As our nation’s political leaders continue to debate how healthcare is paid for in the United States, one thing is certain: Americans are using more healthcare. All sorts of indicators support this claim: Total expenditure on health as a percentage of GDP, at 17.14 percent in 2014, is on an upward trajectory. By 2030 the over-65 population will nearly triple as baby boomers age, of whom six out of every ten will be managing more than one chronic medical condition. The percentage of people without health insurance is at just 8.8 percent and on a downward trajectory.
These factors combine to create faster-than-average employment growth in the healthcare sector, which is expected to grow 19 percent from 2014 to 2024. And healthcare-sector employment growth is swamping growth in other sectors, with 20 of the 30 occupations expected to grow the most between 2014 and 2024 being in the healthcare field. These 20 occupations alone are projected to add 1.2 million new jobs, or 12 percent of all new jobs, between 2014 and 2024, while the industry as a whole is expected to add about 2.3 million new jobs in that period.
We know that health and housing are deeply interconnected. Dr. Megan Sandel of the Children’s Health Watch and Boston Medical Center, who coined the phrase ”housing as a vaccine,” has demonstrated that poor housing conditions can impact everything from asthma and diabetes to brain development and life expectancy, while affordable and quality housing can bulwark against illness and injury. NHC has spent a great deal of time exploring those connections, especially for low-income people and people lacking stable housing.
There are already a lot of people employed in the healthcare sector and there are about to be a lot more. Where those people live in relation to the communities they serve matters. How they get to and from their job matters. The quality of their housing matters. Whether or not they are able to quickly respond to medical emergencies matters. Yet for all five of the occupations featured in “Paycheck to Paycheck 2017: A Snapshot of Housing Affordability for Healthcare Workers,” not a single one of them is guaranteed to be able to afford to rent or purchase a home in all of the 203 metro areas we studied. Let me repeat that for the people in the back: emergency medical technicians, dental assistants, licensed practical nurses, home health aides and physical therapy aides are not guaranteed to be able to afford to live in the community that they serve.
This is both a housing issue and a wage issue, and it’s a large enough problem that we likely need solutions on both fronts. But I think most people would agree that these workers serve a vital role in any functioning community and should be able to afford to live where they work. And that means having a breadth of housing options that are affordable to a wide range of incomes. That idea guides this report and, more importantly, NHC’s work. We clearly still have work to do to make that vision a reality, and I hope you’ll join us along the way.