Enhancing Longevity and Well-Being for All Incomes

by Maya Brennan

The desire to live a long and happy life is nearly universal, and new research points to greater longevity, better quality of life over a long life span, and reduced disparities in longevity by income. However, without an emphasis on equitable access, emerging knowledge and new technologies tend to reach upper-income households first—leading to further disparities. Between 1980 and 2010, life expectancies rose among upper-income groups and remained flat or fell among lower-income groups, according to an analysis published by the National Academy of Sciences. Yet, public health gains have been made in high-priority policy areas. Researchers Janet Currie and Hannes Schwandt found that gaps in longevity are not growing among people under age 50, in part because of smoking reductions and better access to health care for pregnant women and children.

A new report from the Hamilton Project at the Brookings Institution cites several factors that affect longevity, including poverty, drug and alcohol abuse, smoking, and suicide. New health care policies may reduce mortality in some of these areas, while other contributing factors remain ripe for public policy change. For example, to reduce poverty-related mortality, policy interventions could focus on food security, job opportunities, or education. Housing is connected to all of these factors.

The Stanford Center on Longevity has also been examining the contributors to a long and happy life. According to Stanford’s Sightlines Project, a successful life that lasts 100 years or more is realistic with improvements in healthy living, financial security, and social engagement. Healthy living encompasses diet and exercise, as well as avoiding smoking, drug and alcohol abuse, and other risky behaviors. Financial security refers to having an adequate income today, asset-building vehicles for tomorrow, and insurance to protect against crippling expenses. Social engagement includes group activities and supportive personal relationships. Each of these is also related to where people live.

The more we learn about the recipe for successful longevity, the clearer it is that housing and neighborhoods are key ingredients.

For healthy living, peer-reviewed research supports 21 recommendations that involve housing and other aspects of the built environment. The recommendations, which were synthesized by the
Urban Land Institute and the Center for Active Design in the Building Healthy Places Toolkit, include smoking bans, design features that encourage exercise, and the inclusion of healthy food access nearby.

While smoke-free public housing policies are growing, enacting other health-supportive change will take more time. For example, the likelihood of a good walk score is higher for public housing units than other rental housing, but concerns about crime may keep residents indoors. Neighborhood safety may explain the poorer cardiovascular health found among Latinos living in public housing the Bronx compared with other low-income Bronx Latinos. Neither moving whole communities nor reducing a neighborhood’s crime rate can happen quickly, but even a modest change from the status quo would benefit public health.

The evidence on healthy living is strong enough for the housing and planning communities to make changes that lengthen and improve lives up and down the income ladder. New developments can emphasize active design principles. Housing mobility programs could be expanded to provide more choices for current recipients of rental assistance. And in community revitalization efforts such as Choice Neighborhoods, sufficient resources for public safety can ensure that no one has to leave their neighborhood to feel safe outside.

For financial security, the research base also shows the importance of housing. Seven out of 10 low-income households spent more than half of their income on housing, leading to less money going toward food, health care, and retirement. On average, half the retirement assets of older Americans is home equity. Housing also provides a stable platform for residents to work or participate in rental-based asset-building programs. The neighborhoods where families live also affect educational outcomes—and thereby long-term financial security—for children and adults.

Better supporting longevity through improved financial security may call for a stronger housing safety net, the expansion of asset-building vehicles like the Family Self-Sufficiency program and individual development accounts, and continued access to high-quality housing counseling and sustainable paths to homeownership.

Housing policies and programs can also facilitate residents’ social engagement. Having a permanent address helps maintain and grow personal relationships. Reducing homelessness and unwanted moves would lay the groundwork for long-term personal relationships. Building and retrofitting homes to comply with universal design principles is another evidence-based way to encourage interpersonal connections by ensuring that housing is built so that family, friends, and neighbors can visit regardless of disability. Planned activities in multifamily housing and neighborhood civic spaces can also enrich residents’ social and recreational lives, making life worth living and—according to the longevity research—making a long and happy life more likely.