Since the launch of ULI’s Building Healthy Places Initiative a year ago, one of the most important lessons we have learned is the extent to which the work of our members influences all aspects of how well people live—in terms of both physical and mental health.
The point was underscored at ULI’s Building Healthy Places conference earlier this year when Richard Jackson, professor and chair of environmental health sciences at the Fielding School of Public Health at the University of California at Los Angeles, told the land use professionals in attendance, “You probably don’t see yourselves this way, but you are in the health care business. You have more influence on people’s health with what you build than doctors have with the medications they prescribe.”
A recurring message throughout the event was the need for equity to ensure that healthy living environments are available to people of all incomes. “Your zip code is more important than your DNA code in determining your chances for good health. There is no value [in health-oriented amenities] if you don’t have access to them,” said conference cochair Anne Warhover, president and chief executive officer of the Colorado Health Foundation.
This theme of access to healthy living environments was further emphasized at the ULI Terwilliger Housing Center’s recent Housing Opportunity conference, which focused specifically on the correlation between housing and health. It is an issue championed by Terwilliger Housing Center founder and 2013 ULI J.C. Nichols Prize recipient J. Ronald Terwilliger, who set the tone for the conference by describing housing as a basic human need. “Affordable housing falls in the category of healthy housing,” he said. “If you don’t have access to decent, safe, affordable housing, then you don’t have access to health care, education, or other services.”
Conference keynoter Dr. Megan Sandel, co–principal investigator at Children’s Health Watch, built on this premise, describing housing stability as a “vaccine” that can help prevent numerous health problems, including malnourishment, obesity, diabetes, heart disease—even impaired brain development. Each of these, she said, can be linked either directly or indirectly to unstable housing situations, such as being unable to pay rent, being forced to move multiple times, and having to choose between paying utility bills or buying groceries (the harsh reality of “heat or eat”).
If the documented health benefits of housing security could be packaged as a medicine, “it would be available in every pharmacy,” Sandel said. “The prescription to end hunger may be affordable housing,” she told conference attendees, pointing out that lowering housing costs frees up money to cover other expenses. “Think of affordable housing as a vaccine that provides multiple benefits, not just to individuals, but to society as a whole.”
It is an interesting and intriguing perspective. In the land use and real estate industry, we tend to think of housing—particularly affordable and mixed-income housing—largely in terms of how it helps individuals and families attain economic stability and eventually build equity through homeownership. And, while that is an unquestionably valid and worthy cause, it is equally important to make the connection between provision of affordable housing and the community-wide benefits of improved health and higher education levels.
In fact, the best practices in affordable and workforce housing development that we celebrate each year through the Terwilliger Center’s Jack Kemp Awards are examples of housing that is changing many aspects of people’s daily lives—including their physical and emotional well-being—by improving their quality of life. That is an important outcome that is guiding much of the Terwilliger Center’s work.
Our Building Healthy Places Initiative is helping broaden our thinking about the role that housing—and all aspects of land use—plays in creating communities that are conducive to healthy living. As we delve deeper into the initiative, we are preparing a Building Healthy Places handbook that will serve as a nuts-and-bolts guide to real estate development that emphasizes health and wellness as the designated outcome.
The handbook, which will be distributed at ULI’s 2014 Fall Meeting in New York City, will be informed by the recommendations of a group of ULI experts convened this summer, as well as the experiences of other members involved in the financing, planning, design, and development of healthy projects. And though the handbook is still in the works, it is a safe bet that a key message will be this: healthy communities start with safe, decent housing that is accessible to people of all incomes. As Sandel reminded us, when it comes to health, housing does matter.