Home Is Where the Health Is

How Cities and States Can Address the Affordable Housing Crisis

California, Chicago, Denver, and Atlanta are showing how cities and states can look within and to one another to tackle the United States’ rising affordable housing crisis.

A boy rides his bike past a home, June 2015. (Getty/The Denver Post, Cyrus McCrimmon)
A boy rides his bike past a home, June 2015. (Getty/The Denver Post, Cyrus McCrimmon)

Housing affordability is a pressing issue for communities across the United States, with roughly 39 million U.S. households—including nearly half of all renters and 1 in 4 homeowners—struggling to afford their housing. Accessible, safe, and quality homes form the foundation of health and well-being for every household, yet the rising cost of housing is making it increasingly difficult for many U.S. residents to keep a stable roof over their heads while meeting basic needs such as water, groceries, health care, and transportation. While the national housing market has, by most accounts, rebounded, the gains made have disproportionately benefited higher-income households. For residents of modest and limited means, wages and housing subsidies have failed to keep pace with rising rental costs. These costs are consuming a larger share of these residents’ disposable income and savings, increasing household insecurity and deepening existing socio-economic inequality and segregation.

Despite its importance, the supply of affordable housing remains in dire straits: While the need for aid rises, existing rental stock is aging and federal housing assistance continues to stagnate. Today, only 1 in 5 eligible families in need of rental assistance actually receives it, due in large part to insufficient federal funding. Extremely low-income (ELI) households, who represent more than 25 percent of all U.S. renters, face a 7.4 million unit shortage in affordable housing, meaning that there are currently only 35 units available to rent for every 100 ELI households nationwide. Equally alarming, the overall number of housing units subsidized by federal home loan mortgage corporation Freddie Mac has decreased more than 60 percent since 2010, while private-sector investments remain inadequate. And without meaningful action at all levels of government, the ever-shrinking, already deficient national affordable housing stock risks losing many more units over the next 10 years due to maintenance neglect—thereby becoming uninhabitable—or from conversion into market-rate housing once their federally required affordability period expires.

During the Obama administration, several executive actions were taken to meaningfully reduce residential segregation and ensure that financially struggling households are not confined to living in regions with high concentrations of poverty and low rates of opportunity. President Donald Trump not only is seeking to roll back these fair housing rules, but he also is aiming to slash funding for vital housing assistance programs. The truth of the matter is that federal resources and efforts have rarely if ever been able to meet the need for affordable housing—something that seems even less likely, let alone desired, under the current administration and Congress.

Throughout this long-standing crisis, state and local governments have stepped up to fill the affordable housing void left by the federal government, with many doing everything within their means not only to preserve and improve existing fair, affordable housing stock but also to find innovative ways to increase it. Although the Center for American Progress does not necessarily endorse every aspect of what the following states and localities have done, below are some notable examples of approaches that creatively and meaningfully combat homelessness and the ballooning housing affordability crisis.


Although the state boasts a mighty, vibrant economy—the fifth largest in the world—approximately 1 in 6 Californians are living in poverty, and homelessness is rapidly rising and spreading throughout the state, with more than half of residents burdened by the cost of their housing. In September, Gov. Jerry Brown (D) signed into law a comprehensive suite of bills to help tackle the state’s deepening inequality and housing crisis. The legislative package establishes permanent funding sources for the creation and preservation of affordable housing by applying a small minimum recordation fee of $75 on all market-rate real estate transactions, which will raise roughly $250 million in annual funding for anti-homelessness, local planning, and other housing assistance services. Additionally, the housing package places on the upcoming November general election ballot a $4 billion bond initiative to fund current programs that finance the rehabilitation and construction of affordable homes and rental units, as well as increase funding for existing assistance programs that help veterans, farmworkers, and low-income households secure housing.

At the local level, the legislative package seeks to incentivize counties and cities to streamline their planning, review, and approval processes to simplify and accelerate housing development. The legislation also deters local public policies and actions that would make it difficult to develop fair, affordable housing within communities, through increased evidentiary standards and burden-of-proof requirements, as well as strengthened monitoring and enforcement.

For the sole purpose of preventing and fighting homelessness, Los Angeles County recently approved a spending measure—projected to raise $355 million annually over a period of 10 years—to fund rental subsidies and supportive services and improve the county’s shelter system. This effort built on the county’s establishment of the Flexible Housing Subsidy Pool (FHSP) in 2013, an innovative, now $40 million local rental subsidy program designed to secure quality affordable housing and provide intensive case management supports to county residents who are experiencing homelessness and have physical and behavioral health needs.

Chicago, Illinois

According to the most recent U.S. census, of the nation’s 100 largest metropolitan areas, the city of Chicago ranked fifth highest in racial and economic segregation and inequality—disparities exacerbated by the mismanagement of affordable housing funds and the continued use of local exclusionary zoning ordinances to limit affordable housing development and restrict the movement of low-wealth households from marginalized, disinvested communities into advantaged neighborhoods. In an effort to improve its practices, the city council approved a three-year pilot program that amends Chicago’s Affordable Requirements Ordinance (ARO) to increase the percentage of required affordable housing units and the number of eligible households in rapidly gentrifying neighborhoods. Expected to generate an additional 1,000 affordable housing units, the pilot eliminates the opt-out fee option for developers, in addition to raising the percentage of units that must meet ARO requirements for all new, city-backed residential construction projects that have 10 or more units in the pilot areas.

