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January 16, 2024
Katie Hannon Michel
Maya Hazarika Watts
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The law is widely recognized as a structural driver of health.1 The law affects health not only through its substance and design but also through how it is implemented and enforced by law enforcement and other government officials.2 People with both physical and mental health disabilities suffer negative health outcomes through underenforcement, in which they are disproportionately underserved by laws designed to promote their health, safety, and access to opportunity, and through overenforcement, in which they are disproportionately affected by punitive enforcement approaches.
Lack of access to safe, stable, and affordable housing is reaching a crisis point in communities throughout the United States. This crisis affects people with disabilities acutely, particularly those with intersecting forms of marginalization associated with low socioeconomic status, race, gender, and immigration status. Tackling the US housing crisis requires significant investment in affordable housing, including focused investments in accessible housing for people with disabilities. It also necessitates policy changes that address the ways in which current law, as well as its implementation and enforcement, prioritizes people or entities with power and privilege (e.g., property owners, housing developers, real estate investors, and landlords) to the detriment of people experiencing intersectional structural disadvantages (e.g., people with disabilities and people living in poverty). Although acknowledging that many major structural reforms are needed to fully realize access to safe, stable, accessible, and affordable housing for all people, especially those with disabilities, this article focuses on how equitable enforcement of existing laws can help to shift power to and protect the housing rights of people with disabilities.
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The Milbank Quarterly is an editorially independent multidisciplinary journal that offers in-depth assessments of the social, economic, political, historical, legal, and ethical dimensions of health and health care policy.