Summary

This collaborative research brief, produced by Homes for All St. Louis, Health in Partnership, the Vacancy Collaborative, and the City of St. Louis, examines the intersection of housing quality and health disparities in the City of St. Louis, with a particular focus on how poor housing conditions disproportionately affect Black and low-income communities.

The study draws on data from the City's Citizens' Service Bureau (CSB), Housing Conservation District (HCD) violations, and various health indicators to understand the scale and distribution of housing-related health burdens. Geographic analysis at the zip code and ward level mapped patterns of both substandard housing and poor health outcomes.

Key Findings

This study provides more evidence that racial and economic inequities are root causes of the housing and health crisis in St. Louis and that urgent action is needed. We find that:

• The continued legacy of racism and segregation have deeply impacted the health of Black residents of St. Louis, yielding higher mortality rates, premature deaths, and negative health outcomes like cancer
• Residents face mold, pests, inadequate plumbing, and lead, which can lead to health issues such as respiratory diseases, lead poisoning, and developmental delays
• Black-majority and low-income neighborhoods, like North and Southeast St. Louis, endure the highest rates of housing quality complaints, code violations, lead exposures, and respiratory health crises
• Neighborhoods with worse housing quality experience a five-fold greater ER visit rate for asthma and chronic lower respiratory disease
• Zip codes with high code violation rates have a nearly 14 times greater rate of elevated blood lead levels in young children

These inequities are the result of past policy decisions. Decision-makers can chart a new path towards a healthier and more just future.

Policy Recommendations

A diverse group of St. Louis city agencies, residents, nonprofits and local institutions are already working together to improve housing quality in the city, including on the solutions proposed in this brief.

Administrative Solutions:

• Send a copy of inspection notices of violation to tenants
• Collaborate with community-based organizations
• Expand the role of emergency inspectors to allow timely inspection

Policy Solutions:

• Explicitly address mold in building codes
• Include an anti-retaliation statute in renter-related ordinances
• Perform proactive (regular and routine) rental inspections
• Provide relocation assistance