September 2026
Special Series: Hidden in Plain Sight - How Housing is Linked to Healthcare Access among New Yorkers Since the Pandemic
Housing hardship isn't just correlated with poor health in New York City — it actively drives worse healthcare access, with high-need New Yorkers facing persistent housing instability nearly three times more likely to skip needed care, struggle to reach appointments, and lack a safe place to recover than those with stable housing.
Contributors: Francesca Michielli, Mustafa Hussein, Lily Bushman-Copp, Christopher Wimer
Issues Areas: Health & Well-Being, Special Reports
Executive Summary
New York City’s high-need residents — those managing multiple chronic conditions, work-limiting health problems, or serious psychological distress — face a housing crisis layered on top of a health crisis, with unstable and unsafe living conditions actively undermining their ability to get and stay well. New Poverty Tracker research from Columbia University, supported by Robin Hood and The Leona M. and Harry B. Helmsley Charitable Trust, tracked these New Yorkers from the pandemic’s peak (2021–2022) through its waning period (2023–2024) and found that housing hardship — not just economic disadvantage broadly — is an independent and persistent driver of worse healthcare access.
Key Findings
High-need New Yorkers face housing hardship at disproportionate rates: High-need New Yorkers were twice as likely as their non-high-need peers to experience persistent housing hardship (14% vs. 7% across both study periods) and were more likely to live with poor housing conditions such as pest exposure, structural damage, and unsafe neighborhoods.
Housing hardship compounds barriers to physical and mental healthcare: Among high-need New Yorkers, those facing persistent housing hardship were far more likely to delay or forgo physical care (52% vs. 22% for those with stable housing during the peak period) and mental healthcare (60% vs. 32%) — and these gaps persisted even as the pandemic waned.
As routine care eroded, reliance on emergency rooms grew: High-need New Yorkers with persistent housing hardship increasingly turned to emergency rooms rather than doctors’ offices as the pandemic receded, with ER use nearly doubling from 27% to 39%.
Unsafe housing directly undermines the ability to manage health: Nearly a quarter (24%) of high-need New Yorkers with persistent housing hardship reported direct housing-related obstacles to managing their health — such as unsafe living conditions or lacking a clean, comfortable place to recover — nearly three times the rate reported by those with stable housing (9%).
Housing stability alone doesn’t guarantee housing quality or healthcare access: First-person accounts, including a woman managing long COVID, asthma, and depression in a Bronx apartment plagued by rats and safety concerns despite holding a stable Section 8 voucher, show that even secure housing can fail to support health when conditions are poor.