An annual report on the state of housing in Massachusetts’s most populous region offers a grim assessment of the housing crisis, just days after voters narrowly shot down a ballot question seeking to make it easier to build single-family homes on smaller lots.

Greater Boston’s infamously high rental prices and home prices are leveling off, according to the Greater Boston Housing Report Card from the Boston Foundation and the Joint Center for Housing Studies at Harvard. But permits for new units have hit their lowest level in a decade, population growth is slowing, and new units are down, setting the stage for a period of sluggish housing growth as the state struggles to get a handle on its cost-of-living crisis.

“There’s a bigger question on what’s the health of the region’s economy in the next few years,” said Luc Schuster, executive director of Boston Indicators, the research arm of the Boston Foundation. “We could see a stagnation or recession,” he said, and while that may bring prices down, “that’s just not the way we want to address the housing cost problem.”

The report found 32 Greater Boston municipalities had median single-family sale prices above $1 million in fall 2026. Cambridge, Wellesley, Weston, and Brookline all had median single-family prices above $2 million, and just six of the 147 municipalities in Greater Boston had median prices below $500,000. Despite the high costs, the speed of house and rent prices slowed over the year so far.

A decade ago, 42 towns had median single-family sale prices below that amount, adjusted for inflation.

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