HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
HOUSING AND HEALTH
Housing Determines Health
United Nationsi declare that the human right to adequate housing is more than just four walls and a roof. It is the right of every woman, man, youth and child to
gain and sustain a safe and secure home and community in which to live in peace and dignity. Whether one has accessible, affordable, safe, healthyii and stable
housing affects one’s ability to attain full health potential. Those with fair and equitable access to attainable and stable housing experience less stress and better
mental well-being. Conversely, homeless individuals and families are constantly exposed to high health and safety risksiii.
Housing location has a direct link to access to opportunities. Locating affordable and attainable housing near living wage jobs, schools, parks and other amenities
can reduce cost burdens for every household, improve our economy, enrich social life, support health, and improve quality of life. Healthy and adequate housing
meets basic human needs and minimizes threats to health and safety, such as allergens and other hazards. Resilient housing located away from potential hazards
can lessen the stresses of the changing climate, increase household and community resiliency, and prevent negative health impacts.
The Logic Model
Input/Impact
Area
Strategies/Policies
Intermediate Outcomes
Ultimate Outcomes
Accessibility
and Location
• Ensure job-housing balance in compact
centers to minimize commuting.
• Promote access to housing in walkable,
complete neighborhoods with employment
and other opportunities.
• Create mixed-use, compact developments in
growth areas served by transit.
• Co-locate housing within walking distance of
transit, services and amenities.
• Plan for housing growth linked with public
investments including high-capacity transit.
• Locate affordable housing in opportunity-rich
neighborhoods.
• Reduced housing + transportation cost
burden.
• Increased family retention of wealth and
disposable income for nutritious food,
health care and recreation.
• Improved economy and local
businesses.
• Reduced physical inactivity and
emotional stress caused by commuting.
• Reduced burden to emergency rooms.
• Reduced health disparities.
• Improved emotional and mental health.
• Reduced obesity and improve physical
health.
• Increased social, environmental and
physical capitals.
• Improved population health and quality of
life.
• Improved neighborhood safety and sense
of community.
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Input/Impact
Area
Strategies/Policies
Intermediate Outcomes
Ultimate Outcomes
Affordability
and Attainability
• Ensure job-housing match so that housing
units produced in mixed-use compact areas
are affordable to workers nearby.
• Integrate affordable housing in all
neighborhoods, particularly complete,
compact and opportunity-rich
neighborhoods, allowing walking access to
amenities, transit and services.
• Remove barriers or relax land-use
regulations, such as maximum density,
minimum lot size, parking requirements and
cumbersome development standards, to
encourage more production of affordable
housing, including infill and accessory
dwelling units.
• Establish “minimum density requirements” to
ensure land is developed in accordance with
the densities envisioned in the
comprehensive plan.
• Relax or undo single family zoning to allow
missing-middle housing, such as duplex,
triplex, etc.
• Use form-based codes to encourage and
regulate missing-middle housing.
• Provide a continuum of diverse housing
choices, from rental to ownership and from
tiny homes to single detached dwellings, so
that people of diverse incomes, needs and
life cycles can attain housing within their own
means.
• Improved distribution of affordable
housing throughout the city.
• Increased range of densities, housing
types and prices within communities.
• Reduced housing cost burden.
• Increased disposable income for
nutritious food, health care and
recreation.
• Reduced emotional stresses.
• Decreased homelessness.
• Increased aging-in-place opportunities
by accommodating a broader range of
household needs.
• Increased school attendance.
• Decreased mobility of students.
• Improved emotional and mental health.
• Increased social connectedness.
• Increased academic achievement.
• Reduced health disparities.
• Increased social, financial and physical
capitals.
• Increased community diversity and
inclusiveness.
• Improved population health and quality of
life.
• Improved neighborhood integration and
sense of community and belonging.
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Input/Impact
Area
Strategies/Policies
Intermediate Outcomes
Ultimate Outcomes
• Expand options for affordable housing
construction types, such as tiny homes,
micro housing and manufactured housing.
• Utilize Inclusionary Zoning to require
affordable housing in market-rate
developments calibrated to market
conditions.
• Avoid introducing Inclusionary Zoning in
distressed communities.
• Change zoning to promote high-density
housing in and near centers and corridors.
• Reduce unpredictable or streamline lengthy
approval process to reduce costs of housing
development.
• Create dedicated sources of funding to
encourage affordable housing.
• Enhance incentives for affordable housing in
market-rate development.
• Use public-owned land to provide affordable
housing.
• Explore community land trusts and
development corporations to develop and
maintain affordable housing.
