Submitted by: Olive Albanese, MD, Marijo Botten, DO, Marjan Jahani Kondori, MD, MPH, and Sara Robinson, MD

Desired actions:

• Advocate legislatively
• Provide education to members, the public, media and/or specific groups/stakeholders

WHEREAS affordable housing is defined as housing that costs less than 30% of income¹. In Minnesota, over half a million households spend more than 30% of their gross income on housing²;

WHEREAS affordable housing is defined as housing that costs less than 30% of income¹, and the amount of accessible affordable housing across the state of Minnesota is very low. Average home prices increased 19% in the last year², with rent prices in Minneapolis and St. Paul increasing by nearly 20% on average in the last five years³. Also in the Twin Cities, the vacancy rate for affordable housing for those with incomes at or below 30% of the area median income is essentially 0%. Across the state, 69% of newly constructed rental units in the last five years are not affordable to low-income renters. Furthermore, without rental assistance, only 1% of newly built units are affordable to households with incomes at or below 30% of area median income. Finally, the median sale price of a newly constructed home is $430,000, while the median homeowner income can only afford a $300,000 home².

WHEREAS, in 2023, over 10,000 people in Minnesota experienced homelessness on any given night, which is about a 36% increase since 2016. This number is likely an underestimate as this is difficult to accurately track^2,4. People in families (with children under 18) account for 47% of people experiencing homelessness in Minnesota⁴.

WHEREAS Minnesota has the fourth-largest homeownership-rate disparity between white/non-Latinx households and Black, Indigenous and households of color, 77% compared with 44%; and the 25% homeownership rate for Black households is significantly lower than the 46% rate seen in 1950².

WHEREAS housing instability is directly linked to worse health outcomes. Those without homes live on average 12 years less than the general population and have a disproportionately higher disease burden, including twice the incidence of diabetes, twice the incidence of heart attacks, almost four times the incidence of substance dependence disorders and up to six times the incidence of depressive disorders⁵.

WHEREAS a key goal of the Minnesota Housing department is to have 45% of new construction rental units be deeply affordable. Another key goal is to have 40% of first-time homebuyer mortgages going to Black, Indigenous and households of color².

BE IT RESOLVED that the issue of affordable housing in Minnesota be referred to the MAFP board of directors for further discussion and to consider providing education around affordable housing as well as how to advocate for increased access to affordable housing in conjunction with community partners.

Originally submitted resolution:

BE IT RESOLVED that the MAFP support the Minnesota Housing Department’s goals of 45% of new construction rental units be deeply affordable and 40% of first-time homebuyer mortgages going to Black, Indigenous and households of color;

BE IT FURTHER RESOLVED that the MAFP board of directors consider a task force to look for additional opportunities to work on the topic of housing as health care and how we can get all citizens into safe and secure housing.

References and Supporting Information

1. Beiner, C. (2021, December 5). These moms overcame homelessness. but the fight for a better life is far from over. NPR. https://www.npr.org/2021/12/05/1057273975/single-moms-homelessness-domestic-abuse?utm_source=facebook.com&utm_medium=social&utm_term=nprnews&ut+m_campaign=npr&fbclid=IwAR2Jz7sxzpkVv-ofx7hZw8kxINrZTxhZ2rcDWt_zJA0PqE3kWqg4bhn8qbs.
2. 2022-2023 Affordable Housing Plan. Minnesota Housing. (n.d.). https://www.mnhousing.gov/.
3. Horowitz, B., Starling, L., & Tchourumoff, A. (2023, August 14). Waning housing affordability imperils economic growth in Minnesota. Federal Reserve Bank of Minneapolis. https://www.minneapolisfed.org/article/2023/waning-housing-affordability-imperils-economic-growth-in-minnesota.
4. Wilder Research (March, 2024) Single Night Count of People Experiencing Homelessness 2023 Minnesota Homeless Study Counts Fact Sheet. https://www.wilder.org/sites/default/files/2023_HomelessCounts_FactSheet_3_18_24.pdf.
5. Homelessness & Health: What’s the Connection? National Health Care for the Homeless Council. (2019, February 1). https://nhchc.org/wp-content/uploads/2019/08/homelessness-and-health.pdf.

