By Emily Mrakovcic
To students attending Brown, Rhode Island is a charming state with cozy residential avenues and picturesque downtown shops. However, life on College Hill is far from the reality that many Rhode Islanders face. The state is currently amidst a homelessness and affordable housing crisis that has impacted an increasing percentage of low and middle income households. According to the US Department of Housing and Urban Development, unsheltered homelessness has grown in Rhode Island by 56% since 2020.1 Long standing shortages in housing units, state investment, construction workers, rental assistance, and coordinated responses to homelessness are just a few of the factors attributable to this crisis.1 Affordable housing, defined as housing that a household can buy or rent by paying less than 30% of its gross income, is unachievable for over a third of Rhode Island residents.2 The Local Initiatives Support Corporation of Rhode Island issued a report stating that the wage an individual living in Rhode Island would need in order to afford a market rate apartment with two bedrooms is $21.16 an hour, which is two times the state’s current minimum wage.2 As the affordability of housing continues to present itself as a significant challenge, other public health crises have come to light, including those pertaining to criminal justice and healthcare. These issues must be systematically addressed at both private and public levels.
Housing is one of the most critical social determinants of health, as homelessness, housing insecurity, and hazardous housing all impact physical wellbeing, mental health, and cognitive development. Access to education and community resources is also determined by one’s housing situation.2 Urban overcrowding is a result of unaffordable housing and homeless shelter inaccessibility and a primary example of housing influencing health. Urban overcrowding can greatly heighten the prevalence of infectious diseases and psychological distress.2Additionally, people experiencing homelessness tend to have complex and expensive medical needs.3 Emergency department and inpatient hospital visits among Rhode Islanders staying in shelters are double that of the housed population.3 People experiencing homelessness, in conjunction to higher levels of healthcare utilization and housing resources, recurrently fall into the criminal justice system.4 Failure of state and municipal governments to provide adequate housing resources has resulted in worsened health, limited access to critical resources, and unnecessary costs falling into the government’s lap.
Rhode Islanders struggling to maintain their housing also face detrimental effects of the housing crisis. The financial burden of housing can decrease a household’s ability to pay for other necessities, such as food, healthcare, prescriptions, and utility bills.2 People within this demographic are also more likely to postpone medical treatment or hold off on going to the emergency department, fearing costly bills.2 A study conducted by the National Institute of Health during the Great Recession (an event with financial effects similar to that of the COVID-19 pandemic) found that foreclosure and eviction resulted in worsened mental health, adverse health behaviors, and overall poorer levels of health.2 It is also important to note that the effects of unsafe and unstable housing disproportionately affect communities of color and low-income communities, the Rhode Island 2022 Healthy Housing Fact Sheet reports,5 making the affordable housing crisis not just a housing issue, but a public health and racial justice issue as well.
Several efforts in and by the state have recently been made to tackle Rhode Island’s historical failure to provide reliable and affordable housing. The housing crisis has deep ties to public health, so upgrades to the state’s current housing system will subsequently improve public health. One notable plan to resolve the crisis is Governor Dan McKee’s housing legislation package that will allocate 101 million dollars of federal and state funds to affordable housing and homelessness support during the 2023 fiscal year.1 The construction of over 1,000 affordable housing units will ideally be finished within one to two years. Another potential solution is Pay for Success, an exciting new financing model that proposes a way to fund housing relief without placing additional strain on the state budget. In this model, financial risk is shifted from the government to a private investor who will provide up-front capital to fund a social program. The goal of the sponsored social programs is to identify people experiencing homelessness, prepare them for housing, and then provide and maintain housing through supportive services. If the program is successful, the government will reimburse the investor with generous returns, thus incentivizing the private investors. If Pay for Success is effective, housing stability will improve, while health care utilization and criminal justice involvement go down.4 By focusing on the income inequality and poverty that put Rhode Islanders on the streets, Pay for Success could provide a long-term, cost-effective solution to the housing crisis.
Improvements to the affordable housing crisis will benefit all of Rhode Island, not just those directly impacted. When more people in a neighborhood are adequately housed, the entire community experiences a greater sense of safety and togetherness. Increased rates of job retention and educational outcomes are also trends associated with improvements to secure housing,2 showing how the overall well being of a community can be lifted by the rising tide of housing reform.
There are many local opportunities available for Brown students passionate about or eager to learn more about public health, social determinants of health, or affordable housing. Connect for Health, a Lifespan program offered through Rhode Island Hospital, is an excellent opportunity to work one-on-one with people directly impacted by the housing crisis and to provide them with resources that can alleviate stress related to rent, mortgage payment, or utility bills. For more information, visit the Connect for Health page on the Swearer Center’s BrownEngage website. Nonprofits and state programs do not have to be the only catalysts of change during this time of need; anyone passionate about tackling public health issues can and should find ways to get involved and make a difference.
References
- Kirsch, Nancy. “Rhode Island’s Housing Crisis Demands Action.” Ocean State Stories, 6 June 2023,
oceanstatestories.org/rhode-islands-housing-crisis-demands-action/#:~:text=In%20Rhode %20Island%2C%2045%25%20of. - “Housing as a Key Social Determinant of Health | LISC Rhode Island.” Local Initiatives Support Corporation, 2021,
www.lisc.org/rhode-island/regional-stories/housing-key-social-determinant-health/. Accessed 8 Oct. 2023. - oneneighborhoodbuilders. “Report Suggests Housing Can Reduce Publicly Funded Health Costs in Rhode Island.” One Neighborhood Builders, 9 June 2023, oneneighborhoodbuilders.org/report-suggests-housing-can-reduce-publicly-funded-health -costs-in-rhode-island/. Accessed 8 Oct. 2023.
- “Rhode Island Pay for Success: Permanent Supportive Housing | Executive Office of Health and Human Services.” Eohhs.ri.gov, eohhs.ri.gov/initiatives/pay-success. Accessed 8 Oct. 2023.
- Rhode Island 2022 Healthy Housing Fact Sheet. National Center for Healthy Housing, Dec. 2022.
- 2022 Housing Fact Book. HousingWorksRI at Roger Williams University, 2022.