PORTLAND, Ore. – La atención de la salud no termina cuando una persona sale del consultorio médico. Varios factores externos del esquema tradicional de atención, como la vivienda, juegan un papel primordial en la salud general de una persona. Michael Mellick, administrador de casos de vivienda en CareOregon, dice que cualquier persona que experimente una falta crónica de vivienda, seguramente experimenta también otros problemas.

“Puede asumirse que caerán en problemas de dependencia de substancias, y tratamos de ayudarles con eso. Y seguido aparecen problemas de salud mental. Hay problemas de antecedentes criminales que deben ser resueltos.”

Enfrentar las determinantes sociales como una vivienda adecuada es obligatorio para las Organizaciones Coordinadas de Atención (“Coordinated Care Organizations”), que manejan el Plan de Salud de Oregon (“Oregon Health Plan”) en las comunidades locales. En Portland, seis organizaciones de salud –incluyendo “CareOregon" y “Kaiser Permanente”, lanzaron en 2016 la iniciativa La Vivienda es Salud (“Housing is Health”). Los fondos de ésta han sostenido dos desarrollos para propietarios de bajos ingresos, y otro proyecto está programado para abrir sus puertas este verano.

“Housing is Health” es parte de la respuesta de CareOregon a los problemas de vivienda. Los administradores del caso como Mellick ayudan a los clientes no residenciales a buscar soluciones para sus necesidades específicas. Describe a un cliente que había vivido en las calles durante dos años con una enfermedad pulmonar crónica. Dice que el hombre es viejo y está en una posición vulnerable, y que la vivienda le está ayudando a extender su vida.

“Sigue involucrándose en conductas que no necesariamente son las más saludables para él, pero su utilización y el costo de su atención decrecieron drásticamente por el simple hecho de que ahora duerme en un lugar cálido y seguro.”

Mellick dice que una amenaza frecuente para los clientes es el sentimiento de aislamiento. Puede venir de una variedad de fuentes, como un trauma en una edad temprana, o los efectos del racismo o la pobreza. Agrega que tratar esto podría contribuir a una sociedad mejor.

“No estás nada más acabando en el individuo – estás viendo su relación individual con la comunidad. Alivio, recuperación, renovación. Esto va hasta el concepto de las relaciones y el lugar de una persona en la comunidad.”

Residents in a rural North Carolina town grappling with economic challenges are getting a pathway to homeownership.

In Enfield, the average annual income is about $25,000, while the average home price in the state exceeds $300,000. The significant gap between income and housing costs makes homeownership unattainable for many residents.

Mondale Robinson, mayor of Enfield, said it is an issue with which he is all too familiar, having grown up in the town. He acknowledged the dire housing conditions faced by many residents.

"Housing there is third-world," Robinson asserted. "And I know that term is not politically correct, but I use it intentionally to remind people that while we may be in the so-called richest country in the world, my people are suffering from houses that are killing them."

He pointed out many people in the town are living things like severe mold or failing foundations. Recognizing the challenges posed by limited resources both on a town and federal level, Robinson explained he is tackling the issue by forming partnerships with construction firms and lending institutions. He noted through the Horizon Project, they aim to build energy-efficient homes priced affordably at about $105,000.

Robinson highlighted historically, the majority of Black residents there have been marginalized from experiencing positive changes in their neighborhoods. He explained previous investments focused on constructing homes that were unaffordable for the community. Robinson expressed optimism the initiative will serve as a foundation for achieving long-term equality and stability.

"We had a qualification seminar where we brought people in to see if they qualify for homes," Robinson recounted. "Of those 400 people that showed up, 174 already prequalified and have already started ordering their model homes and on the process to become homeowners."

He added families who qualify will receive smart homes with two to four bedrooms, an opportunity most people living on an hourly wage in the town would not have had access to.

In addition to the housing aspect of the project, Robinson emphasized the importance of economic development and sustainability. He said they will offer training to help new homeowners maintain their property.

He stressed another major part of the Horizon project is meant to help promote growth in the town and return ownership to the people who live there.

"When all of these new houses pop up in this rural space, we know what's to follow, businesses to follow," Robinson projected. "Also, we're looking for the mental victory that folk feel when they've purchased a home, alleviating the fact that you have a landlord that is not concerned with how your health is affected by the house you're living in."

By addressing housing affordability and promoting economic empowerment, Robinson hopes the Horizon Project will serve as a blueprint for similar initiatives across North Carolina and beyond. Qualified families will move into new homes by June, while ongoing support aims to assist others in future qualification.


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New York State housing advocates say they are furious about the so-called "good cause eviction bill" in the new state budget.

It grants tenant protections to people in New York City but all other municipalities will need to opt in. It also requires renters to know their landlord's portfolio to determine eligibility for "good cause" eviction protections and the information can be hard to find.

Ritti Singh, communications organizer for the group Housing Justice for All, said previous iterations would have balanced tenant and landlord interests.

"What it required landlords to do was to show they had a valid cause of eviction, which would include nonpayment, violating the lease, causing trouble, if the landlord wanted to move into the unit," Singh outlined. "It also allowed tenants to contest rent increases over 3%, or 1.5 times the rate of inflation."

For all its potential benefits, a New York University study noted "good cause" eviction comes with just as many drawbacks. It can discourage maintenance investments in buildings, and increase the cost of resolving landlord-tenant disputes. Singh noted the bill was not designed to crimp a landlord's ability to do business but to make the housing system fairer.

Cities like Rochester and Ithaca are close to declaring housing emergencies due to rising rents. Municipalities must have a vacancy study rate below 5% to declare a housing emergency. Singh pointed out the housing crisis affects renters statewide.

"Rents are rising faster in Syracuse than they are in New York City," Singh emphasized. "In March, rents hit record highs in New York City. Rural New York is expected to see a surge of evictions over the next decade, and Long Island renters face the highest cost burdens in all of New York State."

Newburgh declared a housing emergency last year but the Orange County Supreme Court recently overturned the decision. The petitioners' attorney argued Newburgh's vacancy study was inaccurate. The Emergency Tenant Protection Act does not cover the city's renters now and jeopardizes other tenant protections the city has proposed.


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Oregon lawmakers passed a major housing package in this year's session, but said easing the state's housing crisis will take more work.

Bills passed during the short legislative session will send a total of $376 million to address the state's housing shortage, including Senate Bill 1530 and Senate Bill 1537, priorities for Gov. Tina Kotek.

Shannon Vilhauer, executive director of Habitat for Humanity of Oregon, said the governor's housing package is groundbreaking.

"We also see important investments in emergency housing assistance, addiction recovery support and renters protections," Vilhauer pointed out. "Those are all investments that are going to help stabilize Oregonians in need of housing assistance and benefit the communities we all share."

The housing package includes funds for housing and homelessness projects and to support counties buying land and developing properties.

However, Vilhauer argued there is still more to do to address the crisis. During the next legislative session, she hopes the state will help first-time homebuyers, as well as make other investments.

"Preserving affordable rental homes that exist now but are at risk of terming out of their affordability and going market rate," Vilhauer explained. "We'd love to see that affordable housing preservation investment move forward in a strong way."

Vilhauer acknowledged the housing issue in Oregon cannot be solved immediately. It is a problem decades in the making.

"It will take a concerted effort over time to continue to make headway," Vilhauer stressed. "We're starting to get there but we need to keep going with a sustained effort."


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