People sometimes ask me why, as a practicing pediatrician, I care so much about housing. But how can I not? For many of my patients, a stable, decent, affordable home is like a vaccine — it quite literally keeps them healthy. That’s why it’s essential for everyone, from architects and builders to public policymakers, to understand how important quality housing is to health and well-being.
When thinking about housing as a vaccine, you can think first about each part of housing that makes it so effective. Housing can be a stabilizing force, where families can get to know their neighbors, and children can attend the same school. Research shows that children who move more than once in their first few years of school are more likely to be kept back a grade. Our work with Children’s HealthWatch, a five-city pediatric research center, shows that families who move more than two times in a year look as bad off as homeless kids do in terms of general health, risks of hospitalization, and developmental delays.
Housing also needs to be of decent quality, which can mean the absence of things that make us sick, such as pests or mold, but also include things to make us feel well, such as natural light, exposure to green spaces, and fresh air. Deteriorating or unsafe housing poses risks of asthma, lead paint poisoning, and serious injury. We spend untold millions treating chronic diseases such as asthma, or the behavioral problems and learning disabilities associated with lead exposure, yet every dollar spent in housing can help prevent many of these negative outcomes before they happen.
Lastly, housing must be affordable. We know 20 million families in the United States are housing insecure, often forced to choose between rent, eating, or heating their homes, paying more than half their paycheck toward rent and having to go without other necessities.
The good news is there is a housing vaccine to make you healthy. Our research shows that families who receive a subsidy to help them pay rent are protected from the health stresses of moving frequently or living in overcrowded conditions. If unaffordable rents were leading to food insecurity, subsidies can also help protect them from stunted growth or other illnesses associated with inadequate nutrition. Similar to receiving one shot against multiple diseases, young children who live in stable, affordable housing are much more likely to be well: developmentally normal, not underweight or overweight, in good or excellent health, and with no history of hospitalizations.
Professor David Williams of the Harvard School of Public Health put it best in the documentary Unnatural Causes: “Housing policy is health policy.” Housing matters, particularly to young children. Strategic investments in the critical developmental window from pregnancy to three years of age can change the trajectory of a child’s life.
When administering childhood vaccinations, we make sure a child receives the right dose. The same goes for housing. Just as vaccines in early childhood have a lifelong payoff for a child and for society, making sure families can avoid housing insecurity is preventive medicine that will help put a child on the right path from the beginning.