Adequate housing is a fundamental human need and a key component of quality of life and determinant for health.
The place we call home forms the very foundation of our daily lives — it creates a place for safety, security and refuge, where individuals and families can rest and collect themselves at the end of the day. Being at risk for homelessness and housing instability are detrimental to health due to chronic (long-lasting) stress that increases the risk of chronic diseases. Also, children who live in older housing have a higher risk for lead exposure, especially among low-income families.
There are three important aspects of housing, all of which are linked to health, the physical conditions within our homes, the conditions of the neighborhood surrounding them, and the cost of the homes. Good health depends on having a home that is safe and free from physical hazards, while providing safety, security, stability and shelter. Poor housing conditions, such as dilapidated structure, roofing issues such as leaks/intrusions, plumbing and electrical deficiencies and radon gas exposure are tied to a variety of health problems such as asthma, respiratory illness, lead poisoning, unintentional injuries and cancer (1).
Health Disparities and Inequities
A 2011 study by the Centers for Disease Control and Prevention (CDC) found that 5.2 percent (5.8 million) housing units in the United States were classified as inadequate (poor physical structure) and 23.4 million were classified as unhealthy (may contain toxins and other environmental hazards) (2). The same study also found that there were significant racial, educational and economic disparities regarding access to adequate housing across the U.S. Unhealthy and inadequate housing is an issue affecting the health of millions of Americans from all income levels, locations and backgrounds. However, it is a problem that disproportionately impacts our most susceptible and vulnerable citizens such as children, low-income families, communities of color, individuals with chronic medical conditions and those with mental health issues (3). Jefferson County has witnessed substantial population growth since the 2010 census, which has resulted in greater cost burdens for working adults and families seeking adequate housing.
Rises in housing price inequality closely mirror patterns in rising income inequality, and recent increases in inequality are driven by changes in the relative value of locations, especially land which has become more valuable (4). Equal access to healthy housing is a vital need since an individual’s health is affected by poor quality housing. Negative health outcomes result not only from childhood asthma and lead exposure, but also overcrowding that results from low-income and minority families ‘doubling’ or ‘tripling’ up to have affordable housing and this has a direct relationship to poor mental health, developmental delay, heart disease, and even short stature (5). Growing research is also connecting homelessness and housing instability to negative educational outcomes in children from families that have unstable house or are homeless — with children often being absent from school or having to change schools frequently — which sets back academic and social progress by months, results in lower test scores and grades and increases the likelihood of dropping out of school (6). Interventions focusing on homelessness must also take into account the needs of children in order to break the generational cycles of homelessness.
Minimum wage work hours needed to afford a one bedroom rental home, by state (2017)
In Colorado, affordable housing is a substantial issue. A recent survey found that three out of four metro area individuals that identified as homeless were employed (7). A Colorado Mesa University poll found that housing affordability was the biggest issue facing Coloradans, with housing taking on average 35 percent of a typical Colorado family’s spending — for households making $50,000 or less a year. As housing unaffordability continues to grow in the state, families on the margins will continue to struggle and potentially be displaced to more affordable areas. Currently, 50 percent of Colorado renter households are cost-burdened — meaning over 30 percent of their individual or family income is spent on housing, and 85 percent of these cost-burdened renter households have annual incomes less than $50,000 (8).
Implications and Data for Jefferson County
Community Health Needs Assessment Focus Group Findings
Health concerns related to the presence of asbestos and mold in low-income housing was expressed by many participants. Many noted that their children struggle with asthma and that poor indoor air quality worsens their symptoms. Participants also mentioned that connecting low-income residents to financial assistance can help meet basic needs like housing.
Community Health Needs Assessment Key Informant Interview Findings
Housing affordability, attainability and stability was a recurring theme across most of the informants. Housing costs for both renters and owners have risen dramatically in recent years with an influx of new residents. These cost pressures create substantial stressors on the ability of low-income families and individuals to meet basic needs such as acquiring food, medicine, education, and health insurance. Informants noted that programs such as Section 8 exist for affordable housing, but housing is often not attainable due to underfunding. In addition, waiting lists for such programs can be years long, and this impacts vulnerable populations such as older adults on fixed incomes.
Families who were already struggling to make ends meet are now faced with even greater pressures with rising costs of housing. As a result, families are being displaced outside of the county or having to reside in transient housing options like motels. Many of these families are near homelessness.
Informants noted that the stresses created by housing instability have had significant health impacts on the community such as worsening food insecurity, poor mental health and inability to make ends meet. The need for affordable housing was the main takeaway from discussions with most informants. Click here to learn more about income.
Home and Rental Values
In the last 10 years (2008-2017), there was a 52.5% increase in home value and 50.4% increase in rental costs in Jefferson County.
