In spring of 2020, just as COVID was ramping up, Judy O’Kulsky began knocking on her neighbors’ doors at the public housing development where she lives in Belchertown, MA. Judy was able to get her neighbors involved in a newly forming tenant group. As of July 2021, the group has held an election, adopted by-laws, and is on the brink of being “officially recognized.” 

Judy took several trainings with the Mel King Institute’s (MKI) Public Housing Training Program (now known as the Resident Leadership Academy) last summer, fall and spring. The Program provides trainings for residents of public housing to support their full participation in the oversight of their housing developments. She has also worked closely with the Mass Union of Public Housing Tenants in getting her LTO up and running. 

In an interview, Judy said getting people on board was slow at first. In many housing developments, residents are held back by fear and sometimes by a sense of hopelessness. After holding many conversations with residents, Judy and others have been able to overcome these barriers and involvement has been good. Eleven people from the Belchertown development participated in the MKI training on how to start a tenants’ organization.  

“As a result of the training, people are excited to get a tenants organization up and running. The training has breathed new life into this place. We’re pretty darn amazing to be able to get this far during COVID! If we can get a tenants’ organization up and running during COVID, there’s nothing we can’t do,” said Judy. 

Over in Greenfield, MA, the residents at the Elm Street development have also started an official tenant group. Along the way, the group experienced some roadblocks due to the COVID-19 pandemic. In an interview with MKI, Greenfield resident L’aura Jordan said the tenant group had some months of inactivity. Participation is relatively low at virtual meetings since many residents do not have access to, or knowledge about, the technology required to attend the meetings.  

L’aura also said that some members of their group do not have much experience and understanding of organizing, and that can be a challenge. Despite these challenges, L’aura was happy to report that as a group, they are having important conversations about bridging divides amongst tenants. She said the MKI training has helped them to brainstorm about steps they can take, and that that hearing from other participants at the trainings about their experiences and about what worked for them was very helpful.  

“I’m really grateful that I have had the chance to participate in the trainings, and I hope I can do more, because it has given me tools and awareness that have made a huge difference in how I approach my work in my community,” said L’aura. 

We also interviewed Randi Parks, a Greenfield resident who serves on the Greenfield Housing Authority board. Randi reports that the MKI training is helping residents to learn the system so that they can change, and then help others to change. Randi said she learned a lot about housing through the training, and it helped her to gain the confidence to speak up and act. 

“Everything I know about housing and the board is all because of the Mel King Institute. I wouldn’t have had any other way to learn it. I used to be scared and just sit back and listen at the board meetings, but I realized that I don’t have to do that anymore. I have more backbone because I get what’s going on now. It makes a lot of difference when I know what’s going on.” 

2020 was a year unlike any other, and (we hope) will not be replicated any time soon. The human cost of the COVID-19 pandemic has been catastrophic, with more than 3 million people dying worldwide, and well over half a million deaths in the United States. The economic fallout from the pandemic has been no less severe. In Massachusetts, the unemployment rate jumped from 2.9% in March 2020 to over 16% the following month; one year later, it still stands at 6.8%, with many more uncounted.

Sadly, but not surprisingly, the health and economic toll of the pandemic has fallen disproportionately on Communities of Color, starting with the first wave of the pandemic, where an analysis cited in the Boston Globe showed that the mortality rate surged higher in MA cities, towns, and ZIP codes with larger concentrations of poverty, economic segregation, People of Color, and crowded housing. The disproportionate economic disparities persist. 

While CDCs responded quickly and creatively to meet the pandemic-related needs of their communities, it is unsurprising that many regular CDC activities were significantly disrupted in 2020. Many CDC construction projects were delayed by construction bans and other disruptions, so much so that 54% of the homes originally projected to come online in 2020 were delayed until 2021. The result is lower than usual housing production totals in this year’s report, and a corresponding reduction in construction jobs and investment dollars. Many regular CDC programs were also disrupted by public health restrictions. 

CDCs found new ways to serve the needs of their community’s most vulnerable residents. Forty-four CDCs conducted wellness calls and other efforts to ensure resident and community health and safety, and 42 CDCs assisted with food delivery. 

Twenty-six CDCs continued long-standing efforts to support small business entrepreneurs, in old and new ways, helping these entrepreneurs access almost $12 million in Paycheck Protection Program loans and close to $10 million in grants, providing an essential lifeline to these small business owners. To help community residents struggling to pay rent for apartments in the private market, CDCs provided cash assistance totaling $28.2 million in 2020, an increase of $10 million from 2019.

