Housing, health, and hope: A conversation on impactful collaboration

0:00:47 Host: Hello and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. Join us as we dig into important health topics, stuff that affects the health of all of us at a population level. From the microscopic to the macroeconomic, the social to the environmental. From cities to neighborhoods, states to countries and around the world.

0:01:20 Host: Across all party lines and all across the country, nearly 75% of Americans say that a lack of affordable housing is a significant issue here in our country. That study from the Bipartisan Policy center plays out in communities everywhere. Today we'll zero in on Detroit, where more than half of Detroit renters spend more than 30% of their income on housing. The University of Michigan's Poverty Solutions Initiative reports that statistic is particularly burdensome for low income and minority communities. Home ownership rates in Detroit have been historically low compared to other cities in the US But a glimmer of hope is that those rates are beginning to rise. But when rents are rising, barriers to homeownership exist, living conditions are poor and safe housing is hard to find. There is a greater risk of poor health outcomes. We sat down with two faculty researchers from the University of Michigan.

0:02:14 Host: Both are part of the University's Poverty Solutions Initiative. The pair discussed how they've made inroads on housing equity issues by combining their unique perspectives, bringing together their respective fields, public health and urban planning. The pair's years-long collaboration has produced invaluable insights, initiatives and action toward building a more equitable housing landscape in the City of Detroit and beyond.

0:02:37 Roshanak Mehdipanah: My name is Roshanak Mehdipanah and I'm an Associate professor here at the School of Public Health. I'm also the Director of the Housing Solutions for Health Equity Initiative.

0:02:47 Margi Dewar: And I'm Margi Dewar. I'm a professor emerita of Urban and Regional Planning in the Taubman College of Architecture and Urban Planning here at U of M. And we've worked together quite a while. Really? Maybe eight years or so.

0:03:00 RM: Yeah, so I remember distinctly about eight years ago There was a Poverty Solutions grant for academics. And at that time I was working with a doctoral student who was doing also some advocacy work in Detroit. And the issue of poverty tax exemptions came up. And I knew coming from a public health background, I would need an expert in urban planning to kind of help understand some of the complexities that go into properties and just property disposition, tax foreclosures and such. And I mean, you were the person, so I was super excited and delighted when you agreed to work with us on that.

0:03:44 MD: And I was so glad you got in touch. And we keep getting more opportunities. So now we've done that multi year evaluation of a program to sell very low value houses to very low income households and to see how that can be sustained and how health influences that sustainability and how the housing influences health.

0:04:05 RM: Yeah, And I think that has been probably the highlight of my work with you, bringing that interdisciplinary approach where we talk about health, but we also talk about urban planning, we talk about housing, and then come together on issues around health equity and pieces that we know that the residents who we're working with and studying are really deeply impacted by it.

0:04:31 MD: I agree, that's been very fruitful. And we came at this topic from some deep abiding interests we've had. So from my perspective, I became distressed about the fact that urban planning is a growth oriented, development oriented field. And yet all around us are these cities that have experienced huge amounts of population decline, employment loss, rising poverty. And so what should planners be doing about disinvestment and un-development and abandonment? And so I've tried to make my career address that. And so looking at housing is key to that, because that's one of the major ways that the physical environment is disinvested or invested. And what behaviors or what kinds of interventions can deter or encourage disinvestment and investment?

0:05:25 RM: Definitely. And I think the health piece there is that people who are experiencing housing instability are going through a lot, whether it's stress and how that stress is manifesting into multiple chronic conditions, or not just the stress of losing your home, but also the stress of not having enough money to then purchase food or adhere to medication. And all of those different factors can just make that cycle of poverty and disinvestment even worse. And that's something that I've always been really interested in better understanding. How do you come up with programs or interventions that support these folks? And particularly how does public health play a role?

0:06:12 MD: Some of my students have joked that urban planners stand on the sidewalk and look at the Structure and say, okay, it has a bad roof and so that's not good. But the foundation is kind of cracked and stuff. But that people in public health go up to the door and knock and talk to the people and find out how their housing condition has been harmed by those features that we see from the sidewalk. And so bringing the people and the properties kind of together has been, I think, a really rewarding part of our work.

0:06:44 RM: Definitely. And I think that has been my favorite part of some of these studies that we've done where you look at a property and you can generate so much history about that property. And then what I can contribute to that are some of the questions around what people are feeling or experiencing while living in those properties and in those conditions that they're living in. Yes, I think we're a good match.

