Yu: Our housing problem is turning into a health care problem

Affordable housing has made local headlines in recent months—and for good reason.

The statewide moratorium on evictions during the pandemic expired in June 2022, and other protectants phased out earlier this year. Despite the spike in evictions already documented, reports suggest more renters are still on the brink of losing their homes.

California already has the most unhoused people of any state in the U.S., it’s the most expensive state for renters and the median cost of a home is $800,000—more than twice the national rate. With this real estate landscape and the potential for these elevated eviction numbers to remain for years to come, we need to consider the implications of prolonged housing insecurity for both the health of the tenants and the community at large.

At CCA Health California, we’ve seen firsthand the toll housing insecurity takes on our communities. Individuals at risk of losing their homes are forced to prioritize housing costs to avoid displacement, often at the expense of essentials such as food, medications and utilities. These financial challenges can lead to irreversible health damage through skipped or delayed care.

For example, people with sleep apnea who have intermittent access to electricity can’t plug in CPAP machines. If left untreated, sleep apnea can lead to stroke, heart disease and more. Unsurprisingly, housing insecurity is associated with higher rates of chronic conditions such as hypertension, diabetes and asthma.

But this isn’t just a problem for individuals. It has far-reaching implications for the health care system. When people devote their limited income to housing, preventative and maintenance health care takes a back seat. Statistics show that people who struggle with housing costs are less likely to have a consistent source of medical care, resulting in delayed doctor visits and a reliance on expensive emergency room services.

Unfortunately, money alone has never solved the issue for California, nor has it for any state. Between 2018 and 2021, California spent nearly $10 billion, but the unhoused population grew. Affordable housing is a critical priority, but improving coordination and communication across existing resources is another key component to addressing housing insecurity—and something we can work on immediately.

The first step is to increase awareness about how housing insecurity has a cumulative effect on health and well-being. A key way to do this is to help resources in the city cross-identify needs. For example, if someone relies on a food bank, they might also struggle to pay for utilities. Some food banks distribute information about utility support with their provisions, increasing awareness of lesser-known resources and improving the likelihood that people continue with at-home medical routines such as CPAP or oxygen tanks. Coordinating more actions like this across resources can help maintain care during times of financial distress.

The second step is to integrate more community health workers into existing organizations. These individuals can look for patterns in individuals’ health data to determine risk for various social and behavioral needs. They then work proactively with providers to ensure those individuals are aware of resources—for transportation, food and mental health—that keep their health on track.

Finally, an integral part of reducing barriers to services is ensuring that information about resources and applications is culturally competent—improving translation options, aligning with reading levels and simplifying forms are imperative to ensure people who qualify know they are eligible.

The link between health and housing is strong. Continuous collaboration and communication between health care stakeholders and community organizations is a critical step in mitigating the negative implications of housing insecurity. Together we can make a difference and keep people living well in their homes. It’s better for them, and better for the health care system across California.

Wil Yu is general manager of CCA Health California.