Raising the Standard: Upgrading Housing Quality Across America

Across the many complexities of housing in the United States, the quality of housing stock emerges as a foundational determinant of public health, community well-being, and economic stability.

In the U.S., the ramifications of poor housing quality extend far beyond a cracked foundation or leaky roof. Studies continue to highlight the negative social, emotional, and psychological impacts of living in poor-quality housing—either as a renter or as an owner.

To effectively mitigate the impact of low-quality, neglected, and dilapidated housing, more affordable options must be made available and more steps must be taken to reduce the negative consequences of substandard housing available today.

What is High-Quality Housing? 

According to U.S. Census Data and the American Housing Survey, there are 135 million homes in America—and 30 million of those homes have serious health and safety hazards. About six million have structural problems and another six million contain lead paint.

So what defines high-quality housing? What makes a home or rental unit safe for an individual or family?


According to HUD, housing is considered affordable if it doesn’t cost more than 30% of household income. If the rent or mortgage costs more than this percentage, the renter or homeowner is considered cost-burdened.

With lower-income families, the percentage of income spent on housing tends to rise due to high costs of living and nearly unaffordable home prices. In 2021, for example, 20.1 million renter-occupied U.S. households met the over 30% income threshold and were considered to be cost-burdened.

Despite the high cost of housing, whether homes are for sale or rent, many families with lower incomes have limited options and must opt for unhealthy, unsafe, or poorly-maintained housing due to budget restrictions.


All housing, regardless of cost, should meet some basic standards of liveability and safety. When homes contain hazardous materials, such as lead or asbestos, psychological and physical symptoms can occur.

Safe and livable homes should be:

  • Free of hazardous materials, including asbestos, formaldehyde, lead paint, or substances high in volatile organic compounds
  • In good repair without peeling paint or crumbling plaster
  • Regularly maintained
  • Accessible to residents, including seniors or people with disabilities
  • Located in safe environmental areas with fresh air free of toxic pollutants


Lastly, accessibility is paramount for the overall quality of life at home. Physical and structural housing conditions disproportionately impact children, older adults, individuals with physical disabilities, and low-income individuals. Older adults can experience serious injuries from falls in the home—especially if the home has unsafe stairs, narrow doorways, or other obstacles.

The Impact of Low-Quality Housing 

Low-quality housing has a profound and far-reaching impact on health and well-being, safety and security, and even long-term economic opportunities. In both urban and rural areas, individuals and families who live in low-quality housing report several adverse reactions that can have a substantial effect on overall health and wellness.

Children’s Mental Health 

For families with children living in low-quality housing, the risks are extremely high. Because children experience many critical development periods during the first few years of life, young children are at a much higher risk of poor health outcomes in relation to housing quality.

One study found that children from low-income households living in concentrated poverty were more developmentally harmed by poor housing quality compared to residential instability, unaffordability, and other housing factors.

The study found that children who lived with leaking roofs, exposed wires, pest infestation, and other problems were more likely to exhibit emotional and behavioral problems, such as anxiety, depression, outwardly aggressive behaviors, and rule-breaking. By adolescence, poor-quality housing continued to play an impact with lower reading and math scores on standardized tests.

Regardless of location, the consequences of low-quality housing are dire: Another study focused primarily on children living in low-quality housing in rural areas and found that children experienced negative psychological health, both internally and externally.

Lead Poisoning 

Lead poisoning is a common threat to health, with rates of lead poisoning remaining high in low-income, minority neighborhoods—and low-quality housing stock is to blame.

In most low-income neighborhoods, the majority of homes were built between 1940 and 1978 when lead-based paint was still legal. While lead was deemed hazardous in 1978, leaded paint was never systematically removed from old buildings.

Today, the U.S. Department of Housing estimates that more than 3.6 million homes still contain lead hazards.


Persistent exposure to air pollution, both inside and outside the home, can lead to several health issues, including asthma.

In the U.S., asthma rates are inextricably linked with environmental policy, housing policies, and racism. A combination of mold, air pollution, and poor-quality housing fuse together to create significant health problems for individuals living in poor-quality housing.

Greater intervention is necessary to mitigate the impacts of asthma and poor air quality. In 2018, New York City’s Asthma Free Housing Act required that landlords identify, treat, and mitigate any indoor asthma triggers each year. If replicated across the country, this law could improve safety in many homes.

Improving Low-Quality Housing

What is required to address the repair needs of the most vulnerable households across the United States?


One study leveraged data from the American Housing Survey (AHS) to analyze the prevalence of and the cost of repairing housing-quality issues among both homeowners and renters.

Prioritizing Affordable For-Sale Homeownership

Policymakers at all levels of government must prioritize high-quality and affordable for-sale housing for families of all income levels. Unlocking access to homeownership serves as a powerful mechanism for individuals and families to obtain intergenerational wealth and establish community roots.

Educate on the Importance of Healthy Homes 

The U.S. Department of Housing and Urban Development offers the Healthy Homes Program, which addresses in-home toxins and asthma triggers. The program outlines Eight Healthy Homes Principles that can make your home a healthier place to live:

  1. Keep it Dry
  2. Keep it Clean
  3. Keep it Safe
  4. Keep it Well-Ventilated
  5. Keep it Pest-Free
  6. Keep it Contaminant-Free
  7. Keep Your Home Maintained
  8. Keep it Thermally Controlled

About Smith NMTC 

Using our expertise with the New Markets Tax Credit (NMTC) program, Smith NMTC partners with CDEs and nonprofit developers to increase access to for-sale affordable housing and community facilities that improve and stabilize low-income communities and provide opportunities to low-income people.

Since our founding in 2007, we’ve structured and facilitated more than 70 transactions in 33 states by using more than $675 million in NMTCs. For our CDE clients, we provide NMTC application strategy and development, manage all closings, source investors, structure transactions, and guarantee the recapture risk.

To learn more about how we can support your organization with NMTCs, click here.

Share this
Published On: August 23, 2023Categories: ServicesTags: , , ,