CDCs redoubled their efforts to make their organizations reflective of the communities they serve.  In 2020, 36% of senior staff at CDCs were People of Color, up from 29% in 2019, and the number of CDCs hiring racial equity consultants increased by almost 50%.  

Some have called CDCs “second responders” to reflect the role they play during a crisis as they help people survive, recover, heal, and rebuild. Never has that been truer than in 2020. While the numbers and stories in this short report cannot tell the full story, we hope they give our readers a sense of how CDCs rose to the occasion during this most difficult and trying of times.

Read and download the report here.

Governor Charlie Baker and Lt. Governor Karyn Polito, joined by senior Administration officials and area legislators, traveled to Lawrence on July 15th to announce funding awards to 28 affordable rental housing projects. This in-person event is evidence that Massachusetts is increasingly open for advancing affordable housing development. 

The Commonwealth awarded $93.3 million in direct subsidy funding and federal and state low-income housing tax credits, which will generate an additional $310 million in tax credit equity. These awards will advance the development of 1,526 new rental units, including 1,311 homes affordable to low and extremely low-income households. 

Eight MACDC Members were among the sponsors receiving awards.  Collectively, the projects sponsored by these Members will create or preserve 327 rental units, including 277 affordable units. 

• Rosewood Way Townhouses is a new construction project for families to be built in Agawam, sponsored by Way Finders. When completed, the project will offer 62 units, including 47 affordable units.
• Valley CDC will newly construct Amherst Supportive Studio Housing, which will include 28 studio units with supportive services, with 20 of these units being affordable.
• Burbank Terrace is a transit-oriented new construction project for families to be built in Boston’s Fenway neighborhood, sponsored by Fenway CDC. The project will provide 27 affordable units.
• B’nai B’rith Housing is sponsoring Residences Off Baker, a new construction project for families to be built in Boston’s West Roxbury neighborhood. It will provide 60 units, including 45 affordable units. 
• The Neighborhood Developers will newly construct 25 Sixth Street in Chelsea, providing 56 rental units for families, including 44 affordable homes. 
• 555 Merrimack Place is a new construction project to be built in Lowell. Sponsored by the Coalition for a Better Acre (CBA), the project will provide 27 affordable units and supportive services for a population in recovery from substance use disorder. 
• Metro West Collaborative Development will newly construct Glen Brook Way Phase 2, and provide 44 affordable units for seniors in Medway. 
• Granite Street Crossing is a new construction project to be built in Rockport, sponsored by Harborlight Community Partners. This intergenerational project will provide 23 affordable units, with 17 units restricted for seniors.
   

Congratulations to sponsors of all these critically-needed projects!

Revitalize CDC in Springfield improves housing conditions by performing assessments and interventions for adults and children with asthma to safely remain in their home. (Photo credit: Revitalize CDC)

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Defining the Problem

In our first blog post, we discussed how housing quality can impact health on a broad scale and how Massachusetts’ housing stock is particularly susceptible to these challenges because of its age. In the following blog post, we detail how specific housing quality and safety problems can result in negative health outcomes for individuals and communities. We also discuss how and why many of these challenges disproportionately impact vulnerable populations such as children, elderly, low-income families and people of color.

Lead
Unsafe Housing Conditions:
Over 70% of homes in Massachusetts were constructed before lead paint was banned in 1978. All homes built before 1978 are likely to contain some lead-based paint which can be inhaled or ingested¹ unless steps have already been taken to make them lead-safe or remove that lead paint.

The Resulting Health and Safety Problems:
Any amount of lead in the body can hurt the brain, kidneys, and nervous system, slow down growth and development, make it hard to learn, damage hearing and speech, and cause behavior problems. These problems are particularly harmful to children who absorb lead more easily than adults and who are still growing and developing. Between 2013 and 2017, 16,961 children in Massachusetts were estimated to have blood levels above 5 micrograms per deciliter – the level at which the Center for Disease Control and Prevention says the source of lead exposure should be investigated.²

Impact on Populations at Risk:
Lead exposure is unevenly distributed across the Commonwealth with communities that face inequities in accessing quality housing being particularly susceptible.³ According to the Massachusetts Department of Public Health, Black children are nearly 2.5 times more likely to have lead poisoning than white children. Additionally, children living in low-income communities are over 3 times more likely to have elevated lead levels than children living in high income communities.⁴ This disproportionate impact translates to over half of children with confirmed elevated blood levels being concentrated in just 19 cities and towns in Massachusetts.⁵

Poor Indoor Air Quality
Unsafe Housing Conditions:
Poor indoor air quality is caused by mold, dust, second-hand smoke, poor ventilation, and leaky pipes and faucets. Outdoor air pollution, from cars, smoke, and industrial sources, can also impact indoor air quality, as can weather patterns like humidity, precipitation, and wind patterns.

