Stopping the Vicious Cycle: Equitable Enforcement Strategies to Achieve Safe, Stable, and Accessible Housing for People with Disabilities

Health Inequities
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Policy Points:

  • People with disabilities experience a vicious cycle of poverty, poor health, and marginalization partly because of the inequitable implementation and enforcement of laws, including underenforcement of civil rights and housing laws and overenforcement of punitive nuisance and criminal laws.
  • Inequitable enforcement reflects policy choices that prioritize powerful entities (e.g., landlords, developers) to the detriment of people who experience intersectional structural discrimination based on, for example, race, disability, and income.
  • Equitable enforcement, a process of ensuring compliance with the law while considering and minimizing harms to marginalized people, can promote health and disability justice by increasing access to safe, stable, and accessible housing.

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.


  1. A Blueprint for Changemakers: Achieving Health Equity Through Law & Pol-icy. ChangeLab Solutions; 2019. Accessed September 12, 2022.
  2. Equitable Enforcement to Achieve Health Equity. ChangeLab Solutions; 2020.Accessed September 12, 2022.

Michel KH, Watts MH, Breslin J, Tobin-Tyler E. Stopping the Vicious Cycle: Equitable Enforcement Strategies to Achieve Safe, Stable, and Accessible Housing for People with Disabilities. Milbank Q. 2024;102(1):0114.