigerator) have higher rates of being uninsured. Poor quality of housing can cause disease and injury, while other housing-related factors such as neighborhood environment and overcrowding can lead to mental and physical health problems. 

Housing issues that can impact health include, but are not limited to:

• Affordability: Cost-burdened families may have difficulty affording other basic needs such as health care, food and heat. Individuals who have difficulty affording housing are more likely to report fair or poor health, certain chronic conditions and nonadherence to prescriptions due to cost.
• Hazards: Hazards in the home, such as lead paint, allergens, water leaks, poor ventilation and inadequate heating, cooling or plumbing, are associated with poor respiratory health and disease, increased risk of cardiovascular conditions and developmental delays in children. 
• Overcrowding: Defined as housing with multiple occupants per room, overcrowding is associated with an increased risk of poor mental health and infectious disease.

Those with a greater risk of experiencing housing-related health conditions include: 

• Low-income families and individuals.
• Racial/ethnic minorities.
• Renters.
• Children and older adults.

Healthy Home programs have improved health by remedying hazardous housing conditions, such as lead and radon hazards. The Centers for Disease Control and Prevention offers more information and guidelines in their Healthy Housing Reference Manual, a comprehensive resource for public health and housing professionals. The National Low Income Housing Coalition provides additional resources and policy recommendations for housing challenges.

More collaboration between the housing and health sectors is needed to promote healthy home environments and to better integrate health care into public housing systems, particularly for those with chronic health needs. 

Healthy People 2030 identifies the quality of housing as a key issue in the neighborhood and built environment domain and has a goal to reduce the proportion of families who spend more than 30% of their income on housing.

Centers for Disease Control and Prevention, and U.S. Department of Housing and Urban Development. Healthy Housing Reference Manual. Atlanta, GA: U.S. Department of Health and Human Services, 2006. https://stacks.cdc.gov/view/cdc/21748.

Donald, Ian P. “Housing and Health Care for Older People.” Age and Ageing 38, no. 4 (July 1, 2009): 364–67. https://doi.org/10.1093/ageing/afp060.

Freund, Deborah, Chengcheng Zhang, Petra W Rasmussen, Safia Hassan, and Gerald Kominski. “Despite Gains From ACA, Lower Rates of Health Insurance Coverage Persist Among Those Lacking Housing Basics,” n.d., 3.

Pollack, Craig, Susan Egerter, Tabashir Sadegh-Nobari, Mercedes Dekker, and Paula Braveman. Where We Live Matters for Our Health: The Links Between Housing and Health. Issue Brief 2: Housing and Health. Robert Wood Johnson Foundation Commission to Build a Healthier America, September 2008. http://www.commissiononhealth.org/PDF/e6244e9e-f630-4285-9ad7-16016dd7e493/Issue Brief 2 Sept 08 - Housing and Health.pdf.

Sandel, Megan, and Matthew Desmond. “Investing in Housing for Health Improves Both Mission and Margin.” JAMA 318, no. 23 (December 19, 2017): 2291–92. https://doi.org/10.1001/jama.2017.15771.

Swope, Carolyn B., and Diana Hernández. “Housing as a Determinant of Health Equity: A Conceptual Model.” Social Science & Medicine 243 (December 2019): 112571. https://doi.org/10.1016/j.socscimed.2019.112571.

Taylor, Lauren. Housing and Health: An Overview of the Literature. Health Affairs Health Policy Brief. Robert Wood Johnson Foundation, June 7, 2018. https://doi.org/10.1377/hpb20180313.396577.