The housing crisis in Saranac Lake, Lake Placid and the greater Adirondack region has prevented many local employees from easily obtaining a place to live that is within a reasonable commute, and that asks an affordable rent. There was only one reasonably priced apartment in the area when I was looking six months ago, and I grabbed it.

Anecdotally, I learned that a number of Manhattanites are buying properties in the North County and converting them into Airbnbs. These developments might prevent some local workers from obtaining viable housing.

As Abraham Maslow discussed in his hierarchy of needs, before one can self actualize in life, they first need to accomplish the basic foundation of having access to stable housing and nutrition, and the security it provides. Prior to the pandemic, there was already a shortage of affordable housing in the North County. However, with the pandemic, the shortage seemed to increase.

From the start of the coronavirus pandemic to late January 2021, more than 75 million unemployment claims were filed throughout the U.S. Financial catastrophe therefore impacted at least 25% of the U.S. population, which rose in total to over 330 million in 2021.

Years ago, in the 1950s and 1960s, the family unit was an integral part of every community. Families are now mostly separated from one another, and the emotional support that maintained the viability of U.S. families has been undermined by a fragmented social existence. It is now apparent that individuals with both employment insecurity and housing insecurity struggle to maintain emotional wellness.

These two variables, employment insecurity and housing affordability, represent a double-whammy impacting U.S. citizens with only one income source per household. What is worse, according to an October 2022 Adirondack Daily Enterprise article that was also printed in the Lake Placid News, is that the “North County housing affordability is at a 33 year low.”

Housing insecurity is a significant component of the social determinants of health. Social determinants of health include, among other variables, one’s income, linguistic ability and education and racial minority status. The absence of these determinants, such as being in a racial minority or being poorly educated, contributes to poor health physically and emotionally. It is a long standing public health issue.

There are several negative health outcomes that are associated with housing insecurity. These negative outcomes include stress, increased victimization both sexually and physically, increased substance abuse, and an increase in physical and mental health conditions. Variables such as ethnicity, geographic location, sexual orientation and socioeconomic status are characteristics that have been shown to present obstacles to attaining good health. Other characteristics include cognitive, sensory or physical disability.

At least one developer in Lake Placid is attempting to address these housing statistics with a new property that can be accessed via a housing lottery. This should help some North County locals to find affordable housing.

In a worldwide research study, an association has been found between economic recession and suicidal behavior, specifically one between working males of employment age.

A Forbes March 2021 article estimated that “30 to 40 million people were at risk of eviction in the next several months if the federal government didn’t intervene.” The Biden stimulus package provided billions of dollars to aid the U.S. citizenry. The breakdown included $21.5 billion for help with funding utility bill payments and for rent assistance, as well as funding for local and state governments to assist low income households who fell behind in their rent payment schedules. A total of $5 billion dollars each to provide emergency housing vouchers to the homeless, and to assist people who were at risk of homelessness. An additional $10 billion was slated to help people who own homes to pay their property taxes, utility bills and mortgages.

Although clinical care is important to maintain health in U.S. citizens, the social determinants of health, which include income and housing security, are actually more powerful in outcomes than the care that the medical community can provide alone. Of note, 19 million households are paying greater than 50% of their annual income in costs of housing. Over 21 million are paying 30 to 50% of their annual income for housing. This is not sustainable long term.

Over the past 30 years, it has been scientifically documented that children and adults both show an independent association between poor health and housing insecurity. In addition, access to care for adults has shown an association between access to care utilization and the extent of housing insecurity. For adults who are experiencing homelessness there is a higher rate of emergency department visits as well as the delay of care that is necessary. Other than the ER, there is no systematic way to help the disadvantaged find quality health care, both physically and emotionally. For children who are burdened with housing insecurity there is an earlier risk for abuse of recreational drugs, poor emotional instability and increased rates of pregnancy and depression among teenagers.

Looking at various correlations, such as those reporting housing insecurity, the most prevalent association is with those who are middle aged adults, members of a minority group, unmarried and low income. Access to care is mandatory for this population. Furthermore, there is an association between housing insecurity and poorly delivered care, poor health and the presence of chronic disease.

As noted in the JAMA 2021 article by Linton et al, “in this nationally representative sample of U.S. adults, housing insecurity was associated with higher psychological distress and lower self-rated health during the COVID-19 pandemic.” The conclusions acknowledge that interventions for housing insecurity may also mitigate against structured racism. Compared to the cohort of those who are experiencing housing security, the cohort of those with housing insecurity demonstrate lower self rated health scores and a higher degree of distress.

Although there are known adverse effects associated with housing insecurity, with a significant impact on mental health, there is a need to better understand what can mitigate this impact.

A Spanish study noted that 85.3% of men, and 89% of women, described poor mental health associated with housing insecurity. This was much higher than the 14.5% of men, and the 19.5% of women, suffering from poor mental health, who make up the general population of Barcelona. Housing insecurity plays a large and significant role in the association with poor mental health.

It is understandable that housing insecurity negatively impacts physical and mental health. Without a consistent roof over one’s head, an individual has no supportive base upon which to build their life. This negatively contributes to food insecurity, employment and access to health care. In a domino effect when one layer of support after another evaporates, the homeless individual desperately needs, and will benefit from, affordable housing. Private-public partnerships can highlight the social entrepreneurship both privately and publicly, which can create more secure housing in the North Country.