Healthy Housing Policies: What Can Still Be Done?

Written By: Maya Kelly

Interested in the social determinants of health? Explore how housing stability policies directly affect public health, and what we still need to improve.

Housing Instability and Public Health

Housing instability is defined by the U.S. Office of Policy Development and Research as “the lack of stable occupancy of a decent, safe, and affordable housing unit.” [1] Healthy People 2030, the DHHS initiative establishing major public health goals for 2030, categorizes housing instability as part of a larger economic stability issue. [2] Economic stability and housing instability are both considered social determinants of health, or the “conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources,” [3] which can affect their quality of life and health.

Housing instability affects health negatively by incurring stress related to eviction, affordability, or safety. [4] Mental and physical health is deeply tied to how affordable, safe, and healthy one’s housing is. Certain populations experience housing instability more than others, reinforcing existing socioeconomic inequalities. [2] This also means that those more vulnerable to housing insecurity and instability are likely subject to the same instability more than once in their lives. [2]

The American Public Health Association first recognized housing as a public health issue in 1937 and has since periodically updated its policy statements to reflect the growing connections between housing and health. [5] Similar to the DHHS, major organizations and agencies have tried to address housing instability to further public health goals but have largely fallen short when it comes to large-scale relief.

Housing Choice Vouchers and Housing Policy

The U.S. government has addressed this public health issue several ways, but its largest program is the Housing Choice Voucher Program run by the Department of Housing and Urban Development (HUD). Housing Choice Vouchers (HCVs) aim to assist low-income families, individuals, the elderly, and disabled people in affording safe, reliable, and sanitary housing. [6] Families that receive Housing Choice Vouchers put 30% of their household income towards rent, and the HUD covers the remaining costs. [6]

According to the Housing Choice Vouchers Fact Sheet from the U.S. Department of H.U.D’s website, “Since the demand for housing assistance often exceeds the limited resources available to HUD and the local housing agencies, long waiting periods are common. In fact, a PHA may close its waiting list when it has more families on the list than can be assisted in the near future.” [6] Families often struggle to receive these vouchers and keep or use them effectively, meaning the administration of the vouchers is the main flaw of the program.

Why We Need to Step It Up

The Housing Choice Voucher program was ill-suited to face the challenge of the COVID-19 pandemic, with the increasing housing prices and demand for these vouchers, the HCV program failed to provide a safety net for millions of families. [7] Recent policy changes have threatened the existence of housing assistance programs like HCV’s and other programs such as emergency rental assistance.

HCV’s can be effective, but we need to change the administration of the vouchers to make them more accessible. Housing policy, along with several other social safety nets, are being threatened on several political fronts today, which would only exacerbate the housing crisis. Since the pandemic, the need for affordable, safe, and stable housing in the United States has grown, not shrunk, [8] meaning policy should be geared towards improving these conditions, not slashing crucial funding programs that positively impact health outcomes. As a whole, Housing Choice Vouchers and similar housing assistance programs are under attack, and it is ultimately up to the next generation of policymakers and public health officials to ensure that the health outcomes of Americans are protected by strong, effective healthy housing policy.

References:

1. Murdoch J, Brahmachari M, Okyere D, 2M Research, Moumen F, Streiff S. Measuring housing insecurity: Index development using American Housing Survey data. Measuring Housing Insecurity: Index Development Using American Housing Survey Data | HUD USER. June 27, 2023. Accessed November 30, 2025. https://www.huduser.gov/portal/publications/Measuring-Housing-Insecurity-Index-Development-Using-AHS-Data.html.

2. Office of Disease Prevention and Health Promotion. Housing instability. Housing Instability - Healthy People 2030. August 18, 2020. Accessed November 30, 2025. https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/housing-instability.

3. World Health Organization. Social determinants of health. Health topics. Accessed November 30, 2025. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1.

4. Bentley R, Mason K, Jacobs D, et al. Housing as a social determinant of health: a contemporary framework. Lancet Public Health. 2025;10(10). doi:10.1016/s2468-2667(25)00142-2

5. Lopez RP. Public health, the APHA, and urban renewal. Am J Public Health. 2009;99(9):1603-1611. doi:10.2105/ajph.2008.150136

6. U.S. Department of Housing and Urban Development (HUD). HCV applicant and tenant resources. Housing Choice Voucher Tenants. Accessed November 30, 2025. https://www.hud.gov/helping-americans/housing-choice-vouchers-tenants.

7. Rice D. More funds needed to avert housing voucher cuts as Covid-related job losses increase costs. Housing. November 24, 2020. Accessed November 30, 2025. https://www.cbpp.org/research/housing/more-funds-needed-to-avert-housing-voucher-cuts-as-covid-related-job-losses.

8. Soucy D, Hall A, Moses J. State of Homelessness: 2025 edition. National Alliance to End Homelessness. September 4, 2025. Accessed November 30, 2025. https://endhomelessness.org/state-of-homelessness/.