Improving Living Conditions is a Critical Public Health Issue

On Thursday, the New Orleans City Council will consider a rental registry that mandates inspections in order to improve the living conditions of renters in New Orleans. The Healthy Homes Ordinance has stirred debate between housing advocates and organized landlord interests. Advocates describe the human and socio-economic costs of substandard housing for tenants, who are largely powerless to use formal mechanisms, like Code Enforcement, to improve their living conditions.

The Louisiana Public Health Institute (LPHI), with its mission to align action for health, supports this ordinance. Housing is one of the foundational pillars of the modern public health movement. The direct link between living standards and health persists today, with respiratory conditions, like asthma, directly associated with home quality. Substandard housing conditions are also associated with elevated incidents of poisonings and injuries, as well as hypertension and substance abuse. Women and children are most likely to experience the negative effects.

The abundance of research and evidence that demonstrates the relationship between health and housing, combined with LPHI’s own analyses of hospital and clinic discharge data, provide a strong argument for supporting this legislation. When LPHI analyzed data on asthma and hypertension, we saw large disparities between Black and White residents. Moreover, these disparities concentrate in disadvantaged parts of the city, where housing stock is dilapidated and blighted.

While this research gives us strong reason to support the ordinance, we also support it as a way to empower tenants and lessen the burden largely placed on the most vulnerable of our city. Renters under the current system do not have the power to use existing tools, like Code Enforcement, without the real threat of landlord retribution through eviction – which has been voiced by several advocates previously in Council Chambers.

Until recently, there was little research on eviction. However, the socio-economically disadvantaged move much more frequently than others, and further, the moves are often from poor neighborhoods into poorer neighborhoods. Researchers, such as sociologist Matthew Desmond from Harvard University, are now beginning to show that eviction is a key mechanism driving this trend, and that eviction is much more widespread than previously believed. Hence, the fears voiced in Council Chambers are very real, particularly for poorer families with children. The research shows the impacts of eviction are also very real - eviction makes people poorer. In addition, newer studies have begun to highlight the health costs of eviction, particularly on stress, depression, and self-reported overall health. Eviction perpetuates lasting, inter-generational poverty.

The findings from these studies clarify what it means when we ask individuals in a lesser position of power to solve housing problems themselves by trusting existing solutions, like Code Enforcement. It means that we are asking them to risk permanent downward mobility for themselves and their families. Such an outcome maintains the negative health effects that we are committed to improving, and it reinforces imbalances of power, thus eliminating the chances for health equity.

Substandard housing and the problems it creates are far too pervasive in New Orleans. Access to affordable, decent housing is a public health concern. LPHI supports the Healthy Homes Ordinance and believes it is a step in the right direction to improving power balances to address poor health.

George Hobor, Director, Healthy Communities, for the Louisiana Public Health Institute (LPHI)

Click here to view the op-ed published in The New Orleans Advocate