0:07:13 MD: I think that in all our work together or separately, we strive to have partnerships with people in the situation and to advance their agendas while we also are doing something that's academically needed. So there's an intersection there where there's mutual benefit, and that's what we always aim for. All of this does relate to the history of what has happened in cities like Detroit. So I know you've studied redlining. Do you want to say anything about how that has affected what we end up looking at?

0:07:56 RM: Definitely. And I think where I've come to, the redlining work has been really focused on what have been the opportunities and the what ifs that folks could have had if redlining wasn't there. And for those who aren't familiar, redlining refers to this process in which the Home Owners Loan Corporation kind of enacted or identified areas that were deemed as hazardous, which corresponded to areas that were largely habited by black and brown residents. And then by doing that, then they would not have opportunities to purchase homes or they were just too expensive or.

0:08:37 MD: They couldn't get mortgages.

0:08:39 RM: Yeah, they couldn't get mortgages. And so then the areas that were deemed as non-hazardous or green on these maps were areas that were predominantly white folks and they would be able to purchase their homes. So a few years ago, we did a study where we examined how historical redlining has impacted social determinants of health. So these are determinants like employment, education, homeownership opportunities to just better understand how those historical influences have manifested over time. And some of the stuff we found was really hard to see that, for example, in areas that were deemed to be hazardous under the Homeowners Loan Corporation, who was behind the redlining of the maps, they deemed certain areas as hazardous. In those areas, they have manifested to approximately a $60,000 difference in what people are bringing home in terms of income between areas that have been redlined or were historically redlined into areas that were not, or in some ways, to simply put it, like, deemed as green or non-hazardous.

0:09:55 RM: That really affects the history of most cities in the United States and since then. So that was started in the 1930s, didn't it? And then finally the late 1960s, the federal government decided they weren't going to restrict mortgages in the same ways. African Americans would now be able to get loans to buy houses. But then what happened was the HUD scandal, sometimes it's called, or the FHA scandal, where the Federal Housing Administration was insuring loans held by African Americans for the first time. But there were corrupt realtors, corrupt appraisers, corrupt inspectors, corrupt loan officers, all of whom conspired to then block-bust, meaning scare white people into leaving and sell their houses for very low prices. And then they sold those houses at very high prices to African Americans. But because the inspection was bad, the appraisal was bad, they then were into a situation where a house needed a great deal of work that they couldn't afford and they couldn't also pay their mortgage. It wiped out 10,000 or so properties on the Lower east side of Detroit, tens of thousands across Chicago and Cleveland and many other of these cities. It was a terrible tidal wave of disinvestment.

0:11:21 MD: So it laid down another geographic layer of historical context. And then most recently, we really had the mortgage foreclosure crisis, where people were given mortgages or recruited to take mortgages if they were African American, Latino, and then they had very unfavorable terms. And a third of the properties that could have mortgages in Detroit experienced at least one mortgage foreclosure, which again, took housing away from people. It was another tidal wave. In between the tidal waves, there's a drip, drip of disinvestment that builds on those. So it's really quite a profound historical context in which we're now operating.

0:12:12 RM: And a lot of the work that you do has focused on that disinvestment and what it has contributed to today. What does that mean for neighborhoods, in your opinion?

0:12:22 MD: Neighborhoods are diverse across the city, but as disinvestment happens, people in a neighborhood start thinking, maybe I shouldn't keep staying here because maybe the neighborhood's not going to be a good place to be anymore. Oh, that neighbor left now. Okay, I think I'll wait to Repair my roof. Disinvestment is contagious. And so a big job is to figure out how to contain it, how to keep it from infecting more places, how to keep it from undermining more neighborhoods.

0:12:57 RM: Definitely. And I remember in our Make it a Home study where we found the detrimental impact of housing repairs and how people just couldn't afford them. I always admire you for being like, we need to bring this up because this needs to be addressed. And when it did, we were able to get some sort of relief through the different funders to help assist those homeowners at that time with that.

0:13:24 MD: Yes. Actually, the make it a Home program was really interesting to us and to others because it was a different approach. What it was doing was saying we have this big tax foreclosure problem where people are either losing the homes they own or losing their homes because the property gets purchased at the tax auction after the landlord stopped paying taxes. And then that we showed leads to eviction often. And so there was a program that got introduced for the city to take those properties occupied by renters whose landlords weren't paying and where those properties were going into tax foreclosure. And then the city owned the properties and transferred them to a nonprofit United Community Housing Coalition, who then sold them to the people who were renting those properties. And we were invited to evaluate that. We found an amazing thing, which is that 85% or so of the people who purchased houses, very low income people, they still owned their houses after five years. While we know that research in general shows fewer than half of lower income people who buy houses still own them after five years. So this was a big success, with some caveats, because the houses are not in great shape and the houses have low value, they do need a lot of repairs.

