Keys to Better Health May Lie in Safe, Stable Housing

Ensuring people have stable and safe housing may improve physical and mental health outcomes and reduce health care costs, research shows. States continue to introduce and enact legislation addressing housing as a driver of health outcomes. At least 37 states introduced 160 bills relating to housing and health in 2023, prioritizing strategies to bolster physical and behavioral health and allow people to stay in their own homes as they get older—or age in place.

For decades, state legislation has focused on the health impact of the physical housing environment, including hazards such as lead and asbestos. Poor-quality housing is associated with many negative health outcomes and chronic diseases. Low-quality home appliances, such as air conditioning, may increase the risk of exposure to carbon monoxide, lead and airborne illnesses. In 2023, Illinois amended its Radon Awareness Act, and Rhode Island enacted two bills related to lead hazard mitigation in rental housing. Legislation in 2023 also addressed emergency response and clean energy programs.

Related: State of Play | How State Policymakers Are Addressing Housing Issues

Half of enacted health and housing legislation in 2023 focused on the impact of housing on behavioral health. People experiencing homelessness are at higher risk for drug abuse, trauma, violence and even death. Due to these factors, along with reduced access to preventive health care services and higher emergency department usage, people without housing tend to have higher health costs and utilization than their housed peers. Colorado and Indiana invested in feasibility studies to provide a system of support for older adults, including those with mental health conditions.

States have also established new funding sources to bolster adult mental health services for people experiencing housing instability or homelessness. Vermont and California appropriated funds toward supportive multifamily housing programs for adults with mental health conditions. Vermont’s program also includes emergency housing, which has been listed as a successful response system to homelessness by the Interagency Council on Homelessness.

In addition to behavioral health, states also enacted legislation relating to housing safety and quality for older adults. Research suggests housing quality has a disproportionate impact on the mental health of older adults. Utah and Oregon have enacted master plans addressing healthy housing for older adults; the plans facilitate services to their aging populations, including housing and financial assistance to people with low incomes. Improving services that allow older adults to age safely in their homes and communities remains a priority for lawmakers.

As 2024 legislative sessions ramp up, states will continue to explore policy options to address housing and health issues, including improving access to safe and stable housing, mental health services and supports for older adults, among others. Visit NCSL’s Housing and Homelessness Database to learn more about state actions on housing and health.

Saquib Syed is an intern with NCSL’s Health Program.

This resource is supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services as part of an award totaling $875,000 with 100% funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS or the U.S. government.