AS HEALTHCARE PROFESSIONALS and affordable housing experts, we strongly support Mayor Michelle Wu’s recently proposed  Inclusionary Development Policy increases and linkage fees for lab space. Increasing funds for affordable housing will lead to improved housing equity in the city and lead to significant positive impacts on the health outcomes of individuals and the communities they represent.

The Inclusionary Development Policy mandates that developers set aside a percentage of new units for affordable housing or, alternatively, pay into a funding pool designed to support affordable housing development projects elsewhere in Boston. The policy has existed since 2000 and, since that time, has led to the creation of over 3,000 affordable housing units. However, the housing crisis has not abated and, in many ways, has been exacerbated since the pandemic. Rapid rising rent prices have placed Boston above San Francisco as the second-highest rent price in the country for a one-bedroom based on Zumper’s national rent report.

To better address this issue, the mayor has recently called for critical and timely updates to the policy, including increases in the percentage of affordable units required under the policy.  Specifically, the proposal calls for lowering the threshold from ten to seven units, requiring all projects to meet the threshold to implement inclusionary development irrespective of the need for zoning relief. For rental developments, the policy would increase the affordable housing component from 13 percent to 20 percent and lower the overall affordability income level.

At the same time, Boston has proposed higher linkage fees for lab space. The linkage policy, established in 1983, currently applies to projects with over 100,000 square feet of commercial space and collects fees for square footage beyond that. However, the outdated formula for calculating these fees has not kept up with inflation and skyrocketing development costs.

In recent years, new, highly profitable lab buildings have exploded across the city. Under the proposed policy change, developers would pay more per square footage to develop lab spaces. These funds would, in turn, be utilized to preserve existing affordable housing projects and advance future affordable development projects. Together, these policies would create more affordable units throughout the rent-burdened city, ensure greater upward mobility for low-income residents, and improve the health outcomes of the residents in our community.

The implications of these policies are manifold. Fundamentally, investment in the space of housing equity represents a critical investment in public health. Housing insecurity is increasingly recognized as a critical determinant of healthcare outcomes and has been linked to increased rates of mental health issues, chronic illness, and reduced life expectancy. Homelessness and housing insecurity increase the risk of exposure to environmental toxins, dangers from extreme temperatures, disease, and gender-based violence. The persistent fear of eviction and lack of stable housing can lead to chronic and biologically embedded stress and anxiety, exacerbating long-standing health concerns such as asthma, hypertension, and heart disease. These issues are compounded from generation to generation as children who experience housing insecurity face cognitive and physical health issues which persist into adulthood.

At a societal level, providing support for the most vulnerable among us is both an ethical responsibility and an opportunity to improve the communities in which we live, grow, work, and play. Advancing housing equity has the potential to foster diverse and vibrant neighborhoods, encourage robust community, improve individual and collective social capital, and improve the well-being of all residents.  The need to expand access to affordable housing is event more acute, especially on the heels of an estimated 300,000 people, who will lose their health insurance through MassHealth following the end of COVID-19 related funding streams.

It is critical to acknowledge that these health-related consequences are merely that – consequences – a symptom of societal disenfranchisement of the vulnerable rather than an individual failing. We must recognize our roles, privileges, and opportunities in front of us to bridge the gaps. The proposed Inclusionary Development Policy changes and linkage fee reforms, accordingly, represent an opportunity to move the needle in advancing housing justice and ensuring that all new developments in some way contribute to a shared vision of a more affordable city and better health. Boston can lead the way in equitable housing reform and an inch-by-inch push toward a healthier society.

Jarone Lee is a doctor in Boston, board member of the Asian Community Development Corporation, and cofounder and president of  Health Tech Without Borders, Inc. Aditya Narayan is a medical student and Knight-Hennessy Scholar at the Stanford School of Medicine. Angie Liou is executive director of the Asian Community Development Corporation. Raymond Liu is a doctor in Boston.