Housing stability and where a family lives are strong predictors of health outcomes. In an effort to begin addressing such health-related social needs, the Center for Medicare and Medicaid Services has invested $157 million in its pilot program called the Accountable Health Communities (AHC).
Housing insecurity has been addressed through the Housing Choice Voucher Program, more commonly known as Section 8 vouchers. A recent study by Dr. Bailey Miles and colleagues however, posits that this program has not been enough. The study identifies many structural barriers that diminish the full benefit of the vouchers, such as limited rental housing and unaffordable rents even with the vouchers in opportunity areas—neighborhoods that are low-poverty with high-performing schools, low crime rate, low unemployment rates, and access to jobs. In addition, Section 8 vouchers are limited and often have long waiting lists. Only one in four income-eligible families receive housing vouchers.
An added obstacle for families with housing vouchers is the dire lack of laws prohibiting source of income (SOI) discrimination in the housing market. The Fair Housing Act does not cover SOI discrimination, leaving it up to cities and states to protect renters, and it is difficult to prove that rental denial is motivated by a type of discrimination. Because 45% of voucher recipients are African Americans and 16% Hispanic, SOI discrimination perpetuates racially segregated housing.
The AHC will have to work within the constraints of the current housing system and will face structural obstacles in effectively addressing housing security. However, the success of the program would be dramatically undercut should the Housing Choice Vouchers program be eliminated as proposed in President Trump’s budget.