• Take steps to ensure existing affordable
housing remains available, such as buying
back subsidized properties, etc.
• Explore financing tools to support the supply
and demand of affordable housing, such as
tax increment financing, property tax
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Input/Impact
Area
Strategies/Policies
Intermediate Outcomes
Ultimate Outcomes
abatement, investment tax credit, and
revolving loan fund, etc.
• Encourage homeownership.
Adequacy and
Habitability
• Ensure affordable units have adequate
space; physical accessibility; adequate
security; security of tenure; structural stability
and durability; adequate lighting, heating and
ventilation; and adequate basic
infrastructure.
• Apply National Healthy Housing Standardiv to
building and other codes to prevent housing-
related diseases and injuries through routine
maintenance.
• Ensure that building standards and practices
provide for safe and healthy homes for all.
• Encourage resource-efficient, carbon-neutral
and high-performance housing by
introducing green building standards,
incentives and technical support.
• Maintain and preserve quality affordable
dwellings, such as developing a rental
housing safety program or adopt a rental
inspection ordinancev.
• Work with the local health department to
provide healthy home environment
assessment to needed low-income
residents.
• Offer housing rehabilitation loan and grant to
help repair, improve, or modernize dwellings,
• Improved housing conditions.
• Increased preservation of low-cost
housing.
• Reduced exposure to allergens,
neurotoxins and other hazards.
• Reduced health issues associated with
poor quality housing, such as asthma or
lead poisoning among children.
• Reduced levels of psychological distress
and helplessness.
• Reduced high blood pressure.
• Improved physical and mental health.
• Reduced health disparities.
• Increased neighborhood/community
stability.
• Increased employment and education
stability.
• Increased economic opportunity.
• Increased opportunity for civic
engagement.
• Increase local construction and industrial
jobs.
• Increased home market values.
• Increased social and physical capitals.
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Input/Impact
Area
Strategies/Policies
Intermediate Outcomes
Ultimate Outcomes
and remove health or safety hazards from
those dwellings.
• Work with the local health department to
encourage smoke-free housingvi.
Stability
• Streamline processes for households to
access rental assistance.
• Provide funding to stabilize rent.
• Provide funding to help low income
households meet home energy needs.
• Assist households facing housing crises,
such as debt advice for tenants with unpaid
rents and legal support in eviction
proceedings.
• Ensure residents have adequate notice for
rent increases.
• Promote tenants’ rights.
• Work with landlords to increase participation
in rental assistance programs.
• Promote homeownership such as creating a
home investment partnership program, etc.
• Create tax relief to stabilize homeowners.
• Reduced lease terminations.
• Reduced involuntary displacements.
• Increased residential stability over time.
• Increased personal wealth through
homeownership.
• Reduced poverty.
• Reduced homelessness.
• Improved physical and mental health.
• Reduced health disparities.
• Increased education attainment.
• Improved sense of community and
neighborhood/place.
• Decreased burden on state systems.
• Increased social and physical capitals.
Equity
• Identify and assess patterns of inequitable
access to housing, and consider changes to
land use and housing growth strategies to
correct them.
• Seek to understand and prevent increased
risk of involuntary displacement when up-
zoning or subarea planning takes place.
• Increased access to opportunities for
the underserved populations.
• Reduced involuntary displacement of
underserved populations and small local
businesses.
• Reduced homelessness.
• Reduced poverty.
• Improved social, economic and
environmental root causes of health.
• Improved community diversity and
inclusiveness.
• Improved health equity and reduced
health disparities.
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Input/Impact
Area
Strategies/Policies
Intermediate Outcomes
Ultimate Outcomes
• Take community actions to prevent
involuntary displacement of both the
vulnerable populations and small local
businesses.
• Develop a fair housing policyvii.
• Seek options to promote accessibility for
people of diverse physical abilities.
• Consider Housing Firstviii policy to provide
rapid access to permanent housing and
support for chronically homeless individuals.
• Locate affordable housing in opportunity-rich
neighborhoods.
• Improved overall population health and
well-being.
• Improved independence and quality of
life.
Research Evidence
Housing and Health in General
American Public Health Association. 2020. Creating the Healthiest Nation: Health and Housing Equity. Washington, D.C.: American Public Health Association.
https://www.apha.org/-/media/files/pdf/topics/equity/health_and_housing_equity.ashx?la=en&hash=feda5cd7041c72cba783ab614e5ec20caa040dca.
deVuono-powell, Saneta, Allison Allbee, and Juell Stewart. 2017. Public Health for All: Rethinking the Legacy of Public Health & Housing. Change Lab Solutions.