Testimony

Housing is a fundamental aspect of living. Yet, with higher housing costs and predatory interest rates, the stories of stable, affordable housing being unattainable are becoming too commonplace. This legislative proposal is aimed at improving access to an essential need. Everyone deserves somewhere to live.

Comments in support (6):

Elizabeth Ingersent – Housing instability and insecurity affects our most vulnerable patients and can be incredibly damaging to their health.

Keith Stelter – A huge problem! I would also like to see more support for entities like Habitat for Humanity that do not charge mortgage interest in homes it remodels and builds. This is crucial in these days of high interest rates because these costs keep people out of home ownership. Mortgage closing costs are a barrier that many cannot overcome and so are relegated to continuing to rent/lease at high cost and result in no built equity. So would like to have forgiveness or funding to cover these costs.

Chris Reif – Housing is so important to health. It’s appropriate the MAFP join in seeking larger solutions.

Christy Atkinson – In support of the spirit of this resolution, and agree with Dr. Slattengren’s comments to consider partnering with community organizations doing this work in order to be more effective in our organizational advocacy.

Sally Jeon – In addition to morbidity disparities, recently the Minnesota Homeless Mortality Report, 2017-2021, showcases that the rate of death is 3 times higher among people who experience homelessness (PEH) in Minnesota than the general population and next steps include “Investing in cross-sector health and housing programs to address the high rates of mortality among PEH. People with lived experience of homelessness should be paid to design and lead development and delivery of these services. This will ensure services center on culture and community and the experiences of American Indian, Black, and other people of color.” I also support Dr. Slattengren’s suggested amendments.

Margaret Kirkegaard – I support this resolution and the development of a task force that can lead more specific action.

Comments against (5):

Andrew Slattengren – Housing instability is linked to worse health outcomes. We may have a role in assisting our communities with this need. It may be more appropriate for MAFP to partner with nonprofits who are already doing this work as there has been recent legislative action to fund affordable housing aid. Having a list of nonprofits to refer patients to on the MAFP site could be a start. This could be an edit to the 2nd “be it resolved”. The 1st “be it resolved” is too vague for action – how do we support? specific legislative action to increase SAHA funding? Statewide Affordable Housing Aid was created by the 2023 MN Legislature. The annual appropriation for Statewide Affordable Housing Aid is $10 million. For 2023 and 2024, there is an additional appropriation of $12.5 million. Statewide Affordable Housing Aid helps counties, Tribal nations, and greater Minnesota local governments develop and preserve affordable housing within their jurisdictions to keep families from losing housing and to help those experiencing homelessness find housing. Qualifying projects include: -Emergency rental assistance for households earning less than 80% of area median income as determined by the United States Department of Housing and Urban Development. -Financial support to nonprofit affordable housing providers in their mission to provide safe, dignified, affordable, and supportive housing. -Construction, acquisition, rehabilitation, demolition or removal of structures, construction financing, permanent financing, interest rate reduction, refinancing, and gap financing of housing to provide affordable housing for households that have incomes below thresholds defined in more detail on state sites.

Eric Poulin – This is likely put forward by well-meaning young members without an adequate education in economics. We have gone down this exact road before as a country with terrible consequences, i.e. the Great Recession of 2007-2009. Before supporting this kind of government intervention in the housing sector of our economy AGAIN, we need to know exactly how they plan to make this time different from last time, so that it has a chance for success. Housing is a problem right now, a big problem. Let’s not make it worse.

Roli Dwivedi – I am in support of first resolve and would recommend amending the second resolve. I think having a task force who can help in enriching our website with resources is reasonable.

Robert Koshnick – I do not support the first resolve. This would take an enormous bureaucracy and government regulation that will increase, not decrease housing costs. The second resolution is okay in that it is well meaning but I do not think that it will be able to reach a beneficial solution other than recommending government control of housing. If government-run housing worked, then there would be examples of it elsewhere in the world. When I have traveled to Cuba, Russia, and China, what I find is that people do not keep up or take care of property that is not their own.

Kim Krohn – I agree with the previous comments.