0:14:55 MD: And that's why we then kept saying, this needs to be supplemented with repair funds. But now isn't it? Cleveland and Syracuse are trying these programs based on the Michigan model, the Detroit model.

0:15:10 RM: Yeah. And I think it truly caught people's eyes. It was a program that was not the norm. Right. It was really folks that would, in other circumstances, never have an opportunity to purchase a home, especially in the markets that we're dealing with today. I do sometimes wonder if that 85% would have been slightly higher if it wasn't right during COVID that our study took place. I often think it would have perhaps been slightly higher. But one other finding that our study that I think was really interesting was that when the COVID financial relief programs and some of that funding came out, we did see some of our homes be able to pay off their taxes, not have to fall under tax delinquency. So we've talked a lot about tax foreclosures, but we know that another emerging but consistent issue that we have in our societies is eviction. So I'm wondering, what measures have you used or have found in being effective in preventing evictions? And how can urban planners really incorporate these measures in the types of work that they do?

0:16:29 MD: Right, that's a big question. So evictions happen for numerous reasons. A major one is that the tenants haven't been able to pay the rent. Another is that the landlord would like to get some people out because they're too noisy or bothering other tenants. Sometimes there's a legitimate reason behind that, which is they've been a threat to other tenants or done substantial damage to a unit. But they often have sought evictions in order to upgrade units to be rented at higher rents. So they won't necessarily renew a lease, and then they may well evict. So how to prevent that? One big issue is that landlords tend to be represented legally. They have lawyers, tenants tend not to. It doesn't cost very much for a landlord to file for an eviction, meaning file a lawsuit to get the tenant out. But then the process is heavily weighted in favor of the landlord, no matter whether it's a legitimate fair eviction or not. And so one way is to have a right to counsel for the tenants, that there'd be some way for public assistance to help with that. And the research has shown that a lot more tenants are not evicted ultimately, when they have a lawyer that's a little biased because I think the lawyers need to take on the cases that are most likely illegitimate. So then they have victories disproportionately among the people who they represent.

0:18:05 MD: But if we could have broader right to counsel, that would include more people, that would be a help. We know. Again, if we had rent assistance or we had vouchers in larger numbers for very low income households, then they could afford the rent. Sometimes what happens is that the landlord raises the rent and all of a sudden they can't pay. And yet the landlord often needs to raise the rent because the landlord has costs to cover as well. So it again gets back to the challenge of very low incomes and that there's a mismatch between what decent housing requires for maintenance and repair versus what people can pay. In our research on the poverty tax exemption, which helps people with their property taxes, really makes it Possible to have no property taxes owed. I think we found some useful things about how a policy can intervene to prevent some of these problems we were talking about in disinvestment.

0:19:08 RM: Yeah, I think the poverty tax exemption is still a policy that could help alleviate low income homeowners. I think when we first started the research, we heard a lot about the amount of paperwork, the bureaucracy the...

0:19:23 MD: Lack of response.

0:19:26 RM: Exactly. The lack of response. How difficult it was for folks to year after year have to go and fill out a document that would be the same app, like their situations hadn't changed. So they still had to go through that process every year. And so one of the things that came out of that study, I think, was just even the ability to have an influence on the process. Right. Even the application itself. Being able to reduce the amount of paperwork that folks had to do was really helpful. But I think it also shed light on how much of an issue it is when folks fall behind on their taxes and what that means for the process of folks then potentially being at risk for tax foreclosure. And oftentimes it wasn't a lot of tax. Like the amount that they owed wasn't that much. Oftentimes folks didn't even know they owed that much money. And so this process was really hard to kind of see that over just a couple hundred or thousands of dollars, folks would be at risk of losing everything that they had.

0:20:40 MD: Yes. And I think that we did then say a lot about what should be changed, and it's a lot better now. At the time, it seemed like city officials kind of didn't tell anybody about the poverty tax exemption because that would mean they would get less taxes. But we kept saying, but they can't pay the taxes, so you're not getting the taxes anyway. So over time, things gradually change.

0:21:06 RM: Right. And I think it was around that time too, where, particularly in Detroit, payment plans became more attainable for folks or other sorts of aids that I know you've also studied very closely in your work, which have really, truly made a difference in people's lives.

