Where you live and how much you pay to live there can affect your health

How fit you are and how much you exercise may not affect your health as much as how much you pay in rent or toward a mortgage.

In Florida’s counties where the majority of people’s incomes are going toward housing, residents are suffering from more premature deaths, greater levels of obesity, more hospital stays and lower birth rates, according to a the 2019 County Health Rankings & Roadmaps, released today by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

“The more people spend on housing, the more it takes away from money they could be using to buy fresh food or go to doctor to tend to a medical need,” said Ericka Burroughs-Girardi, an Action Learning Coach with County Health Rankings and Roadmaps, provider of an annual snapshot of how health is affected by where we live, learn, work and play.

Across Florida, researchers found a troublesome trend—18 percent of households spend more than half of their income on housing costs—something that is particularly evident in households headed by black residents who are most burdened by severe housing costs at 26 percent compared to white resident households at 14 percent.

“It’s unacceptable that so many individuals and families face barriers to health because of what they have to spend on housing,” said Richard Besser, president and CEO of the Robert Wood Johnson Foundation, a private foundation devoted to improving the nation’s health.

High housing costs make it difficult for families to afford healthy food, medicine, or transportation to work or school. “We want to draw communities’ attention to this because we know that it is something that can be changed,” Burroughs-Girardi said.

Broward County is one of the healthier counties in Florida, ranking 14 out of 67 for overall contributing factors to good health. Still, there is work to be done; almost a quarter of the county spends more than half of their earned income on rent or mortgages.

“They are spending most of their money just to keep a roof over their heads and that causes a lot of stress,” Burroughs-Girardi said. Broward County residents had a higher number of hospital stays than the Florida average and a higher percentage of poor mental health days.

Ralph Stone, Broward County’s director of housing finance and community redevelopment, said South Florida metropolitan area—Miami-Dade, Broward and Palm Beach counties—is among the worst in the nation when it comes to cost burden from housing. Add transportation costs to housing and the problem is striking.

“If three-quarters of your paycheck is going to housing and transportation, what do you have left for healthcare, child care and food?” he said.

Stone said efforts are underway to alleviate some of the housing cost burden. With county voters approving the creation of an affordable housing trust fund in November, $5 million is going to gap financing to make it worthwhile for developers to build lower-cost housing.

The county funds are being used to create more than 600 affordable rental units, and state funds provide for another 400, he said, adding that these renters will spend no more than 30 percent of their income for a unit. In the last few years, most new residential construction in Broward County has been high end, million-dollar units—well past the reach of even middle-income earners.

In Central Florida’s Orange County, with more than a million people, the severe housing cost burden is a concern, too. About 19 percent of residents are experiencing a severe housing cost burden, a slightly higher figure than the state average of 18 percent. On the positive side, health behaviors such as adult smoking, obesity and physical factors such as pollution are lower in the Orlando area than state averages. Overall, Orange County is ranked 10 out of the 67 counties in Florida for health outcomes.

The least healthy of Florida’s 67 counties this year is Union County in northern Florida, the smallest county in the state and home to Florida State Prison as well as U-Pick farms. Union has a population of about 15,500 people, but more than double the number of premature deaths, adult smokers and alcohol-impaired driving deaths as the state average.

In contrast, the most healthy county in Florida is St. Johns, part of the Jacksonville metropolitan area and home to St. Augustine. The county has a high percentage of home ownership as well as significantly higher access to exercise opportunities and much fewer children living in poverty, according to the rankings report.

Stone said the lack of affordable housing is particularly strenuous on residents in a state with mostly low-wage workers. In Florida, 67 percent of all jobs pay less than $20 per hour and 72 percent pay less than $15 per hour, according to the 2018 United Way ALICE Report for Florida, which studies workers and families who are employed but struggling.

With low wages in Florida and high housing costs in many of the counties, expect to see continually increasing disparities in health, the ALICE report asserts. This will become particularly evident with expensive medical advances that are out of reach of lower-income households, the report said.

“There has always been a connection between communities that work on policies that make housing more affordable and better health outcomes,” Burroughs-Girardi said, “but I think we are seeing it more strongly now.”

A look at how Florida’s counties rank for health outcomes based on physical environment, social and economic factors, and quality of life.

Florida’s Top 15 counties based on key drivers in health 1 St. Johns; 2 Collier; 3 Martin; 4 Seminole; 5 Miami-Dade; 6 Sarasota; 7 Santa Rosa; 8 Monroe; 9 Flagler; 10 Orange; 11 Lee; 12 Palm Beach; 13 Wakulla; 14 Broward; 15 Leon

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