The Resulting Health and Safety Problems:
Poor air quality can cause respiratory and allergy symptoms including coughing, sneezing, and difficulty breathing. Exposure to air pollution can also cause asthma or make asthma symptoms worse.  Asthma is particularly pervasive in Massachusetts: about one in eleven people currently has asthma,  including 10.2% of adults and 12.9% of children. Asthma that is not well-controlled interferes with daily lives. For example, almost half of children with current asthma missed at least one day of school or day care as a result of their asthma symptoms.⁷

Impact on Populations at Risk:
Like many other health outcomes associated with housing quality, asthma is unevenly distributed across the Commonwealth. In Massachusetts 13.8% of Black, Non-Hispanic adults in Massachusetts suffer from asthma as compared with 10.4% of white adults.⁸ This trend is mirrored in children where, according to a 2017 report⁹, Emergency Department visits were 2.5 and 3.5 times higher for Hispanic and Black non-Hispanic children as compared with white children in 2012. This same report showed that 17.1% of children living in a household with income of less than $25,000 suffered from asthma as compared with 8.1% of children living in households with an income of $75,000 or greater.

Properties in Unsafe Condition
Unsafe Housing Conditions:
In rental housing in MA, the landlord is responsible for compliance with the Massachusetts State Sanitary Code. The Code requires, among other things, that the rental unit have adequate sewage disposal, heating, and hot water. The home must also be free of hazards, ranging from pest infestation to asbestos and, for households with a child under 6 years old, lead paint. While a tenant has rights in the event a landlord is not in compliance with the Sanitary Code, enforcing these rights can be time-consuming and challenging, while in the interim the unsafe conditions persist. Owner-occupants may lack the resources to address unsafe conditions in their homes. 

The Resulting Health and Safety Problems:
Renters and homeowners who live in homes that are substandard or not suitable for them can suffer health consequences, including accidents and falls and the spread of infectious disease. The risks associated with overcrowded living conditions became potentially deadly during the COVID-19 pandemic. Fires, whether stemming from unsafe (and often hidden) electrical problems or other causes, can have deadly consequences. 

Impact on Populations at Risk:
The same populations that are particularly impacted by unsafe housing face the double whammy of having fewer housing choices when they determine that their current homes are unsuitable.  Many elders and persons with disabilities encounter a dearth of homes with the accessible or adaptable features they require. For low-income and low-wealth households, the high cost of renting or buying limits their options. For all of these households, and households encountering discrimination, finding other safe, suitable and affordable housing may not be an option at all. Further, in the event that a family is able to relocate to safer housing, the unsafe conditions that they left persist for the next family. 

Despite state and federal laws that prohibit discrimination in the sale and rental of housing, discrimination persists in MA. A study released in 2020 by the Housing Discrimination Testing Program (HDTP) at Suffolk University Law School, showed that housing providers showed Black testers about half the number of apartments they showed to white testers.  The same study demonstrated that, about 40 percent of the time, the housing providers stopped communicating after testers revealed they intended to use vouchers. HDTP researchers also found that families with young children faced rampant housing discrimination.

Two Factors That Exacerbate the Impact of Substandard Housing on Resident and Community Health
Two broader problems deepen substandard housing’s impact on health, and make addressing this impact more complex and challenging:

• Neighborhood-and community-level property distress requires policy interventions that go beyond individual property strategies; and
• The already pernicious impacts of climate change render addressing housing quality, without addressing climate resilience, inadequate in order to protect resident and community health.

Neighborhood Disinvestment:
Lead paint, poor indoor air quality, and unsafe housing conditions each affect community and individual health in distinct ways. As noted previously, they each disproportionately impact particular populations. Geography also plays an important role. 