0:21:27 MD: And not just because of us, for sure. It means huge numbers of people working on this across the city, huge amount, and foundations supporting efforts to reach out to people to help them avoid tax foreclosure. Nationally, the discussion of what's needed to enable people who have very low incomes to live in decent housing that's affordable to them requires a lot more than what's happened so far. Only about one in four of the people who are eligible for federal aid for their Housing are actually getting it because there just isn't enough. And so policy advocates talk about increasing the number of housing vouchers available, which means then no matter what the income of the tenant, that tenant only pays 30% of their income for the rent. And the federal government makes up the rest to the landlord, up to fair market rent. But we'll see. That's been talked about for a long time. Some of the solutions nationwide, I think, are not so applicable to a place like Detroit. There's a great deal of talk about zoning and densifying in Detroit. Poverty is a much more pressing issue. People cannot afford housing that in any other place might seem quite affordable. They don't have the income. So really it's an income supplement kind of need.

0:22:54 RM: Definitely. And one of the things that I constantly get asked is, with all the changes happening in Detroit, is Detroit going through a gentrification? And that question always gets me because it's like, yes, but no first no, because we're still talking about. And for those who aren't familiar, gentrification is the process where the neighborhood's socioeconomic composition goes from a lower income to higher income, primarily through the folks moving into those areas and then negatively impacts the lower income folks and often are displaced either through high rents or just not being able to afford living costs. And with Detroit, there are now maybe one or two areas where we could say gentrification could become an issue. But I think the big issue still, it's such a low density area that folks, by the time they move in, we're talking about years potentially. But nonetheless, it's important for us to always be cautious about those effects.

0:24:04 MD: Right. And even when in such situations, when people aren't forced out, a lower income homeowner might think, I could get $200,000 if I sell my house. I need that money for a car, for paying medical expenses for my kid, for, you know, other desperately needed things.

0:24:25 RM: Definitely. And I think that's the one side of gentrification that often is not considered, that a lot of these folks who do want to sell have been stuck in their place for so long because their housing value is so low that they've wanted to move out to where their kids or their families are, but just physically haven't been able to. So as housing prices increase, they are given that opportunity.

0:24:57 MD: So one way that I've found that our work complements each other is that I can bring from Urban Planning a body of evaluation research on what kinds of housing interventions work or don't work, just to take an example of something getting discussed right now, community land trusts. How do land trusts work to help the housing problem and help add to stability and therefore reinforcing health? And a lot of the discussion from my urban planning perspective, what I notice is a lack of real estate finance and how do you pay for that? How do you set up such a system so it's sustainable? And how is putting public money into that going to produce more decent, affordable, sustained housing than putting it into something else? So I feel like, and I wonder if you do that. Bringing our fields together. We both think about questions we haven't thought about yet.

0:25:53 RM: I completely agree. And I think one of the frustrating things that has been from the public health side is that oftentimes we have that section in a paper report where we talk about recommendations. But unless we have urban planners on our team or folks that are familiar with the real estate market and such, those are missed opportunities because the comments that come about or the thoughts behind it aren't able to really address some of the fundamental barriers that are experienced. So, for example, we talk a lot in public health now, or we're talking more about vacant land remediation programs. However, the fundamental question there is also land acquisition or how do you purchase that land? Especially knowing that there's so much complexity in deeds in cities like Flint or Detroit. And such. And so I think it's critical to have folks like you on these teams that can guide us as public health professionals or researchers to better understand. Well, yes, this is a great program, but there's these fundamental barriers that need to be addressed first. And so that has been something that I've always appreciated working with you, where when I think I've come up with the greatest solution, you're like, well, actually, let's think about this.

0:27:21 RM: And it's truly been eye opening because I do believe that without those expertise, a lot of this work would fall flat. Margi, it's been an absolute pleasure getting to talk to you today about these issues around housing, land disinvestment and such. And I truly appreciate all of the work that you have done and continue doing. And I hope we get to do a lot more.

0:27:49 MD: Thank you for all that I have been learning from you and I'm looking forward to this afternoon because we're going to work on trying to extract findings from some equations with some data we've collected, which would be fun.

0:28:04 RM: It's always fun with you.

0:28:15 Host: Thank you for listening to this episode of Population Healthy from the University of Michigan School of Public Health. Visit Our website populationhealthy.com for more resources on the topics discussed in this episode and to find more episodes. If you enjoyed the show, Remember, subscribe, rate and review wherever you listen to podcasts. Be sure to follow us on social media and consider sharing this episode with friends. Population Healthy is produced by Andrea Laferle, Brian Lillie and Chrissy Zamaron and hosted by Michael Kasiborski. We hope you can join us for our next episode where we'll dig in further to public health topics that affect all of us at population level.

[music]