Nurses walk through the UCSF Medical Center Parnassus campus in San Francisco, Calif. October 2, 2012. (Mike Koozmin/2012 S.F. Examiner)

Nurses walk through the UCSF Medical Center Parnassus campus in San Francisco, Calif. October 2, 2012. (Mike Koozmin/2012 S.F. Examiner)

The housing crisis is making Californians sick, Prop. 10 offers remedies

As physicians and nurses, we know passing Proposition 10 is a vital step toward remedying the extreme health impacts of eviction, displacement and homelessness. Our patients who are tenants are experiencing high blood pressure, debilitating anxiety, depression, toxic exposure, and even death by suicide or stroke at the hands of a system protecting endless real estate profits over their lives. The real estate lobby that put forth unjust laws like Costa-Hawkins, and who are backing “No On 10”, are clear that their mission is to provide dividends, not to provide housing and shelter. We medical professionals are just as clear: you either care about the health of people with no stable housing, or you privilege affluent landlords’ ability to make endless profits off their extra homes at all costs to low-income residents, workers, seniors, families and folks with disabilities. Voting yes on 10 to return the right for local municipalities to strengthen rent control laws and prevent homelessness is a moral and humane decision based on valuing the health and dignity of California’s growing renter population.

Proposition 10 offers us an opportunity to intervene in what is not only a housing crisis, but what has now become a serious public health crisis. The real estate lobby passed Costa Hawkins in 1995 to severely inhibit local rent control. It prohibits “vacancy control” laws, which means that currently anywhere in California, if a tenant moves out of (or is forced out of) a rent-controlled unit, the landlord can spike rents to market rates. It also prevents rental protections on single-family houses, condominiums, and units built after 1995 or the year a city gained rent control (1979 in SF). Proposition 10 would allow counties to implement rent control more broadly based on their communities’ needs and prevent the continued decline of their renters’ health.

Each of us has seen patients harmed by the cycle of poverty and eviction perpetuated by unjust housing laws like Costa-Hawkins. We have seen patients with worsening chronic health conditions such as high blood pressure and diabetes because eating cheaper, less nutritious foods and working longer hours is the only way to maintain housing. We see how stress related to housing exacerbates mental health conditions and substance use disorders. We bear witness to these issues every day and do our best to treat them, but we know our interventions are limited if they do not address the root of the problem: excessive greed, leading to extreme inequality and exploitation. The current housing policies and practices represent an assault on our patients’ health.

The impacts of high rent burdens, lack of stable housing and lingering threats of eviction we have seen in our hospital are verified by a wide variety of studies, which show devastating consequences, and even fatal ones for tenants. Evictions have been shown to increase the risk of suicide, intimate partner violence, syringe sharing among people who use injection drugs, difficulty staying on medications for people with HIV, an increase in sexually-transmitted infection rates, and much more.

Rose, a primary care patient of one of our authors, is one of many Californians whose health has suffered as a result of the rising rents, residential evictions, and the lack of affordable housing that make up our statewide housing crisis. Her doctors were flabbergasted by how quickly her diabetes was progressing. They repeated her tests and considered other rare diseases. But then Rose told them the real trigger that set off her rising sugar levels: two months ago, her landlord had doubled her rent, and she had been coping with the stress ever since. While it is no secret that real estate speculation has wreaked havoc on California tenants’ economic stability, what is less recognized is the various ways it has harmed their health and well-being.

The potential public health impacts of Proposition 10 are reflected in its supporters. Recently, the AIDS Healthcare Foundation contributed $10 million to the campaign to pass Prop 10, joining the California Nurses Association. These organizations understand affordable housing to be integral to health, particularly among already vulnerable populations, or those with chronic health conditions.

As doctors and nurses, we recognize that the health of our patients hinges on their ability to maintain safe and affordable housing. We yearn for a day when patients like Rose can live free of the constant worries of eviction and financial ruin, and instead focus on taking care of their health and contributing to their family and community. Rent control is healthcare. Join us, and vote yes on Proposition 10.

Juliana Morris is a family medicine physician in San Francisco. Chris Ahlbach and Rachel Schenkel are third-year medical students at University of California San Francisco. The three are members of the Do No Harm Coalition. Zenei Cortez is an RN and Co-President California Nurses Association. These affiliations are provided for identification purposes only.

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