February 25th, 2021 – “Stay home, stay safe” has been a constant refrain used during the COVID-19 pandemic to encourage people to protect themselves and others. However, for those who are experiencing homelessness or are on the cusp of it, they may not have a safe home to protect them from the virus. Early in the pandemic, housing and health advocates recognized the increased risk of transmission in overcrowded shelters and homes. Rising unemployment threatened the ability of many households to pay rent, placing thousands of people at risk of eviction. Although Massachusetts enacted a temporary moratorium on evictions and foreclosures and enhanced funding for emergency rental assistance and rapid rehousing, eviction filings have been on the rise since the moratorium expired last October.

Housing insecurity during the pandemic is a symptom of the broader housing affordability issue facing the state. Chronic homelessness and frequent moves can lead to less stability to manage health conditions, more exposure to environmental hazards, and fewer resources for nutrition and medical care. Evictions and foreclosures are associated with higher rates of depression, anxiety, alcohol use, and suicide. The cost of these health outcomes are borne not just by those who experience it, but also the health care system and society at large. In Boston, the cost per day to serve one chronically homeless individual ranges from $40 for a shelter to $1,770 for a hospital stay. Studies show providing permanent supportive housing for individuals experiencing chronic homelessness can significantly lower health care spending.

In 2016, nearly half of renter households in Massachusetts were considered cost-burdened, paying more than 30% of household income toward housing. There is currently less than one affordable and available unit for every two extremely low-income renter households. Furthermore, housing affordability is a racial equity issue. In Boston, the median net worth for Black residents is $8 compared to $247,500 for white residents. Eviction filings for rental housing are concentrated in neighborhoods where the majority of residents are Black and the rate of homelessness is highest among Black and Hispanic residents in Massachusetts.

Local hospitals – including Boston Medical Center, Boston Children’s Hospital, Brigham and Women’s Hospital, and Massachusetts General Hospital – are funding affordable housing projects, as are national health insurers and Massachusetts life, property, and casualty insurance carriers. In this moment when the health impacts of housing could not be more important, we urge leaders throughout the health care sector to make a wide-range of investments to help people avoid displacement and homelessness, reduce health costs, and strengthen communities.

Adelina Huo, Housing and Health Practicum