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How Affordable and Attainable Is Accessible Housing?

A Health Equity Story
June 12, 2023

When people live in safe, affordable, and accessible housing, they are better able to manage their health. People with mobility disabilities and other types of disabilities can live more independently when accessible housing is attainable. Affordable housing leaves room in the budget for other expenses, including food, transportation, healthcare costs, and supportive services. How easy is it for people to find both — accessible housing that is also affordable?

What Is Accessible Housing?

“There are 61 million adults in the United States who live with a disability. That’s one in four people,” said Merrill Friedman, regional vice president, Inclusive Policy and Advocacy at Elevance Health. “Many experience inequities in accessing healthcare, education, employment, and transportation, and they also have trouble finding housing that is affordable and accessible.”

Considering that approximately 11% of adults have mobility disabilities but less than 4% of housing is designed to meet their needs, it’s clear there’s a housing gap.

People with mobility disabilities often require specific adaptive modifications in their housing. A U.S. Department of Housing and Urban Development (HUD) accessibility index classifies and measures the accessibility features in housing.

  • Level 1, potentially modifiable: Housing with a stepless entry from the outdoors and a bedroom and bathroom on the first floor or accessible by elevator. These housing options are classified as potentially modifiable and often referred to as ‘visitable.’ About one-third of U.S. housing units is potentially modifiable.

  • Level 2, livable for individuals with moderate mobility disabilities: Housing with existing modifications for people with moderate mobility disabilities. These housing options include the features listed in Level 1 as well as no steps between rooms or installed grab bars by any stairs and an accessible bathroom with grab bars. Fewer than 4% of housing units meet Level 2 classification.

  • Level 3, wheelchair accessible: Housing with the necessary accommodations to provide full wheelchair access, allowing residents who use mobility devices to easily navigate the home and have the most independence. The accommodations include those in Level 1 and 2 housing, as well as extra wide doorways and hallways, no steps, sink, and door handles instead of knobs, height-appropriate light switches, electrical outlets, climate controls, kitchen cabinets, and appliances. They will also have countertops that can accommodate a wheelchair by having a clearance area below the counter or are low enough for a little person to access. Only .15% of housing is accessible enough for people using mobility devices. Even among homes currently occupied by a person who uses a wheelchair, less than 1% are considered wheelchair accessible.

While the accessibility index focuses on mobility access, people with vision and hearing disabilities also benefit from accessible home modifications. For example, installing smoke alarms for those who are deaf or hard of hearing can greatly improve safety. These include alarms that use strobe lights or emit a loud, low-frequency sound. Installing a doorbell alert that flashes, activates a shaker device, or amplifies the doorbell sound also makes the home more accessible.

Modifications for people who are blind or have low vision may include a phone doorbell that allows residents to talk to someone at the door, non-slip floors and low-pile carpet to minimize tripping hazards, and talking thermostats and appliances.

What Is Affordable Housing?

Housing is considered affordable if the home’s residents pay less than 30% of their income for the housing and its related costs. Paying more than 30% is considered a cost burden, while paying more than 50% is considered a severe cost burden.

Of the 11 million adults with extremely low incomes who rent, 71% are severely cost-burdened. The national average demonstrates that for every 100 renters with extremely low incomes, only 36 affordable houses are available. One reason for the lack of affordable and attainable housing is that people with higher incomes are renting them.

This lack of affordable housing is significant for people with disabilities who are twice as likely to live in poverty  than people without disabilities.

Although there are many difficulties for people with disabilities in attaining affordable and accessible housing, it is even more challenging to find housing options that are both. There are 5 million households with extremely low incomes and at least one adult with a disability or a head of household over 62 years of age.  Finding affordable housing often increases the financial burden due to the cost of modifications to make the home more accessible.

What Is Attainable Housing?

Attainable housing is accessible and affordable.

“People with disabilities will continue to experience barriers to securing accessible housing that is also affordable until inventory increases,” Friedman said.

Some solutions to help people attain the housing that is available and increase the availability of more units include:

  • Supporting subsidy programs available to those who need affordable, accessible housing.

  • Coordinating with community groups to install accessibility features into affordable homes (such as features that are not already covered by their insurer).

  • Working cooperatively with community planners, developers, builders, renovators, and investors to increase the number of accessible, affordable housing options.

“Raising awareness of the housing situation and working in partnership with community leaders to promote universal design can help increase the number of accessible and affordable housing units,” Friedman said.

Having access to affordable and accessible housing can have a positive impact on almost every facet of life for a person with a disability, including people who age into a disability. By spending 30% or less of their income on housing, they may then have available funds necessary to have increased spending power to obtain long-term services and supports or assistive technology, engage in community activities, or purchase nutritious food. Having stable housing minimizes stress, improves mental health, and increases access to civic opportunities and community resources that support independent living.


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