As the novel coronavirus courses through the United States, it sheds light on the inextricable link between housing, socioeconomic status, and health. Individuals experiencing homelessness are particularly vulnerable to infection due to an inability to practice social distancing compounded by a lack of access to timely information about the spread of the virus, and barriers to medical care, including COVID-19 testing and treatment. Individuals experiencing homelessness are also more likely to have a range of comorbidities, including lung diseases such as bronchitis and tuberculosis, increasing their risk of a catastrophic health outcome in the event of COVID-19 infection.
Housing insecure and housing cost-burdened individuals are also more vulnerable to COVID-19 infection due to disparities in health status and access to care. At the same time, the economic impact of the outbreak may plunge many such individuals into homelessness as business and school closures, and illness lead to loss of income.
Rightfully, federal, state, and local government agencies are working along with landlords and property owners to provide relief to the housing cost-burdened through eviction and foreclosure moratoria. Some local jurisdictions are also taking steps to guarantee that all households have access to utilities, including running water, in an effort to ensure that adherence to public health guidelines on handwashing and sheltering in place is not income-contingent.
These actions are necessary, but not sufficient to address the immediate and lasting effects of the COVID-19 outbreak. Eviction moratoria and utility service restoration do nothing to protect the health of the more than half a million Americans experiencing homelessness, and orders extending only a few weeks or months will not protect individuals and families affected by the lasting economic impact of the outbreak. It should also be noted that individuals and families living paycheck-to-paycheck before the outbreak will not be able to pay off months of housing-related expenses once the crisis has abated. Non-profit developers and property managers are already beginning to feel the economic strain of the outbreak, as they continue to provide life-sustaining services such as health checks and food distribution despite the prospect of lost rent and investment revenue.
As federal, state, and local governments continue to respond to this public health emergency, it is critical that the needs the nation’s homeless and housing cost-burdened residents are taken into account. This includes not only developing and implementing policies that directly alleviate economic and material hardship, but also investing in human service organizations to prevent disruptions in service delivery and avoid further reductions in affordable housing stock.
Protecting the health of individuals experiencing homelessness and housing insecure individuals is a moral imperative, but it is also a public health imperative. The COVID-19 outbreak shows how deeply our own health and the health of our loved ones is intertwined with the health of our communities. We are only as resilient as our most vulnerable neighbors, and investment in the health of some is an investment in the health of us all.
Nora Daly, Director Programs and Community Engagement