June 30, 2020

Social Determinants of Health

Addressing social determinants of health - the circumstances in which people are born and live - is a business and moral imperative.

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Research shows that housing instability – which includes a number of challenges, like trouble paying rent and spending the bulk of income on housing – can have a big impact on health.¹ Living in substandard housing can expose people to a number of environmental factors within homes that are correlated with negative health outcomes: lead exposure, which can result in irreversible brain damage; water leaks; poor ventilation; dirty carpets; and pest infestation are associated with asthma and other health conditions. Furthermore, exposure to high and low temperatures is correlated with cardiovascular events, and residential crowding is linked to physical illness and psychological distress.^2-5 

Affordable housing is becoming less attainable in the U.S. Nearly half of renter households and a quarter of owner households in the U.S. are cost burdened, meaning that people pay more than 30% of their income for housing and may have difficulty affording food, clothing, transportation, medical care and other life necessities.⁶ In addition, a family with one full-time worker earning minimum wage cannot afford fair-market rent for a two-bedroom apartment anywhere in the U.S. , while at the same time, house prices rise at twice the speed of inflation and pay.^7,8 

A Global Issue

The crisis transcends U.S. borders. In Reykjavik, Iceland, the cost of purchasing or renting a home was unattainable for IKEA employees, so the company built apartments within walking distance from its store at lower-than-average rent prices.⁹ In China, major technology companies and multinationals are faced with rising costs in some of the country’s most developed cities. China’s biggest e-commerce company, Alibaba, built 380 apartments next to its headquarters in Hangzhou and sells them at a 40% discount.¹⁰ The company also guarantees affordable housing for employees near their factory and headquarters.¹⁰ In 2016, Starbucks chains in China began offering full-time employees a monthly rent subsidy that covers approximately half of their monthly housing costs.¹¹ 

Ideas for Action

Through employer-assisted housing initiatives, employers can help employees meet their immediate housing needs and can also positively impact neighborhoods near the workplace.  

• Offering a down payment assistance program (in the form of a lump sum or interestfree loan) as a part of your financial well-being benefits;
• Assisting employees in navigating state and local financial assistance programs;

• Building a residential development on company-owned land; and
• Purchasing housing units in nearby developments and then renting to employees at below-market levels.

When offering a housing assistance program, it can be advantageous for employers to require participants to purchase or rent near public transportation, addressing two needs at once: improving productivity and reducing the environmental impacts of commuting.

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Articles & Guides Social Determinants of Health Community Health Equity