The affordable housing crisis is also a health crisis

Dr. Craig Evan Pollack, a professor at the Johns Hopkins Bloomberg School of Public Health, has long centered his research on the intersection between housing and public health.

Getting to that point, however, proved to be a journey, with Pollack tracing his initial interest in the subject to a college trip to Bosnia, Herzegovina, where he traveled intending to study a memorial being built to commemorate the 1995 end of the Bosnian War.

“I was doing a medical program at Berkeley and UCSF (University of California, San Francisco), and through that I went to Bosnia, Herzegovina, five years after the war ended, five years after the massacre,” said Pollack, who will appear as part of “Home Matters: Opportunity, Neighborhood and Belonging,” a panel discussion led by Hanif Abdurraqib and taking place at the Lincoln Theatre on Wednesday, Sept. 25. “I went there [intending] to do interviews about a memorial that I heard was being built. But instead of people talking about the memorial, which was something they very much didn’t want to talk about, it became a study about the meaning of ‘home,’ of their desire to go back to their homes, and of how trauma can impact how people view their homes.”

These experiences spurred Pollack’s earliest interests in exploring the meanings we attach to place, as well as the various ways a person’s living accommodations can impact their health and well-being – a line of research he began to pursue more vigorously in the aftermath of the 2008 housing crisis. In the time since, he has studied the many ways in which housing affordability can intersect with health, hoping to create a blueprint that can better inform and shape public policy, with his research delving into everything from the ways housing vouchers and rental assistance can lower stress and benefit overall health to the reduction in illnesses such as asthma seen in children who relocated from high-poverty areas to better resourced neighborhoods.

“There are four fundamental pathways we think about when we’re connecting housing and health, and one of those pathways is around housing affordability,” Pollack said. “We know that housing is increasingly expensive nowadays, and that almost half of renters live in unaffordable housing. And when that happens, people make tradeoffs between paying for housing and paying for medicine or paying for healthy, nutritious food. [Sociologist] Matt Desmond coined the phrase ‘the rent eats first,’ and that’s something we definitely see in our studies and in the patients that I talk with.”

The other three pathways include: housing instability, with Pollack citing patients who have lost medications or needed medical devices while being forced to make more frequent moves; housing quality (older buildings have more issues with lead paint and infestations); and health issues related to the neighborhood in which a home exists. In some cities, including Columbus, affordable housing is often more prevalent in areas designated as food deserts, with studies showing that this lack of access to healthy food can lead to higher rates of obesity, diabetes and cardiovascular disease, among other diet-related conditions.

In an August interview, Columbus artist Azubuike Akunne recalled growing up with a father who owned a pharmacy in the Bronzeville neighborhood, and how as a child he observed patients streaming in to collect medications for ailments such as high cholesterol and diabetes. These observations served as the earliest seeds for “Guess Who’s Coming to Dinner,” an expansive late-summer art exhibit that Akunne created in tandem with Imani Mixon at Urban Arts Space in which the two asked viewers to consider the link between these ailments and the foods people consumed.

In some ways, the exhibit is indicative of the larger shift that Pollack has seen take place within his field of study, particularly in more recent years as the shortage of affordable housing has become a more salient reality for many people. According to a recent assessment of the region’s Homeless Response System conducted by Focus Strategies and RAMA Consulting Group, for example, the median gross rent in central Ohio has increased by 34 percent since 2017 (compared with 29 percent nationally). Rental availability, meanwhile, has decreased by 40 percent in that same time– more than double the national average.

“I think there’s just been a real sea change in the way we think about these things,” said Pollack, who would like to see policymakers take a multipronged approach to the issue, continuing to experiment with programs designed to help individuals and families move to so-called “opportunity neighborhoods” while also ramping up investment in areas that been historically neglected. “The housing-mobility studies and the studies that talk about investing within an area, sometimes those are viewed as a zero-sum game. And I think that’s a false dichotomy, and something we need to move away from. For people who want to move, they should be able to exercise that choice. … But also, when we’re talking about areas that have been historically disinvested in [owing to] systemic racism and other factors, I think people realize that turning that around is something that’s going to require sustained, substantial engagement and investment.”