Approaches for Improving Rural Housing Affordability

Approaches for improving rural housing affordability focus on strategies and mechanisms for improving residents' access to affordable housing to reduce homelessness. Some programs implementing these approaches may provide subsidized housing for residents directly or help people secure permanent, affordable housing.

Where you live, including the quality of your housing, can have direct impacts on your health and well-being. Homelessness and substandard housing can make existing health conditions such as diabetes, a mental illness, and HIV/AIDS worse. Similarly, a person with a chronic medical condition or a disability is more likely to experience homelessness. Being able to afford housing that is safe and high quality is an important first step towards living a healthy life.

Approximately 18% of the homeless population in the U.S. live in rural areas, and many rural individuals are at risk of becoming homeless. A lack of economic stability and a livable income contribute to the rates of rural homelessness.

Homelessness is associated with an increased risk of poor health outcomes, especially for individuals who find themselves without stable housing for long periods of time. Certain populations experience higher rates of homelessness in rural communities, including veterans and youth. Homelessness for youth living in rural areas may be as widespread as in urban areas, and rural youth face increased challenges to accessing services and support to find stable housing. Recent studies show that rural parts of the U.S. have seen the highest increase in rates of homelessness for public school students, with over 162,000 youth reporting that they have experienced homelessness.

Several strategies included below have been identified to address rising rates of rural youth homelessness and may apply to other rural populations:

• Developing partnerships among health and social service providers and organizations working to end homelessness to provide more support services
• Expanding local outreach to help identify homeless populations and connect them with care
• Involving local leaders and champions, especially faith-based organizations

Rural areas may offer limited affordable housing options, putting many more people at risk of homelessness. The types of houses available to rent or buy may be older, and there are more manufactured homes, like mobile homes and trailers. Historically, manufactured homes offered a more affordable option for many rural residents, but increasingly, mobile home parks are being purchased by real estate companies and other for-profit entities that can increase rent on the land, in some cases, making it unaffordable for people to stay in their homes.

Much of the funding to address homelessness comes from the U.S. Department of Housing and Urban Development (HUD), and funding amounts are determined by population size. As a result, rural areas receive less financial assistance to address housing issues. Tenant-based rental assistance programs are funded by HUD and are recommended as evidence-based by the Community Preventive Services Task Force to improve health equity for low-income individuals and families living in urban settings. These programs, which provide subsidies in the form of vouchers to use towards rent each month, have not been studied extensively in rural settings. Community organizations are often the ones who try to coordinate housing using HUD federal funding for rural individuals and families facing homelessness. Funds from the HUD Continuum of Care (CoC) Program aim to end homelessness and provide resources for communities to rehouse individuals and families.

Housing First is one promising approach that has been successful in rural communities working to end homelessness. This approach centers on improving quality of life and well-being by providing permanent housing to people experiencing homelessness. The Housing First approach also offers additional support services for those interested, like connection to transportation, employment, and healthcare.

Programs implementing a Housing First approach may offer different models for providing housing. Two of the most common models include permanent supportive housing (PSH) and rapid re-housing. PSH provides people experiencing long-term homelessness with long-term support and housing assistance. Often, these individuals have a chronic illness or disability. Rapid re-housing focuses more on short-term housing solutions.

For more information about the Housing First approach, as well as considerations for rural people experiencing homelessness, see People Experiencing Homelessness in the Rural Services Integration Toolkit. Housing quality is also an important SDOH. For more information about substandard housing and associated health impacts see Housing Quality Approaches.

Examples of Programs that Focus on Improving Housing Affordability

• CASA of Oregon is improving the quality of life of underserved farmworkers and rural Oregonians by developing affordable housing and programs that increase financial well-being. CASA of Oregon was founded in response to the housing needs of migrant, seasonal, and year-round farmworkers and their families. While CASA of Oregon continues to primarily serve the farmworker community, they have expanded their work to develop other rural housing throughout Oregon. CASA of Oregon operates a Manufactured Housing Cooperative Development Center. This program has helped home owners in 15 communities to purchase their communities and operate them as Resident Owned Cooperatives (ROC).
• Rural Alaska Community Action Program, Inc. (RurAL CAP) is a nonprofit organization helping to empower low-income Alaskans by providing culturally appropriate advocacy, education, affordable housing, and direct services. RurAL CAP operates many housing programs in Alaska to address SDOH. The Planning and Construction Division of RurAL CAP helps improve housing affordability and quality of housing for residents, and also helps weatherize homes around the state. They operate a Mutual Self-Help Housing Program that provides affordable housing to Alaskans, including help for low-income families and first time home-buyers. RurAL CAP's Supportive Housing Division provides affordable rental housing opportunities for people with low incomes and limited credit histories, those experiencing homelessness, people living with a several mental illness, and people with a substance use disorder.
• Open Doors Homeless Coalition focused on ending homelessness for veterans in the Mississippi Gulf Coast. The program used a Housing First approach which emphasizes the importance of helping people find permanent housing first before attending to other needs. Through a multi-county partnership, leaders in the region have helped reduce the number of people experiencing homelessness by connecting people with housing and also providing wraparound services. Open Doors Homeless Coalition acted as the convener bringing partners together to address the complex issues facing veterans. Aside from housing, veterans were also connected with transportation and social services to help address other needs.
• The Pathways Vermont Housing First Program is another program implementing multiple strategies to address SDOH and reduce homelessness using the evidence-based Housing First approach adapted for rural Vermont. Although providing permanent rental housing to participants is one of the key elements of the program, the many coordinated support services made available to participants is critical to the program's success. The rural adaptation of the program uses local service coordinators who meet individually to build trusting relationships with participants. This one-on-one coordination of services and support is an important component of successfully integrating social services for these individuals. Participants in the program have a severe mental illness, substance use disorder, or are recovering from trauma. Some of the many services provided to participants include daily on-call support, access to a computer and internet with training on how to use, telehealth access for medical visits, substance use treatment, counseling and therapy services, as well as providing connections to job opportunities. The program has saved the state money while also keeping participants in safe housing and out of hospitals and jails.

Considerations for Implementation

Implementing programs to address housing instability and affordability can be challenging in any location, but rural areas provide several unique considerations. Although there are an increasing number of rural people experiencing homelessness or living in substandard housing that they struggle to afford, rural homeless populations can be harder to identify. Homeless shelters are more limited in rural locations which may lead people to seek shelter outdoors or in indoor places that are not safe for living. People may resort to sleeping in open fields, abandoned buildings, or vehicles which are more hidden from plain sight. Many programs that aim to improve housing affordability and reduce homelessness are often concentrated in urban areas.

Limited transportation access in rural communities can contribute to the inability to secure and retain a job which is a risk factor for homelessness. A lack of transportation also limits the ability of individuals to connect with community resources and housing opportunities. In addition, limited access to healthcare services for the treatment of chronic illnesses or substance use disorders can contribute to homelessness. People with a substance use disorder may struggle to afford housing costs and may experience hospitalization. People may struggle to pay medical expenses and may not have the resources to also pay housing costs.

Program Clearinghouse Examples

• CASA of Oregon
• RurAL CAP

Resources to Learn More

Rural Homelessness: Strategies for Addressing Rural Homelessness
Website
Resources and information for rural communities addressing housing instability and homelessness. Includes links to toolkits with specific strategies for addressing and preventing homelessness in rural areas.
Organization(s): U.S. Department of Housing and Urban Development

Rural Issues
Website
Provides resources about rural homelessness and healthcare. Includes reports about the scope of rural homelessness as well as strategies to address the issue.
Organization(s): National Health Care for the Homeless Council