Editor’s note: This post is part of a series of responses to Health Affairs’ recent Health Policy Briefs focused on housing and health.
Growing evidence cited in Health Affairs’ recent series of Health Policy Briefs and elsewhere indicates that safe, affordable housing is necessary to improve health. These points include reducing exposure to toxins, boosting mental health, and freeing up a greater share of a family’s income for health care and food.
Local policy can be a major driver of affordable housing. It can also create displacement and market failure, which are all too present in many cities. Local housing laws target three major policy objectives: protecting low-income people from eviction by reserving space for affordable units, creating new affordable units, or preserving affordable housing stock.
CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, assesses the largest US cities on nine evidence-based policies that can create healthier communities that thrive. Recognizing housing as a determinant of health and overall quality of life, CityHealth spent more than a year considering a range of pragmatic policy options available to city leaders that could improve the quality, availability, and affordability of housing in urban settings. It found that no single policy is a cure-all for the highly variable housing challenges facing cities, but that inclusionary zoning is one tool that must be part of a larger and more comprehensive toolbox, ensuring safe, stable, and affordable housing. It is an important indicator of a city’s commitment to producing affordable options alongside new development and growth.
What Are Inclusionary Zoning Policies?
As described in a recent Health Affairs Health Policy Brief, inclusionary zoning is an affordable housing policy tool that requires developers to set aside a portion of housing units for low- and moderate-income residents. Units created via inclusionary zoning are available to homeowners and renters and are typically part of multifamily developments. These policies may apply to all or certain units and often require that any resales go only to low- or moderate-income purchasers.
Inclusionary zoning policies promote inclusive communities by locating affordable housing in low-poverty, high-opportunity neighborhoods. In its 2016 review of the evidence, the Robert Wood Johnson Foundation’s County Health Rankings found that inclusionary zoning policies increase access to quality, affordable housing and boost neighborhood socioeconomic diversity—both of which are shown to decrease health disparities and improve quality of life for children and adults.
What’s Happening With Inclusionary Zoning In Cities?
With the advice of national experts, CityHealth identified the four key criteria that should exist in a comprehensive inclusionary zoning policy: have an inclusionary zoning law in place, require program evaluation, apply to projects of at least 10 units, and mandate that at least 20 percent of the total number of units in a development are affordable.
For 2018, CityHealth found that 13 of the 40 largest cities across the country earned a medal for their inclusionary zoning policies. Three (Chicago, New York City, and Los Angeles) met the gold standard by meeting all four criteria, six (Boston, Sacramento, San Diego, San Francisco, Seattle, and Washington, D.C.) earned silver by meeting three of the four criteria, and four (Baltimore, Denver, Portland, and San Jose) received bronze by meeting two of the four criteria. Inclusionary zoning laws are most common where housing prices are highest—predominately along the East and West coasts. With only about one-third of the largest cities in the country having adopted an inclusionary zoning policy, there is room to grow—and opportunities to seize—for city leaders in the vast majority of major US cities. (Visit cityhealth.org for the full report on cities’ performance on inclusionary zoning and other CityHealth policies.)
While CityHealth assesses the quality of inclusionary zoning policies, it does not consider how well the law, rules, or executive orders are implemented. Limited budgets, enforcement, or political interventions can impact the effectiveness of any city policy.
There is no silver bullet when it comes to building health, but we know now that the status of one’s health has a lot to do with where a person lives. The good news is that city officials have the power—and, indeed, the imperative—to help create healthier places that can help improve residents’ quality of life. Inclusionary zoning is one robust, viable option that can help city residents thrive. CityHealth urges city leaders across the country to explore their policy options, whether on housing or through CityHealth’s eight other evidence-based policies that improve public health.