2: Core Messages

Message 1: Life Expectancy

Where we live can negatively impact how well and how long we live. Unhealthy, unsafe housing is one reason why.

Key Phrases

• Where you live shouldn’t determine how long or how well you live.
• Healthy and safe housing is more than four walls and a roof. It is a structure free of toxins and other hazards that make people sick, a place that supports people reaching their full potential.
• Without a commitment to healthy and safe housing, the home can be one of the most dangerous places for families.
• Housing is health care.

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General

• Life expectancy can change from block-to-block. (This map shows life expectancy by ZIP code.)
• We spend about 70% of our time in our homes, so where we live has significant impact on our ability to live well. 
• Medical care is estimated to account for only 10%-20% of a person’s health. The other 80-90% is tied to socioeconomic and environmental factors that are usually beyond our control—like how or where our housing is built.²
• Nearly 40% of US metropolitan homes— 45+ million houses—have at least one health or safety hazard, including lead, mold, broken heating and plumbing, or rodent and roach infestation.^3,4
• Old housing stock and inconsistent maintenance by some landlords pose pervasive threats in many cities, rural areas and Tribal communities.

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Lessons Learned from COVID

• The increased time we spent indoors during the COVID-19 pandemic reminded us that for those in unhealthy and unsafe housing, this was not only an inconvenience. It was a health and safety risk.
• At the height of the pandemic, home safety inspections were halted or slowed. Programs such as WIC were forced to close, so a main avenue for testing for high levels of lead in children stopped.
• Evictions and lack of affordable housing may push people into crowded living situations and accelerate transmission of diseases.⁵

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Children

• The risk of lead poisoning falls disproportionately on children of color, with Black children nearly three times more likely than white children to have elevated blood-lead levels.⁶
• Childhood asthma, a major preventable health condition and the leading cause of school absences, is directly tied to unhealthy homes.⁷
• Some people—especially kids—are more likely to get sick from the place they live than others.

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Seniors

• Much public housing stock is in poor condition and exposes older adults to health hazards, putting them at serious risk.
• More than half of households in public housing are headed by a person who is 62+ and/or disabled.⁸

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Local Proof to Gather

• Identify the populations/communities/neighborhoods MOST impacted by the health issue you are addressing and why.
• Define the health issue you are focusing upon and how it relates to housing. 
• Gather block-by-block discrepancies in life expectancy or other health-related data.
• Gather local data on childhood asthma.
• Gather local data on the state of public housing.

Message 2: All Residents Deserve Access

All residents, especially kids, deserve access to healthy, safe housing. But not everyone has such access. Municipal policies are often at the root of these disparities and disproportionately impact communities of color and those with lower incomes.

Key Phrase

• Access to safe, healthy housing is an essential foundation for human potential.⁹

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equity

• Many people, including working families, don’t have a choice in where they live due to many factors: income, access to jobs, affordable housing and housing services, as well as current and historical discrimination based on race such as zoning ordinances, redlining and decisions regarding the built environment. 
• The risk of lead poisoning disproportionately impacts children of color, with Black children nearly three times more likely than white children to have elevated blood-lead levels.¹⁰ 
• Families of color who have low incomes tend to live in neighborhoods with low housing quality. These families also have higher rates of asthma than white families.¹¹ 
• While many cities have systems in place that provide financial assistance for housing, not every person has access to those programs, for a variety of reasons. For instance, immigrants and people who are undocumented are not eligible to receive state housing funds. 
• In Indian Country, the overcrowded housing situation contributes to higher rates of diabetes, cancer, heart disease and asthma.¹² 
• Healthy housing is an integral component of environmental justice. Focusing on healthy and safe housing,  stakeholders gain an additional way to address conditions that affect people’s health and that lead to disparities in chronic disease and health outcomes. 

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Root Causes

• Decades of discrimination and racism are baked into municipal policies, practices, systems and structures. In many cities, BIPOC people, as well as people living with lower incomes, historically have been forced into neighborhoods with a higher share of unhealthy and unsafe housing.¹³  
• Systemic racism, especially prevalent in today’s credit scoring system and some lending practices, continues to present barriers to homeownership.¹³ 
• The financial status of individuals makes their housing situations even more fragile. They may not be able to afford to move out of unhealthy, unsafe housing, or they might not ask their landlord to fix safety issues in the home out of fear of losing their lease. 
• There is a dire shortage of affordable and available homes for people with incomes below the poverty level or 30 percent of their area median income. Most of the time, those people are either Black, Native American or Latino/a/x. Racial disparities in income are the result of systemic racism that has led to differences in educational attainment, wages and employment rates, among other factors.¹⁴ 
• Black people and Latinos/as/x are more likely to live in communities with higher eviction rates, and these are usually linked to discrimination by landlords.¹⁵ 
• Mothers and children are more likely to experience eviction.¹⁶ 
• Sixty percent of households that receive federal rental assistance are working families. Yet wages for many jobs have not caught up to the spike in rental costs. There are 10.7 million households that pay more than half their income for rent, which often means people must choose housing over other crucial needs, such as food and medicine.¹⁷ 

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Local Proof to Gather

• As possible, specify the communities most affected by lack of healthy and safe housing in your area, e.g., Black, Latino/a/x, Indigenous, etc. 
• As possible, point to the root causes that have resulted in current discrepancies. 

