Turns out Colorado’s severe affordable housing crisis isn’t just bad for your bank account. Experts say it’s also bad for your health.

“That's the context and background for why we ... put on a symposium that was focused on housing as a health issue [last month] in Keystone,” said Kyle Legleiter, senior director of policy advocacy for the Denver-based Colorado Health Foundation.

“We'd heard loud and clear from people across Colorado, in lots of different ways, that housing is a top concern for them and that it is actually impacting both their physical health and their mental health,” Legleiter added.

Four out of five Coloradans surveyed in a poll for the Colorado Health Foundation and Kaiser Family Foundation right before the 2018 midterm elections said that housing costs are getting worse across Colorado. A majority (55%) said the same about health care costs and substance abuse (53%).

Similarly, of the 1,800 people surveyed, 80% said lowering the cost of health care was “very important” for state government, and 69% said the same about making housing more affordable.

Legleiter said the 2019 Colorado Health Symposium -- the July 24-26 gathering of health care experts, policymakers, housing advocates and developers in Keystone, entitled “The Intersection of Housing, Health and Inequity” -- identified four key ways in which housing is related to people's health, for better or worse.

The first is the overall affordability of rents and mortgages in a state where a growing number of residents are spending more than 30% of their income on housing. The Denver metro area consistently ranks as one of the nation’s priciest housing markets, and Colorado overall is among the least affordable states in the nation.

Still, people keep moving to Colorado in droves, with the population nearly doubling in the last 40 years from 2.89 million in 1980 to an estimated 5.7 million in 2018. There are nearly 700,000 new residents since the last U.S. Census in 2010, and yet home ownership is on the decline.

“As housing becomes more and more unaffordable or takes up a greater proportion of an individual or household budget, people often end up having to make really impossible choices or trade-offs between what we pay for,” Legleiter said. “Do we pay for our rent or our mortgage? Should we pay to put food on our table? [Or] do we pay health insurance premiums or childcare or other things that are really important to our overall well-being?”

The second key takeaway from the symposium, he said, was the importance of housing stability. People stressed by instability, rising rents and having to move from place to place, suffer obvious anxiety but also lack consistent access to services, including reliable health care. The foundation’s 2018 survey found nearly a third of Coloradans worry they may lose their home in the next 12 months because they can’t afford the monthly payment.

A third key connection between housing and health is more direct -- people living in housing that’s exposed to lead, asbestos, radon or other things that can be toxic to physical health. Or homes in unsafe neighborhoods with substandard water or transportation.

And finally, it’s all about location and what kinds of resources and amenities are nearby. As homes are pushed farther and farther out of city centers and away from where people work, for the sake of affordability, that creates a different set of health issues. Long commutes and a lack of amenities can have a very real impact on peoples’ health, especially in rural areas.

“Just the combined effect of having to spend an hour and a half of your day going back and forth to a job, that eats away at your mental health because it’s sort of an isolating experience to be commuting for that long,” Legleiter said.

“It sort of chips away at your time to do other things that might be good for your health, whether you’re taking time to be physically active, to cook and eat a healthy diet, to spend time with your family … That's more of a challenge that we're hearing about increasingly, certainly in rural resort communities, but also in other parts in Colorado.”

Mountain housing crisis

While home costs along the state’s Front Range have risen in recent years to some of the highest levels in the nation, Colorado’s mountain resort areas have been in housing crisis mode for years, with sky-high real estate values, vacant second homes, companies like Airbnb and Vrbo cutting into the long-term rental pools, low-paying tourism-sector jobs and demand for workers at an all-time high.

Couple those factors with astronomical health care costs, and people in mountain areas are struggling mightily.

Harry Frampton of Vail, founder of East West Partners and a group of companies that develop, sell and manage real estate across the West, sits on the board of Vail Health – the area’s largest health care provider and Eagle County’s second-largest employer.

Frampton said the scarcity of housing is definitely impacting the overall health of Vail Valley residents, prompting hospital officials to scramble for ways to bring down health care costs along with runaway health insurance premiums.

“You go through all these issues, and I’m on the hospital board and we've been talking about it a lot, struggling with it, and I say, ‘Well, all of this is great, but if we just paid people more, they’d do better,’” Frampton said. “They're struggling financially because we do have a nutty cost of living.”

Frampton called on Vail Resorts, the largest employer in Eagle County and one of the largest in the state, to up its minimum wage to $15 an hour – a move that its rival, Aspen Skiing Co., recently made and one that he says East West made more than two years ago.

Broomfield-based Vail Resorts operates the Vail, Beaver Creek, Breckenridge and Keystone ski areas and has hotel and other real estate interests in those areas.

Low wages, Frampton said, is one of the biggest factors impacting the overall physical and mental health of Colorado residents, especially in the Vail Valley.

“All the above. It's one of the reasons I believe we were the first company in the Vail Valley two years ago to raise our minimum wage from 12 to 15 bucks,” Frampton said. “Part of the problem is Vail Resorts doesn’t pay enough …”

Vail Resorts raised its minimum wage to $12.25 an hour last season and has reportedly yet to set its wages for the coming ski season, but CEO Rob Katz has acknowledged the need to do better on both wages and housing.

