Excerpted From: Khushbu Patel, Covid-19 Policies & Their Impact on Housing and Health Outcomes in the City of Chicago, 24 DePaul Journal of Health Care Law 1 (January, 2023) (149 Footnotes ) (Full Document)

KhushbuPatelConditions of poverty often result in poor health outcomes and are further aggravated by limited access to affordable and proper housing. For example, poor housing conditions can lead to higher rates of asthma, lead poisoning, as well as injury from poorly maintained structures. Lack of income and access to public benefits can result in food insecurity, low birth weight, and depression. In Chicago, there are more than 500,000 people who are at or below 100% of the Federal poverty guideline, and one in six children in Chicago is living in poverty.

Many agencies within the State of Illinois work to address the issues of families living in low-income areas, living at and below the poverty line, experiencing financial hardships, and lack of access to healthy affordable food options. One of those agencies is the Chicago Housing Authority (CHA). The CHA is the third largest public housing agency in the nation and serves more than 200,000 low-income households, by providing safe, decent, and affordable housing in healthy, vibrant communities. The CHA's Housing Choice Voucher (HCV) Program plays a vital role in housing families with children, the elderly, and people with disabilities across Chicago. Individuals who fall into these categories are the most vulnerable groups of people and as such the HCV works to use federal funds provided by the U.S. Department of Housing and Urban Development (HUD) to help participants pay for housing in the public market.

However, since there is never a shortage of families that need rental assistance, this program has a long waiting list resulting in many families being unable to easily access these funds which were established to aid those who most need it. Despite the availability of federal funds and agencies that delegate those funds, many needy families end up being unable to access these funds due to difficulty applying, eligibility, and even language barriers that make understanding and utilizing the process difficult. Even without these barriers, families are still unable to access funds when agencies use their discretion when to open and close the waiting list without the public having any accurate knowledge of when they will reopen.

The notion that health status and health outcomes are significantly affected by social determinants of health such as access to healthcare, economic status, education, and social and environmental context has increasingly become the subject of research and the focus of attention at the national and international levels. More so with the COVID-19 pandemic, the disturbing role that the social determinants of health have played in the distribution of the disease is more evident by the disparate rates of COVID-19 cases, hospitalizations, and deaths among the most vulnerable communities and marginalized groups.

This paper concludes that the COVID-19 mandates and policies that were implemented by both the state of Illinois and the City of Chicago such as eviction moratorium dramatically improved health outcomes by alleviating financial stress of many households. Part II of this paper will discuss social determinants of health and the impact that the different areas of social determinants relate on housing and health outcomes. Part III of this paper will discuss the overall concept of housing in Chicago and the health outcomes of low-income individuals. Part IV of this paper will discuss the housing laws and place prior to COVID-19 at the federal, state, and local level. Part V of this paper will discuss the COVID-19 policies and state mandates in response to the pandemic on the local and state level. Part VI of this paper will then discuss the positive impact that these policies and executive orders on housing in Chicago. Then, Part VII will discuss the negative impact of these policies and executive orders on housing in Chicago. Finally, Part VIII will highlight the future of affordable housing in Chicago and health outcomes.

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A new and important area of research will be understanding the impact that COVID-19 has on evictions and the “efficacy of antieviction policies”, as well as examining the downstream consequences that eviction has on health. In particular, “the full scope of the lifetime consequences of evictions experienced during childhood and the health consequences of eviction” for medically at-risk adults are still to be completely understood. The extent of state, federal, and local policies create in response to the COVID-19 pandemic has initiated “many natural experiments”, resulting in research opportunities to improve and expand the base on knowledge of evictions and their impact. These natural experiments can prove useful in understanding how maintaining stable housing results in increased health outcomes for at-risk individuals.

The pandemic has made it clear that quick action is needed to address situation surrounding low-income renters who face the possibility of losing their home. “In the short term, moratoria could be expanded and strengthened by covering all eviction cases, not just those for nonpayment of rent” as was the norm prior to the pandemic. However, temporary moratoria are momentary solutions, and rents continue to build, which results in future impending financial stress for many individuals. “assistance programs must be implemented immediately to reduce evictions and to provide tenants and landlords with funds to weather this economic and public health crisis” as the impact will be felt for decades to come especially for those impacted socioeconomically and socially. Federal, state, and local governments should look to creating policies that make safe and affordable housing available and accessible to Americans with low-income.