Why Housing for LGBT Elders Is a Public Health Issue

(This article appeared previously on the website of the Diverse Elders Coalition.)

Summer is here. The knockout rose bushes are in full bloom, the other flowers are blooming in the garden. At the time I wrote this, in the spring, Old Man Winter was gone and we could sit on the front porch. Yet I was in my Washington, D.C. house, bundled up in a turtleneck and cable knit sweater thinking Old Man Winter hasn’t gone far enough and I should perhaps turn on the heat.

At times like those, my mind automatically drifts to thinking about the older adults that are in need of warm, safe, decent, affordable housing, the increase of homelessness and the decrease of affordable housing among elders in the country and in my city.

As with many issues, when we speak of homelessness older people are invisible. We focus on “families and children” and rarely on older people who are homeless.

Traditionally, there are two major paths to homelessness for people over 60. In the first, the person is classified as a product of chronic homelessness. That is, they have been homeless before they were old and are in a seemingly unbreakable cycle of housing instability.

The second pathway is a much newer phenomenon and is increasing at an alarming rate. Older adults and elders who heretofore have lived independently, in their own private living spaces, are experiencing first-time homelessness. Research is identifying the following trends present and overlapping, contributing to homelessness of older adults and elders:

• Living on a fixed income, using more than 30 percent of income to pay for housing
• Financial problems, including job loss and discontinued public assistance
• Disagreement with person with whom they were staying (relationship breakdown)
• Physical and/or mental health problems
• Lack of access to affordable senior housing

The calls and emails I receive every month from people looking to live at Mary’s House confirm that there are many elders on the second path. Like the phone call I received from an older gay man who was completing the online Letter of Interest application.

“Dr. Woody,” he began, “I know Mary’s House has not opened yet, but I wanted to put my letter of interest in because I need the housing now. I am a white, gay man, and I am unable to afford my rent and the rising rent increases in the city. I have to find some other place to live. Do you have any ideas of where I can go?”

After we spoke a little longer and I collected some information, I understood what he was really asking: Are there places that will accept the whole of me? The gay, male part of me? The old of me? The economics of me? A place that will accept my friends?

Then there's the woman who had lived with a friend and her friend’s dad for many years. She shared in the care of the friend’s dad for a long time, even after her friend died. However, at some point the siblings wanted Jane out. She had no place to go; her homophobic brother promised violence if she brought “any of that homosexual s--- up there.”

That's why we need to build LGBT-friendly housing.

With continued help and support, and with a little luck, we will build the first Mary’s House in 2017.  It will be among the approximately six to eight brick-and-mortar residences in various stages of completion across the U.S. that are LGBTQ-affirming.

However, it’s not likely that we will be able to build enough affordable residences that are affirming of LGBTQ/SGL (same-gender-loving) individuals to stem the tide of increased homelessness for older adults. So, what can we do in the interim?

One of the first things we can do is to acknowledge that housing is a determinant of health and therefore it is a public health issue. We are all familiar with the woman who has to make choices about paying for medicine, food or rent. Or the man  who is forced to use more and more of his resources to obtain shelter, making affordability and accessibility equally important variables in the equation to confront elder homelessness.

As a public health issue, we can recognize that without stable housing, older adults, like families and children, are prone to myriad health issues and their quality of life can suffer. Research has shown that “housing affordability shapes the neighborhood conditions and the ability of the person to make healthy choices.”

Strategies must focus on the safety and quality of housing for everyone. They should include an awareness and acceptance of the culture of the individual as well as the neighborhood.

By considering housing a public health issue, we can stimulate greater advocacy and address broader and more complex problems. Participation should be collaborative, from the individual, the community, the agency, the local and federal governments, and others working together to end current and potential disparities and create safety nets for those most vulnerable.