Frampton advocates for a wide array of solutions to the housing and health care crisis, arguing there’s no single silver-bullet policy fix.

“We've got to pay people more and we do have to support them and have a better infrastructure in mental health,” Frampton said. “We do have to remain creative in employee housing. We do have to have a great education system. So my sense though is that if you look at Vail overall, we're doing pretty good in the community addressing tough issues and we're doing a lot of innovative stuff. Some will work, some won't work.”

Frampton also cites East West’s month-long sabbatical program as one of the reasons the company in May was named the top firm among large companies in The Denver Post’s 2019 Top Workplaces contest.

Frampton, whose company developed downtown Denver’s Union Station and Riverfront Park neighborhoods, agrees that long commutes can have a negative impact on Coloradans’ health.

“Everything we do should be to discourage cars and encourage pedestrian walking and public transportation. Every decision,” Frampton said. “I understand we're spread out, different areas, you've got to move back and forth. But how do we discourage traffic and cars?”

Finding creative solutions

Clark Anderson grew up in Vail and now lives in Glenwood Springs, where he runs an organization called Community Builders that focuses on transportation, planning, housing and economic development in communities across the West. Walkability of mountain towns is a big buzzword for his nonprofit.

“You guys have got to stand up and recognize that if we want to have community, if we want to have mountains towns that have people in them, that have a real soul, and we want to address climate and the environment, we can't keep going the way we have been,” Anderson said at CampSight -- described as "an innovation and marketing unconference for outdoor industry brands" that was help in Vail April 10-12.

“We’ve got to advocate for housing that is affordable, we've got to advocate for infill and redevelopment, we've got to advocate for density in the right places, and that's a hard sell. It's harder and harder to do that because this is an increasingly divisive time and we don't agree with each other. Politics are ugly, but the cool thing is at the local level is where you can actually get things done,” said Anderson, who adds that healthy communities translate to healthy residents.

In a recent workforce survey conducted by the Vail Valley Partnership – the chamber of commerce for the greater Eagle County area – two-thirds of businesses felt their employee had a negative opinion of the availability of affordable health care. The same survey found that “frustration with housing continues to be a major issue …”

“When my dad [Chuck Anderson] was on city council in Vail in the early '80s, affordable housing was his number one priority,” Anderson said. “He died serving on council in 1984, and  I know he would be so disappointed despite all the work that has happened. … He'd be so disappointed and amazed how much work there still is to do, and it's because of the politics of it.”

Frampton acknowledged that "not-in-my-backyard" syndrome (NIMBYism) makes it difficult to get all the various types of affordable housing built in Colorado communities – from temporary workforce rental units to for-sale middle-income housing for young families. But that doesn’t mean communities should stop trying.

“I think as a general rule, we people who've kind of made it, we kind of figure workforce housing is the bad people. BS. We all started in workforce housing, did we not?” Frampton said. “At some point in time, we all did. We're talking about people who are good people. They're our future leaders.”

State Sen. Kerry Donovan also grew up in Vail. She now ranches nearby and her family owns and operates the Honeywagon waste disposal company. She and her parents all served in local government at various times.

Two of Donovan’s greatest areas of emphasis this past legislative session were bringing down health care costs and finding money to seed affordable housing.

“We’re asking people to make choices between things they shouldn’t have to choose, like getting an annual exam, paying for a maintenance medication,” Donovan said of the high cost of both housing and health care. Stability is key, she said, citing her longtime Vail Valley doctor.

“I’ve had the same doctor basically my entire life because I had a grounding home, right?” Donovan said. “A home does relate to long-term health outcomes that are better, and we know that long-term health outcomes are one of the places where we can really point to savings for the entire system -- where you're not seeing someone when they're in an acute state, when you're catching it early and building healthy practices throughout life.”

Donovan said she’s weighing more legislation next session to help the state deal with the housing shortage.

“They're all intertwined [housing and health care], but certainly affordable housing will continue to be a conversation down at the Capitol,” Donovan said.

The Vail Valley Partnership workforce survey also noted that 38% of Eagle County’s housing stock is classified as “vacant, primarily second homes” – a factor that exacerbates the crisis. And the proliferation of Airbnb and Vrbo business rentals, catering exclusively to tourists, has taken even more rental housing out of the rotation for workers.

“It's probably time for the state to take a look at Airbnb units and start to look at how that particular platform has evolved and if we should be treating [differently], for example, people who use it as a business versus owners who rent out some space while they're gone,” Donovan said.

“Nearly every community that's experienced … population growth … is seeing issues with this short-term rental market,” Donovan said. “When all these units are being taken off the market to rent for a couple of days out of a week, there's less rental ability for employees.”

It’s up to governments to make tough decisions to safeguard a sense of community, Donovan said. In Vail, that could mean square footage restrictions or enforcing rules for caretaker units.

“There are a lot of solutions that sometimes people aren't willing to take because they're harder, but sometimes there isn’t the will to do some of those harder things,” Donovan said, adding that’s sometimes what it takes to protect the health of a community and therefore the health of its residents.

“With a home comes a neighborhood, with a neighborhood comes a community and all those things gives you someone who helps you, someone who cooks you that plate of lasagna when you're having an issue, or the stability to go to a regular doctor.”

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