Leading State Health: Ed Ehlinger
In his latest blog post, Ed Ehlinger, MD, MSPH, Minnesota Commissioner of Health, delivers a thought-provoking essay about health, housing instability, and policy decisions through the eyes of characters from a classic fairy tale, The Three Little Pigs. “Housing and public health are linked in our efforts to create healthy and vibrant communities,” says Ehlinger. Without affordable housing options, people are often forced to live in substandard conditions, which can pose a variety of health and safety risks. Ehlinger contends that housing instability in our country was created by economic policy decisions and continues to be viewed and debated through a lens that favors personal responsibility over government regulation. Ehlinger reframes the story of The Three Little Pigs to help challenge this narrative and help people see the connection between housing and other social issues and outcomes, like education, health, and employment.
Housing Security Is Not a Fairy Tale
The importance of safe, stable and secure housing has been on my mind over the last few weeks – especially since the outside temperature has dropped far below zero. Being reminded at the last Interagency Council on Homelessness meeting that thousands of adults and children are homeless every night in Minnesota’s cities, suburbs and rural areas underscores the reality that housing is a major public health issue. But the initial trigger for my thinking about housing was the tragic fire in a warehouse in Oakland, California that killed 36 people followed a week later by the collapse of a building in Nigeria that killed 23 people. What haunts me is that each of these situations was/is preventable.
Housing instability in our country didn’t happen by accident; it was created by policy decisions about how our economy should function and the role of communities and government in assuring safe and stable housing. Unaffordable housing forces people to live in unsafe dwellings that frequently don’t meet fire and safety codes – codes that are often undermined or unenforced by an individual responsibility narrative that contends government involvement and regulation is the problem, not a solution.
As I pondered our current situation, a familiar fairy tale came to mind. Perhaps a reframing of the story of "The Three Little Pigs" could help challenge that narrative.
You all know the story of "The Three Little Pigs." One lived in a house of straw, another in a house of sticks, and the third in a house of bricks. The moral of the story is that the choices we make have consequences and that hard work pays off. The two little pigs who lived in the houses of straw and twigs are often depicted as frivolous creatures who made bad choices and didn’t work hard enough to build substantial dwellings that could withstand the attacks of the Big Bad Wolf (BBW). The third little pig, on the other hand, is depicted as a diligent worker which allowed him to live in a BBW-Safe house of bricks.
But what the story doesn’t tell is that the three little pigs lost their parents when they became homeless due to a home foreclosure and ultimately fell victim to a pack of BBWs. The three little orphaned and homeless pigs lived in constant fear of meeting the same fate as their parents. Together they did their best to escape the vengeance of the BBW, but after months of being pursued, they decided to split up and go to different towns in an attempt to ditch their nemesis.
The first little pig ended up in a town where there was no available housing and was told by the townspeople he would just have to fend for himself. He couldn’t find a job so he had few resources to use in building or renting a house. He diligently searched but the only affordable building materials that he could find were pieces of straw so he used those to build his home. He knew it wasn’t the safest home but it was comfortable and kept him from the elements.
The second little pig moved on to the next village where he found a decent paying job and soon earned enough, he thought, to rent a house. But as he searched, he realized housing was more expensive than he anticipated. He was nearing despair when he met a man who had just constructed a bunch of houses for the new folks in town. He hadn’t gotten approval from the city to build but he knew he would be able to rent them easily. To make them affordable he built them out of sticks. When the second little pig saw the house of sticks, he fell in love with it, paid the rent and moved in.
The third little pig ended up in another town. This town welcomed new arrivals and recognized their need for housing. The town also had a program to create affordable housing. They also required that every house constructed be made of bricks and have a sprinkler system, smoke and CO detectors, and plumbing and electrical systems that met the highest building code standards. The townspeople knew this was a sound 100 year investment that benefited everyone.
Although the third little pig was only able to find a minimum wage job, he discovered that he qualified for a low interest loan which allowed him to actually purchase a home that was just being built. He was pleased and thankful for this opportunity.
While all of this was going on the BBW continued to stalk the three little pigs and it wasn’t long before he came to the first little pig’s straw house.
"Little pig, little pig, let me come in."
"No, no, not by the hair on my chinny chin chin I won’t let you in."
"Then I'll huff, and I'll puff, and I'll blow your house down."
And he did.
You know the rest. The first little pig ran as fast as he could to the next town seeking shelter in the house of twigs with the second little pig. The BBW then blows down the house of sticks and moves on to the house of bricks where he is ultimately foiled. Supposedly everyone but the BBW lives happily ever after. But that’s not the case.
The truth is that the story about the three little pigs made the rounds to all the towns in the area. After hearing what happened, civic leaders decided to establish sustainable safe, secure and affordable housing initiatives for all homeless and new arrivals in their communities. They also began to make plans to end homelessness and enact strict building codes to protect all the residents of their town.
However, the builder of the stick houses knew that these building codes would put him out of business so he started to lobby the decision makers to back off on the codes. The builder was joined in this effort by the BBW and his friends who also didn’t like the codes and declared that it was better for the towns if these codes were voluntary because “the market” should dictate how houses should be constructed. They also argued that the resources used to help the homeless and newcomers be divided up and given back to business owners to help them create jobs that would ultimately solve the housing problems.
These arguments were countered by the three little pigs who contended that both ending homelessness and having safe and secure housing for everyone were not only the right thing to do but in the long-term best interest of the community and everyone who lived there.
As of today, some civic leaders are still debating the issues while the wolves and the builder and the three little pigs wait to see what happens.
Edward P. Ehlinger, MD, MSPH, is Minnesota's commissioner of health and immediate-past president of the Association of State and Territorial Health Officials. Read the original post at: http://www.commissionerblog.health.state.mn.us/2016/12/housing-security-is-not-fairy-tale.html.