HOUSING COSTS are rising along with utility costs, putting increased burdens on families. Many are forced to choose between paying rent, paying their utility bills, or buying food – a situation no family should have to face. Recently we experienced a particularly vexing example, which illustrates the systemic and policy challenges in providing better and more stable housing to Boston’s families.  

A family with five children, two of whom (ages 11 and 18) have asthma and allergies, had been living in an over-crowded, mice-infested apartment. Then, finally they secured the opportunity to move into Section 8 housing and the new landlord assured them the home would be clean and ready for move-in.

They showed up to an apartment that was dirty and not up to Section 8 standards. Even worse, there were mice in the apartment yet again! Despite landlord assurances, days went on, more mice came, and nothing was fixed.

The 11-year-old’s asthma started acting up – the housing conditions were making her asthma worse and her preventative asthma medication wasn’t working because of the constant exposure to mice droppings. After two emergency room visits, Mom followed up with me, her family pediatrician, and I did what I could to adjust her medications. Then, she contracted a viral illness, which coupled with the mice dropping exposure, meant she had to return to the emergency room a third time, ultimately ending up in the intensive care unit (ICU).

Meanwhile, Mom called Boston’s Inspectional Services Department and met with the hospital social worker. We referred the family to Breathe Easy, a program that partners with the city to expedite urgent inspections for children with asthma. Finally, a housing inspector came and found mice feces everywhere. The landlord then sent an exterminator, which was only a temporary fix to the problem, because the mice returned. 

Frustrated and worried about the negative impact of this environment on her children’s health, Mom knew she had to move somewhere else to protect her children – their home was making them sick. The landlord refused to end the lease. Mom spoke with her housing worker who said that if the landlord refused to fix the problem and refused to terminate the lease, there was nothing more that could be done. 

NOTHING that can be done? A child is in the ICU because of poor housing conditions and no one feels responsible? No one is taking action? This child’s life is in danger, but no one – not the landlord or the housing worker – is doing what is needed.

If housing conditions are bad enough to send a child to the ICU once, it could happen again, and I was concerned that something even worse could happen. We directly called Mom’s housing worker, the city’s Breathe Easy program, and the deputy director at the Office of Housing Stability in Boston. Now that the patient’s pediatrician called and told them that this 11-year-old’s life depended on it, people had to pay attention.

The daughter eventually went back to school after many missed days but there were still mice. The city was working on getting her out of her current housing situation, but it was not happening quickly enough. She got sick again and went back to the ICU. Once again, her life was in danger due to the terrible conditions she was being forced to live in.  

After four days in the ICU, she was discharged. Then, it was not until four weeks later that she moved into a new apartment without mice. She was behind academically, which took a toll on her mental health. She felt insecure both socially and academically and as a result was feeling depressed. Boston Community Pediatrics was able to not only help navigate the housing situation, but provide the necessary mental health services. 

Several emergency department visits, a hospital admission and not one – but two – ICU stays, resulted in not only expensive healthcare bills, but also dramatic negative impacts on physical health, school performance, and mental health. Our current policies protect landlords over children and allow people to live in unsanitary, mice-infested “homes.” The situation is not suitable for anyone – and the costs of these poor housing conditions far outstrip the cost of fixing the problem right away.  

This situation has left us wondering when our elected leaders will make effective policies that protect our children without needing a pediatrician to take matters into her own hands so that children don’t become sick from our very broken system.

Dr. Robyn Riseberg is the founder of Boston Community Pediatrics, a nonprofit that describes itself as a private pediatric practice bringing equity to pediatric healthcare in Boston.