This past summer, several news articles called attention to the County Health Rankings’ finding that people who live in urban and suburban environments tend to be healthier than those living in rural areas. The Wall Street Journal and the CBS Early Show should be applauded for calling attention to the fact that of the more than 3,000 counties assessed in the 2011 Rankings, 84% of the unhealthiest were rural while 48% of the healthiest were either urban or suburban. But we need to keep in mind that cities are also home to populations facing enormous health challenges.
New York City provides an excellent case-in-point: New York County (a.k.a. Manhattan) ranked 25 of 62 (total counties in the state) in the 2011 County Health Rankings, while neighboring Bronx ranked 62 of 62. While there are many factors driving the health differences between these two places, this post will focus on one – housing – that doesn’t often come up in conversations about health.
The link between health and housing is well established. The Robert Wood Johnson Foundation’s Commission to Build a Healthier America's Issue Brief on Housing and Health identified three interrelated aspects of residential housing that influence health: (1) affordability, (2) the physical conditions within homes, and (3) neighborhood environments surrounding homes. In May 2011, the Center for Housing Policy released two important research summaries on The Impacts of Affordable Housing on Health and the Impacts of Affordable Housing on Education.
Rankings data reveal stark disparities between Manhattan and the Bronx with respect to housing. In Manhattan, 39% of households have high housing costs (defined as 30% or more of household income) vs. 52% in the Bronx. New York University’s Furman Center for Real Estate and Urban Policy reported that fewer than 10% of Bronx home sales were affordable to the median Bronx household in 2010.
Like many population health problems, this one has no quick fix. But those who are looking for possible solutions should know about the South Bronx’s new Melody building that has “hit all the right notes.” The Melody is a 63-unit LEED-Platinum housing cooperative that is open to families with incomes from $35,000 to $90,000. The development is a public-private collaboration among Blue Sea Development Company, Habitat for Humanity, and the City of New York. Financing for the $18 million building was provided through city, state, and borough funding (primarily bonds) and it is the first in the city to incorporate the 2010 Active Design Guidelines to encourage the construction of buildings that facilitate increased physical activity and mobility. The building’s fitness-promoting elements earned it the first LEED Innovation Point for Active Design awarded to a multifamily project.
Building features include:
- Outdoor exercise equipment, children’s play structure, rooftop patio, and indoor gym that is free for residents;
- Colorful, brightly lit sets of stairs, featuring silhouettes of dancing women and piped-in jazz (the building’s one elevator is slower than average, has no music, and is less prominently placed than the stairs);
- Multiple mechanisms for maintaining high levels of air quality within the building (South Bronx asthma rates are eight times the national average), such as each unit having its own sealed ventilation and filtration systems that vent directly outdoors and low VOC materials throughout in paints, adhesives, and floor coverings.
The Melody development showcases the power of public-private, cross-sector collaboration. But without adequate incentives, this type of effort is likely to remain the exception rather than the rule. Inclusionary zoning (which requires developers to make a percentage of housing units in new developments available to low- and moderate-income families) is one policy option that has drawn praise (as well as criticism) in recent years. We need to continue to explore all policy options and examine the evidence to determine which approaches work best. The South Bronx’s Melody housing co-op is an impressive example of what needs to happen on a broader scale in urban communities throughout the country to improve health. It provides hope for a trend toward expanded options for working families who have a need for – and should have a right to – healthy and affordable housing.
Kirstin Q. Siemering, DrPH is a Researcher with the University of Wisconsin Population Health Institute.
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