You Can’t Have “Housing Plus Services” Without Housing

Alisha's Blog | June 22, 2016

We could improve the health of older adults by implementing models that deliver health and supportive services, at home, to seniors with multiple chronic conditions and functional limitations. But that won't happen without an adequate supply of affordable housing.

A few months ago, The Wall Street Journal ran a story about how many older Americans are increasingly getting pinched by rising rents.

Seniors living on fixed incomes can be hit hard by rent increases, Journal reporters argued, particularly in high-cost areas like California. Then, they profiled individuals experiencing big jumps in their rent.

Several readers commenting on the article asked why the older renters featured in the piece didn’t just move to lower cost places like Texas or Florida.

I’ve heard this “solution” before. And it has never made sense.

When you are old, living on a fixed income, and struggling to keep up with your rent, would you want to pack up and move across the country to find an apartment you could afford?

Let’s ignore, for the moment, the emotional trauma involved in leaving behind your community and your support networks, just as you might be starting to need them more. Instead, let’s examine how realistic it is to assume that older adults could find more affordable housing in other locales.

Finding Cheap Housing

The National Low Income Housing Coalition (NLIHC) recently released its annual Out of Reach report. The report documents the gap between wages and the price of housing across the United States.

NLIHC estimates that on average, in 2016, a person would have to earn $16.35 per hour in order to afford a safe and modest one-bedroom rental unit.

Do older adults meet that earnings requirement? Let’s consider a few financial facts.

Social security is the primary source of income for most elderly. Almost half of unmarried beneficiaries rely on it for 90% or more of their income. In April 2016, the average monthly social security benefit was $1,278. Using a crude calculation, that’s equivalent to about $8 per hour.

That means a whole lot of seniors earn just about HALF the wage required to afford a decent apartment across the country.

But some locales are cheaper, The Wall Street Journal commenters insist, and mobility is the simplest answer to the rent crisis facing seniors.

Not so.

In Texas, for example, it turns out the hourly wage needed to afford a one-bedroom apartment is $14.10. In Florida, it’s $15.97.

West Virginia is our most affordable state. But, even there, a renter would need an hourly wage of $10.73 to afford a one-bedroom apartment. That’s still beyond the ability of many seniors.

Affordable Housing: The Glue Holding Everything Together

The Bipartisan Policy Center’s Senior Health and Housing Task Force recently released its recommendations for addressing the “unprecedented strains” that a growing older population will place on the nation’s health care and housing systems.

Healthy Aging Begins at Home is an excellent document that shines a spotlight on the centrality of housing. It declares that “housing is widely recognized as a leading determinant of physical and mental well-being, while the home can serve as a vital platform for the delivery of health care and other critical services.”

The BPC task force suggests that we could improve the health of older adults by implementing models that deliver health and supportive services, at home, to seniors with multiple chronic conditions and functional limitations. Its report includes several recommendations to facilitate better integration between health care and housing.

As managing director of the LeadingAge Center for Housing Plus Services, this sounds great to me.

There’s only one problem. Without an adequate supply of affordable housing, the BPC recommendations fall flat.

Job 1: Expand the Supply of Affordable Housing

The BPC task force recognized that a supply-demand imbalance already exists, and it’s only going to get worse in the future as the number of low-income seniors grows, and more seniors become renters.

In response, the task force offered 10 recommendations aimed at increasing the availability of affordable rental options for seniors. These recommendations center around:

  • Funding rental assistance programs at adequate levels to meet the current and growing demand.
  • Expanding and targeting funding to support the development of new affordable housing communities, and to preserve existing affordable properties.
  • Reducing regulatory barriers that can stymie or increase the cost of developing housing units. 


These recommendations, and those calling for better coordination between the housing and health systems, echo what LeadingAge and the Center for Housing Plus Services have been promoting for many years.

Job 2: Make the Case for Change

So what’s next? How do we ensure that the BPC task force report doesn’t just become a collection of words that make us nod our heads in agreement, but don’t result in real change?

Clearly it’s time to turn those words into action. In fact, it’s time for each of us to take responsibility for:

  • Convincing local, state, and federal policy makers that the nation’s need for more affordable housing is at critical stage.
  • Working with community partners to integrate health and supportive services with housing, and to demonstrate that this solution deserves widespread support and replication.


Resolve to do something today. Resolve to stick with this mission for as long as it takes. And resolve that you’ll do everything you can to make sure it doesn’t take too long to achieve success.

Given the nation’s rapidly shifting demographics, we don’t have many more years to get this right.