California’s housing crisis is worsening hunger and health

Sandy Nemec of Carmichael buys a bag of cherries with CalFresh coupons at the farmers’ market at Cesar Chavez Park in Sacramento in May.
Sandy Nemec of Carmichael buys a bag of cherries with CalFresh coupons at the farmers’ market at Cesar Chavez Park in Sacramento in May.

The holiday table gives families and friends the opportunity to reflect on what they are grateful for – a roof over their head, food on the table and good health. These basics are a foundation for sustaining a family and, like a family, tightly interconnected.

But for many families in California, access to these basics seems tenuous this year.


California is in an affordable housing crisis. Homeownership has become out of reach as wage growth lags behind skyrocketing housing prices. Rental prices didn’t drop during the recession and have been rising fast ever since. Families must spend more of their take-home pay on housing, leaving little money left over for other essentials.

For many families, rent comes before food. They skimp on food at the end of the month as the pantry runs bare. Or they rely on cheaper foods with processed grains and added sugar, instead of more expensive but healthier vegetables, fruits and whole grains. While this makes sense in the short term, these diet changes are bad for health.

It doesn’t stop there. Families stressed by housing costs have to make difficult decisions that can result in poor health. Food or prescription refills? Rent or an appointment to check blood pressure? Transportation to work or healthy food for the family?

The housing crisis, hunger and poor health are complex issues on their own without easy answers. But because they are so tightly connected, policies that support households in each area can ripple through the others. Policies and investments that lower housing costs also increase money available for food and health care. Similarly, successful resistance to federal efforts to make health care less affordable and available can reduce pressure on a family’s food and housing budget.

We need to start quantifying the power of these ripple effects so that we understand the full implications of cutting funding to important social programs, or of failing to invest in affordable housing.

For example, CalFresh, the state’s food stamp program, helps families afford healthier foods. New research shows that those enrolled in CalFresh spend an average of $1,400 less a year on health care than similar families not in CalFresh. This suggests that if we reduce CalFresh funding, much of that savings will be lost to health care costs.

The upcoming farm bill before Congress is a huge opportunity to invest in CalFresh. California’s congressional delegation needs to recognize that CalFresh is a powerful tool not only for affording healthy food, but also for freeing up money for rent and reducing health care costs. When food stamps were cut nationally in 2016, hospital admissions for low blood sugar went up among diabetics, leading to millions of dollars in extra health care costs.

So let’s commit to taking real action to address these related challenges of housing, hunger and health. If we do, more of our relatives and friends can give thanks next holiday season for a roof over their heads, for food on the table and for good health.

Hilary Seligman is a physician at San Francisco General Hospital and Trauma Center and an assistant professor at UC San Francisco’s Center for Vulnerable Populations and can be contacted at George Manalo-LeClair is executive director of California Food Policy Advocates and can be contacted at