Summary

We developed The Root Cause Test as a practical tool to guide public health organizations in advancing housing policies that address the deep, systemic drivers of housing and health inequities.

The guide challenges public health actors to move beyond short-term, “band-aid” interventions and toward strategies that meet four criteria, asking them to consider whether a given proposal:  

‍1. Power: Increases the power of working-class and BIPOC communities to decide the future of their families, homes, and cities?

2. Universality: Ensures stable, affordable, dignified homes for all?

3. Racial Healing: Repairs and heals the harms of systemic racism?

4. Sustainability: Supports the collective well-being of all living things and the earth?

This tool can help public health practitioners focus our attention on interventions that heal the continued legacy of housing decisions that have extracted wealth and power from working-class communities and Black, Indigenous, and other communities of color, and concentrated it in the hands of corporate investors and wealthier, Whiter communities. 

The Criteria

The public health field has played a complex and sometimes contradictory role in US housing history, leading early pushes for habitable housing, but also sometimes legitimizing harmful policies. And as a field, we have too often invested our credibility, data, and power in temporary fixes, or “band-aids.” Some of these, like Section 8, are necessary short-term interventions that we have falsely come to treat as real solutions. Others, like the Low Income Housing Tax Credit serve an essential purpose but move us further from root causes and can be harmful. 

Our task is not to eliminate all housing band-aids. Short-term patches may be necessary interventions in the immediate term. But to create real and lasting change, public health practitioners must move beyond band-aids, and research, develop, and demand solutions that fundamentally transform power imbalances and address housing and health inequities at the root.

The four criteria of the Root Cause Test help practitioners determine whether given actions do so. This tool includes a worksheet that allows readers to evaluate proposals and develop ways in which they could best advance root causes.

Recommendations

The public health field can make important contributions by centering the self-determination and power of impacted communities, developing our own capacity to work for housing justice, advocating for policy and systems changes, aligning resources, making the case through research and data, and building strong inside-outside partnerships with housing justice movements.  

If we turn our attention to the root causes of housing injustices and enact transformative solutions, the public health field can help make a world in which we all have the power for self-determination, and access to the stable, affordable, dignified housing we need to be healthy.