Modeling after Los Angeles County, last month, the city of Chicago announced the creation of its own tailored FHSP model, dedicating $1.8 million in 2018 to place residents with chronic housing insecurity and high health needs into permanent housing with comprehensive case management and support services. Chicago’s FHSP program encourages an active, expanding partnership between the city’s housing and social services departments to help streamline administrative processes to allow for rapid housing placement and better-integrated social and health services. It also works with landlords and local housing nonprofits to cover participants’ housing costs.

Chicago launched its FHSP program at the same time that city-based medical institutions such as the University of Illinois Hospital began to invest in programs designed to house frequent users of the city’s emergency rooms who are also experiencing homelessness. Since implementing the program in 2015, the hospital has reduced its spending on participating patients by at least 18 percent, or $13,128 per patient, annualized. The hospital plans to expand the program to house more patients experiencing chronic homelessness, and three other local hospitals are implementing similar programs.

Denver, Colorado

Colorado saw one of the largest drops in housing affordability between 2010 and 2016, with its supply of federally subsidized affordable housing declining from 32.4 percent to just 7.5 percent for very low-income households. With rapid increases in the population share of high-income new residents and housing prices far outpacing the city’s wage growth, Denver is grappling with rapid, citywide gentrification resulting in the involuntary displacement of its low- to moderate-income households—disproportionately people of color, residents with disabilities, and seniors.

This past July, Denver accomplished its five-year 3×5 Affordable Housing Initiative a full year ahead of schedule, exceeding its 2013 goal to build, rehab, and preserve at least 3,000 units—45 percent of which were designated for particularly vulnerable populations. Seventy-one percent were in communities vulnerable to gentrification, 97 percent were built a quarter-mile from a major bus route, and 47 percent were within a half-mile of a mass transit rail line. Additionally, the Denver City Council recently approved the creation of the city’s first affordable housing fund, which is set to raise more than $150 million over 10 years in dedicated funding to boost new housing development, preserve existing units, and provide emergency assistance to help cost-burdened residents stay in their homes.

Building on this progress, in an effort to provide the 21,000 more affordable housing units needed to meet the city’s minimum demand, Mayor Michael Hancock (D) recently unveiled Denver’s five-year strategic plan to increase access and opportunity: Housing an Inclusive Denver. Under the plan, the city aims to build 2,000 affordable units by 2023, preserve 1,000 existing housing units, and develop programs that increase access and resources to fair housing opportunity—as well as tools that help protect vulnerable residents from being displaced—while fostering a better-connected, more supportive infrastructure. Finally, the city’s first Social Impact Bond program (SIB), launched in 2016, has dedicated almost $8.7 million in private investment funds, coupled with $15 million in federal resources, to provide permanent housing and supportive case management services to Denver’s most vulnerable residents who are frequent users of the city’s emergency services. The SIB program is similar in scope to Los Angeles County’s and Chicago’s FHSP models, and a preliminary outcome evaluation found that after one year, 89 percent of participants remained stably housed and enrolled in the support program.

Atlanta, Georgia

In 2017, Mayor Kasim Reed (D) concluded his eight-year tenure governing the city of Atlanta having effectively ended veteran homelessness, surpassed the city’s annual job and affordable housing development goals, and established the municipality as “the first … in Georgia to pass an inclusionary zoning law.” Part of a new, citywide Workforce Housing Policy, the landmark ordinance requires all subsidized, new residential construction projects within Atlanta’s booming beltline and transit-accessible communities to designate 10 percent to 15 percent of units as affordable for residents who make between 60 percent and 80 percent of an area’s median income. The new, ramped-up investments and requirements come on the heels of recent analyses finding that the city had lost more than 1,000 units per year over the past decade and was also falling far short of its fair, affordable housing promises. Despite being one of the highest-ranking job-creating cities, Atlanta’s residents also suffer from some of the highest levels of socio-economic inequality, due in large part to historical and chronic underinvestment in affordable housing; sustainable, high-quality infrastructure; and public transportation. As a result, Atlanta residents face the highest water utility costs in the nation and some of the longest average commutes, with 68 percent of low-income households spending more than half of their monthly paycheck on rent.

New Mayor Keisha Lance Bottoms (D) recently announced plans to launch the Atlanta Affordable Housing Initiative and raise $1 billion to increase and expand citywide affordable development and anti-displacement efforts. As one of the largest owners of vacant land in the city, the Atlanta Public School system recently established an Affordable Housing Task Force to explore opportunities to convert its unused properties into stable housing for local educators, students, and families most in need. Coalitions such as City for All and the TransFormation Alliance continue to advocate for the new mayor and city council to prioritize inclusive, equitable, and transit-oriented development that centers the creation and preservation of affordable housing around accessible public transportation, a key factor in combating structural barriers such as concentrated poverty, low mobility, and segregation.


Stable, supportive, and accessible housing is a core building block of a quality of life that enables individuals and families to pursue the American dream. The rising housing affordability crisis tears at the very fabric of this national ethos, forcing far too many households to defer individual pursuit as they struggle to afford rent while covering basic living needs. If the current trend continues, the disparity between the need for and the supply of accessible, affordable housing will worsen.

It is important to take note of—and accountability for—this rising inequality, exacerbated by recently proposed and enacted public policies and regulatory rollbacks that threaten the nation’s opportunity to ensure fair, quality housing for all residents. At a time of retrenched federal support, communities are increasingly looking to their state and local governments to address this rapidly growing need. As a result, it is important for localities to ensure that they are not serving as purveyors of the nation’s deepening inequity. Instead, they should be leveling the playing field by looking within and to one another for creative ways to preserve and expand inclusive, affordable housing.

Rejane Frederick is an associate director for the Poverty to Prosperity Program at the Center for American Progress.

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Rejane Frederick

Associate Director, Poverty to Prosperity Program