Affordable and Healthy Homes in North Carolina

Healthy, affordable housing is in short supply in North Carolina, and demand is rising. A new BlueCross BlueShield of NC Foundation report by UNCG Center for Housing and Community Studies’ Dr. Stephen Sills outlines what we can do to reverse the trend.


More than a 1.1 million households in North Carolina are considered cost-burdened, spending more than 30 percent of their incomes on housing expenses, and being forced to choose between substandard conditions or cutting costs elsewhere. Even with assistance from the Department of Housing and Urban Development (HUD), 250,000 individuals live in subsidized housing. More than half of the extremely low-income rental households have no other option than to live in aging properties that are in disrepair, and in less-than desirable locations.

This is about more than a place to live. While there is a complex dynamic between housing, sociodemographic factors, and negative health outcomes, one point is clear: poor-quality housing has a negative impact on physical and mental health.

Addressing the intertwined issues of housing affordability and healthy living environments calls for a coordinated, multi-prong, systemic approach; one that brings together community members, developers, state and local governments, health care providers, philanthropy advocates, and other stakeholders. North Carolina has the opportunity to change the current system that has resulted in zones of exclusion and concentrations of poverty. Effective public-private partnerships can support and implement a range of policy and practice recommendations.