Many lower-income neighborhoods in Massachusetts—most notably, but not solely, in the state’s Gateway Cities and some rural communities —struggle with the challenges of weak real estate markets, where low rents and declining values, caused in significant part by decades of discriminatory housing policies, make it difficult to maintain an aging housing stock. According to a 2018 study by the Brookings Institution, “Homes of similar quality in neighborhoods with similar amenities are worth 23 percent less in majority Black neighborhoods, compared to those with very few or no Black residents.”  As a result, all of the housing quality and safety problems described above can exist, and persist, on a neighborhood or community-wide scale.

In these neighborhoods, as the cost of maintenance rises, home values can steadily decline to the point where it can stop making economic sense to invest in these structures for the long term. Where this happens, one sees absentee owners buying cheap and collecting as much rent as they can before rot wins out and the building is no longer habitable. Often the result is a dilapidated problem property sitting idle, sapping value from surrounding homes and devaluing the equity that nearby homeowners were counting on to provide financial security and a nest egg for retirement.¹⁰ These community-wide impacts call for community-level (or even regional) responses.

Climate Change:
Climate change impacts many aspects of our lives. Efforts to combat climate change, and its impact, are underway in Massachusetts, including passage of legislation to dramatically reduce climate emissions.  Nonetheless, the harmful impacts of a warming climate are already being felt, in homes and neighborhoods across the Commonwealth.

The Massachusetts Executive Office of Health and Human Services (EOHHS), in its Massachusetts Environmental Public Health tracking, identifies the most serious climate-related health hazards as those resulting from:

• Increasing numbers of very hot (>90°F) summer days
• Increasing precipitation leading to flooding
• Increasing storm-related inland and coastal flooding
• Rising sea levels

According to EOHHS, climate change is expected to increase the number of days over 90°F each year, which may increase hospitalizations for heat-related illnesses. People who work outdoors, live in urban areas with limited greenspace, or lack air-conditioning are more likely to experience heat illness during extreme heat events. The U.S. Environmental Protection Agency has determined that “heat islands” (urban areas where structures are highly concentrated and greenery is limited) were responsible for daytime temperatures in urban neighborhoods rising as much as 7 degrees higher than those in outlying areas. The EPA found that the worst temperature differences are in more humid cities along the East Coast.

There are a wide variety of other ways that climate change can negatively impact human health. Air pollution events, sea-level rise, flooding, and severe weather that can result in both acute and chronic health impacts, including mental health. People who live near rivers or coastlines that experience flooding may come in contact with contaminated flood waters or experience respiratory impacts from mold growth in water-damaged homes or buildings.

Conclusion: 
While housing quality and safety challenges pose a threat to community and individual health, and an even more serious threat to particular populations, there are a number of interventions that are designed to address these problems. In our next blog post, we will introduce you to these interventions and begin to identify where there are gaps. 

We welcome your thoughts and reactions and would encourage you to share them with us. Elana Brochin can be reached at elanab@macdc.org; Don Bianchi at donb@macdc.org.

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1 - https://matracking.ehs.state.ma.us/Inspections/lead-inspection.html
2 - http://www.mass.gov/guides/phit-data-childhood-lead-poisoning https://www.mass.gov/guides/phit-data-childhood-lead-poisoning
3 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222490/; https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/quality-of-housing
4 - https://www.mass.gov/doc/childhood-lead-exposure-impact-at-a-glance/download
5 - High-risk communities are defined as those with a 5-year incidence rate of children who have a confirmed concentration of ≥ 10 micrograms of lead per deciliter cases that is above the state 5-year incidence rate after adjusting for low to moderate income and old housing stock (built pre-1978)
6 - www.mass.gov/service-details/statistics-about-asthma#:~:text=About%20one%20out%20of%20every,United%20States%20and%20in%20Massachusetts.
7 - https://www.mass.gov/service-details/statistics-about-asthma
8 - https://www.mass.gov/service-details/statistics-about-asthma#:~:text=The%20prevalence%20of%20asthma%20is%20high%20in%20Massachusetts&text=The%20prevalence%20of%20current%20asthma,ethnicity%20subgroups%20in%2020152.
9 - https://www.mass.gov/doc/pediatric-asthma-data-bulletin-0/download
10 - Ben Forman and Alan Mallach, “Building Communities of Promise and Possibility: State and Local Blueprints for Comprehensive Neighborhood Stabilization”, January 2019