As a physician, Dr. Ben Carson knew the right prescriptions to give to his neurosurgery patients. But as the newly confirmed secretary of the Department of Housing and Urban Development, will he be able to provide the right prescription for HUD?
The wrong one is cutting HUD’s budget by a staggering $6 billion (down 13.2 percent from last year), as proposed by the new budget from the Trump administration.
As a physician, I know that stable, affordable homes are as necessary as medicines, a good diet, and exercise to help people achieve good health. HUD, as the primary federal agency charged with alleviating poverty and ensuring that America’s families, seniors, veterans, and people with special needs have access to healthy homes they can afford, needs an injection of resources, not a withdrawal of them.
No amount of medicine will make asthmatic children breathe easier if they are living in homes filled with mold. Families who are choosing between rent and food almost always choose rent. As Matt Desmond, author of the book “Evicted,” writes, “the rent eats first.” Homeless patients don’t heal well after surgery if they are sleeping in shelters or on the street.
Think of a stable home as a vaccine, something that can keep people healthy now and in the future.
Having worked with HUD for over 15 years, I have seen that it can be incredibly effective at helping millions of Americans achieve better health. Its partnership with Veterans Affairs is helping end veteran homelessness and its partnership with the Department of Health and Human Services has created “housing first” models that have decreased excessive use of health care services and saved money. HUD has led public health efforts in smoke-free housing, reducing thousands of asthma attacks.
And recent studies have shown that stable public housing increased the lifetime earnings of children in those families, offering a step up out of poverty and toward better health.
We don’t need an eviscerated HUD. What we need is a more invigorated one to address the current housing crisis. More than 2 million children are homeless each year; 6 million families live in substandard housing; and more than 11 million households, roughly 1 in 4, are spending more than 50 percent of their incomes on rent. For these families, not having a stable home undermines vital connections to education, jobs, and health.
The good news is that there are many proven ways to address this crisis.
We can renew public housing through HUD’s Rental Assistance Demonstration, which has a long list of developers ready to partner with public housing authorities to bring construction jobs back to inner cities.
HUD can help improve the supply of affordable homes in partnership with the Treasury Department through America’s main tool for creating and preserving affordable home, the Low-Income Housing Tax Credit. This proven strategy is severely underused.
We can also strengthen the National Housing Trust Fund, which creates homes for those most in need through reforms of the Fannie Mae and Freddie Mac federal lending programs.
There are also exciting new ideas like a federal Renters’ Tax Credit to help working families make ends meet to pay for rent and a universal housing voucher, which the Bipartisan Policy Center endorsed to help millions of struggling hardworking families. With only 1 in 4 families with the “home vaccine” they need, these tax credits and vouchers would provide a huge booster to help these families be healthier today as we build more homes for tomorrow.
As any doctor will tell you, dose matters when using most medicines. We saw that we can end veteran homelessness when we apply the right dose of the treatment and target it to those in need. Dr. Carson understands the deep connection between health and home. He now has an opportunity to write the right prescription for HUD that will boost the dose of stable and affordable homes for all families in America. By doing that, he would make a powerful impact as the head of HUD that truly reflects his origin as a healer.
Megan Sandel, MD, is an associate professor of pediatrics and public health at Boston University Schools of Medicine and Public Health; associate director of Boston Medical Center’s Grow Clinic; principal investigator of Children’s HealthWatch; and a trustee at Enterprise Community Partners, a national affordable housing and community development nonprofit.