Message 3: Align with Priorities

Unhealthy, unsafe housing is a solvable problem that aligns with other priorities, including community health and well-being, equity, educational success, economic and workforce development, neighborhood stability, energy efficiency and cost savings [adapt this list to your city, town or village and your audience’s concerns and values].

Key Phrases

• Healthy and safe housing aligns with other municipal priorities and creates back-end savings in other programs. 
• The pandemic illuminated many cracks in all systems. Healthy and safe housing policies can help patch multiple cracks. 

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General

• By collaborating with landlords, tenants’ rights groups, foundations and other decision-makers across sectors, we can use healthy and safe homes as a strategy to advance our other shared goals for economic development, health and well-being, and educational success. 
• Focusing on healthy and safe housing, health care and public health stakeholders gain an additional way to address conditions that affect people’s health and that lead to disparities in chronic disease and health outcomes. 
• Landlords who strive to provide safe housing may lack the information or resources to do so successfully. 
• It’s hard for the average person to see hidden dangers such as mold, lead, water intrusion, pests and electrical deficiencies.
• Tenants may be unaware of their rights as renters and unaware of the short- and long-term impacts of unhealthy and unsafe housing. 

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Community Health and Well-Being

• Healthy and safe housing promotes good physical and mental health. It helps people avoid health complications and reach their full potential. 
• Serious health issues, caused by or complicated by unhealthy and unsafe housing, result in strains on mental health.¹⁸ 
• By focusing on healthy and safe housing, health care and public health stakeholders gain an additional way to address conditions that affect people’s health. 

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Economic Development and Educational Success

• Local economies benefit from higher-quality housing, which impacts neighborhood stability, economic development and housing value.  
• Serious health issues, caused by or complicated by unhealthy and unsafe housing, result in time missed from work and school.¹⁸ 
• Having a healthy population advances other community goals, such as having a skilled, engaged and productive workforce and strong educational outcomes. 
• Healthy and safe housing promotes good physical and mental health, which boosts people’s ability to succeed in school and work.

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Energy Efficiency and Cost Savings

• Many of the causes of unhealthy and unsafe housing also cost tenants and landlords money—for example, improving energy efficiency can both improve air quality and reduce energy bills. 
• Serious health issues, caused by or made worse by unhealthy and unsafe housing, results in rising health care costs.¹⁸ 
• It costs the U.S. billions of dollars annually to address asthma, lead poisoning, carbon monoxide poisoning, radon-induced lung cancer and other unintentional injuries.¹⁸ 
• Landlords and property owners save money and protect their investments when housing issues are immediately addressed instead of festering over time and causing more significant damage to property. Making properties healthy and safe for tenants can reduce costs, risk and liability. 
• Municipalities save money when residents thrive. Health and safety hazards in the home are estimated to cost the nation billions of dollars annually in health care costs.¹⁹ 
• Covering the management and control of pests can avoid the costs of hiring a pest-control company.²⁰ 

Message 4: Join the Movement

We have an exciting opportunity to work together to increase healthy and safe housing, building on our existing efforts and joining other cities, towns and villages as champions for the health and well-being of residents. Doing so will bring numerous benefits and positive outcomes.

Key Phrase

• We can achieve what other U.S. cities have achieved for their residents.

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Support from Other Municipalities

• Increasingly, cities are including healthy housing policies in their comprehensive housing strategies, in collaboration with residents, property owners and other stakeholders. 
• See Stories from Other Municipalities (Chapter 3).
• Housing staff, landlords and others can play powerful roles in people’s health, helping them save money and stay in jobs and school by building healthy and safe housing measures into existing policies. 

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Support Locally

• Here in , tenants, property owners and municipal leaders are already making investments in stable, affordable housing. This is an opportunity to make that strategy even stronger, more sustainable and more effective. 
• Community-based organizations working with specific populations can be liaisons with people who need support to understand their tenant rights and navigate services, including people who are undocumented or immigrants. 
• Parents are taking action to keep their children healthy, but they cannot do it alone.

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Results We Will See

• The number of emergency room visits and hospitalizations decreases when children live in healthy and safe housing²¹. Evidence shows this is true also for older adults.²² 
• Health outcomes improve and overall costs lower for older adults when they are provided coordinated health services in affordable housing.²³  
• Childhood asthma control improves with healthy home interventions such as weatherization. 
• Complying with smoke-free housing regulations results in less maintenance and reduced risk of fire.²⁴ 

Core Message 5: Call to Action

But to ensure healthy, safe housing for all individuals, families and kids, we urgently need to change municipal policies, programs and practices. That’s why we’re asking you to… [insert your specific calls to action].

Key Phrase

• By [insert your call to action] we make important progress toward providing healthy and safe housing for all.

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Present a Clear Call to Action

• Show how the policy you’re advancing is the solution to the challenge you’ve outlined above. 
• Reinforce the benefits to people, property owners and your community. 
• Emphasize available funding streams, tax breaks, incentive programs and other resources to help landlords and property owners implement and enforce healthy and safe housing measures—or make a clear case for this funding. 
• It is powerful to include any information you can about ROI (Return On Investment), feasibility, support, tenant demand, etc. 
• If possible, specify where your policy will be implemented first to have the greatest impact (for example, in specific parts of your municipality, in low-income housing, etc.). 
• Be ready to address barriers or opposition to your policy and identify what you’ll need to address those (e.g., data, stories of success, etc.). (See Chapter 4)