- US Census, American Community Survey data
The two maps below show the burden of housing on lower income families. The map on the left shows the median house value, by census tract, for Jefferson County, where the lighter colors equal areas with lower house values and darker colors equal areas with higher house values. On the right, the map shows those areas where more (darker) households are spending 30% or more of their income on housing. With a few exceptions, the majority of areas with lower house values are also the areas where many households are spending much of their income on housing costs.
Median house value (dollars)
Households spending 30% or more of their income on housing
Source: US Census, ACS 5-year estimates (2013-2017), Table: B25077 and B25095
In Jefferson County, of occupied units, 71.4% of units are owner occupied, while 28.6% are rented
- US Census, American Community Survey data (1-year estimates, Table: B25003)
Age of Housing
Children who live below the poverty line and live in pre-1950 housing are at the greatest risk for lead exposure because the home is more likely to have aging lead paint that is in poor condition (9).
To find more about lead risk exposure, check out CDPHE's lead outreach tool.
Percent of houses built prior to 1960, by census tract
Darker areas represent tracts that have a greater percentage of houses that were built prior to 1960.
Source: US Census, ACS 5-year estimates (2013-2017), Table: B25034
Understanding the burden of homelessness in Jefferson County is difficult to estimate. The Metro-Denver Homeless Initiative, 2017 Point in Time Survey (a survey conducted on one day a year in January), identified 394 homeless individuals. Of these, 61% were parents and their children. However, through discussions with community partners, we know that this survey does not reach many of our homeless population. The Title One division of Jefferson County Public Schools, which consists of area leaders whose job it is to direct families and children to resources, identified 2,733 children as homeless during the 2015-2016 school year.
Of the estimated 2,733 children that the Title One division of Jefferson County Public Schools identified as homeless,
• 63 or 2.3 % were unsheltered (living in car, street, etc)
• 226 or 8.3 % were living in shelters
• 306 or 11.2 % were living in motels
• 2,137 or 78.2 % were living 'double up' (meaning more than one family is living in a home)
The charts below show that among the 394 Jefferson County homeless individuals who were surveyed in 2017, about 60% had one-two episodes of homelessness in the past 3 years, and about 40% had 3 or more episodes of homelessness. The majority (40%) have been homeless for 1-3 years. Among those surveyed, the main reasons given for homelessness in Jefferson county were high housing costs and relationship issues (abuse/violence in the home or family break up). About 15% said mental illness and 25% said that substance abuse contributed to their homelessness .
Community Resources within Jefferson County
1. Krieger, J., & Higgins, D. L. (2002). Housing and Health: Time Again for Public Health Action. American Journal of Public Health, 92(5), 758–768. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447157/
2. Breysse, P. & Gant, J. (2017). The Importance of Housing for Healthy Populations and Communities . Journal of Public Health Management and Practice. 23 (2): 204-206. Available at: https://journals.lww.com/jphmp/Fulltext/2017/03000/The_Importance_of_Housing_for_Healthy_Populations.20.aspx
3. U.S. Department of Health and Human Services. (2009). The Surgeon General’s Call to Action to Promote Healthy Homes. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK44192/pdf/Bookshelf_NBK44192.pdf
4. Albouy, D., Zabek, M. National Bureau of Economic Research. (2016, January). Housing Inequality (Working paper 21916). Retrieved from: http://www.nber.org/papers/w21916.pdf
5. Bashir, S. A. (2002). Home Is Where the Harm Is: Inadequate Housing as a Public Health Crisis. American Journal of Public Health, 92(5), 733–738. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222229/
6. Galvez, M. & Luna, J. (2014). Homelessness and Housing Instability: The Impact on Education Outcomes [Issue Brief]. Retrieved from: https://tacomahousing.net/sites/default/files/print_pdf/Education/Urban%20Institute%20THA%20Homelessness%20and%20Education%202014-12-22.pdf
7. Guiding Golden (2018). Affordable Housing. Retrieved from: https://www.guidinggolden.com/affordable-housing?tool=news_feed#tool_tab
8. Newcomer, J., & Resnick, P. Shift Research Lab. (2018). Exploring Colorado’s Housing Affordability Challenges in All their Complexity. Retrieved from: http://www.shiftresearchlab.org/sites/default/files/2018-02/Housing%20Unaffordability_Final_Report_0.pdf
9. Washington State Department of Heath. (2015). A Targeted Approach to Blood Lead Screening in Children, Washington State. Retrieved from: https://assets.documentcloud.org/documents/2644455/Expert-Panel-Childhood-Lead-Screening-Guidelines.pdf
National Low Income Housing Coalition: http://nlihc.org/sites/default/files/oor/OOR_2017.pdf
US Census, ACS: American Community Survey - American Factfinder (Tables: DP04, B25064, B25077, DP25003): https://www.census.gov
Jefferson County Housing Authority: http://www.jcha.org/
Metro Denver Homeless Initiative: https://www.mdhi.org/
Title One, Jefferson County Public Schools: http://www.jeffcopublicschools.org/programs/diversity_inclusion/title_1
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Published on July 17, 2018
Updated on June 21, 2019