Accessed April 7, 2020. https://medium.com/the-block-project/public-health-for-all-rethinking-the-legacy-of-public-health-housing-685842f1b5f0.
Dannenburg, Andrew L., Howard Frumkin, and Richard J. Jackson, ed. 2011. Making Healthy Places: Designing and Building for Health, Well-Being, and
Sustainability. Washington, DC: Island Press.
https://www.researchgate.net/publication/261215792_Making_Healthy_Places_Designing_and_Building_for_Health_Well-
Being_and_Sustainability_by_Andrew_L_Dannenberg_Howard_Frumkin_and_Richard_J_Jackson.
Krieger, James, and Donna L. Higgins. 2002. “Housing and Health: Time Again for Public Health Action.” Journal of American Public Health 92, No. 5: 758–768.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447157/.
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Norton, Ruth Ann, Brendan Wade Brown, Catherine Lee, Malomo-Paris, Kiki, and Jamal Lewis. Achieving Health and Social Equity through Housing:
Understanding the Impact of Non Energy Benefits in the United States. Accessed August 12, 2020. https://www.greenandhealthyhomes.org/wp-
content/uploads/AchievingHealthSocialEquity_final-lo.pdf.
Shaw, M. 2004. “Housing and Public Health.” Annual Review of Public Health 25: 397-418.
https://www.annualreviews.org/doi/full/10.1146/annurev.publhealth.25.101802.123036?url_ver=Z39.88-
2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed.
Taylor, Lauren A. 2018. “Housing and Health: An Overview of The Literature.” Health Affairs Health Policy Brief. https://doi.org/10.1377/hpb20180313.396577.
Accessibility and Location
Christian, T.J. 2012. “Trade-offs Between Commuting Time and Health-related Activities.” Journal of Urban Health 89, no. 5:746-57.
https://www.ncbi.nlm.nih.gov/pubmed/22689293/.
Housing Wiki. “Jobs-Housing Balance”. Accessed August 12, 2020.
https://housing.wiki/wiki/Jobs-housing_Balance#Housing_affordability_and_adequate_employment_issues.
Pollack, Craig, Susan Egerter, Tabashir Sadegh-Nobari, Mercedes Dekker, and Paula Braveman. 2008. Where We Live Matters for Our Health: The Links
Between Housing and Health. Housing and Health Issue Brief 2 of Robert Wood Johnson Foundation, Commission to Build a Healthier America. 12 pages.
http://www.commissiononhealth.org/PDF/e6244e9e-f630-4285-9ad7-16016dd7e493/Issue%20Brief%202%20Sept%2008%20-
%20Housing%20and%20Health.pdf
Affordability and Attainability
Claflin, Katie. 2016. Can Your Housing Situation Affect Your Mental Health? Studies Say Yes. Texas State Affordable Housing Corporation. Accessed April 7,
2020. https://www.tsahc.org/blog/post/can-your-housing-situation-affect-your-mental-health-studies-say-yes.
Enterprise Community Partners. 2014. Impact of Affordable Housing on Families and Communities: A Review of The Evidence Base. Columbia, MD: Enterprise
Community Partners, Inc. https://homeforallsmc.org/wp-content/uploads/2017/05/Impact-of-Affordable-Housing-on-Families-and-Communities.pdf.
Kottke Thomas, Adrianna Abariotes, and Joel B. Spoonheim. 2017. “Access to Affordable Housing Promotes Health and Well-Being and Reduces Hospital
Visits.”. The Permanente Journal 22, No.17-079. https://doi.org/10.7812/tpp/17-079.
HOUSING AND HEALTH LOGIC MODEL
(SEPTEMBER 30, 2020-CMOS)
Lubell, Jeffery, Rosalyn Crain, and Rebecca Cohen. 2007. Framing the Issues—The Positive Impacts of Affordable Housing on Health. Washington, D.C.: Center
for Housing Policy and Enterprise Community Partners. https://pdfs.semanticscholar.org/0dbf/ed563545d8b93877db82ee0634e68796ede7.pdf.
Maqbool, Nabihah, Janet Viveiros, and Mindy Ault. 2015. “The Impacts of Affordable Housing on Health: A Research Summary.” Center for Housing Policy.
https://www.rupco.org/wp-content/uploads/pdfs/The-Impacts-of-Affordable-Housing-on-Health-CenterforHousingPolicy-Maqbool.etal.pdf.
National Low Income Housing Coalition. 2019. “Severely Housing Cost-Burdened Households Experience Greater Food Insecurity, More Child Poverty, and
Worse Health Outcomes.” Accessed April 7, 2020.…