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<br /> ORANGE COUNTY
<br /> HEALTH DEPARTMENT
<br /> Improving health. inspiring change.
<br /> ORANGE COUNTY BOARD OF HEALTH
<br /> RESOLUTION PROMOTING THE DEVELOPMENT OF ADEQUATE AFFORDABLE HOUSING
<br /> WHEREAS, housing is a human right, not a commodity', because humane and adequate housing' is necessary for all
<br /> humans to live their best lives and to rise to their full potential2; and
<br /> WHEREAS, Orange County is experiencing a housing crisis:
<br /> • County residents identified a lack of affordable, humane housing as a top concern, both in the 2023 Community
<br /> Health Assessment3 and the countywide assessment for the Orange County Strategic Plano;
<br /> • The county has 13,689 fewer units5 than we need, and this deficit disproportionately affects individuals earning
<br /> less than 50% of the area median income, with a deficit of 9,555 units6;
<br /> • National data show that 16% of Orange County residents spend at least half of their income on housing, a
<br /> proportion that is considered severely housing cost-burdened. This greatly exceeds the proportion in neighboring
<br /> and peer countiesa which ranges from 9% to 13%7. The annual income to afford a two-bedroom in Orange
<br /> County is $74,880, exceeding earnings for teachers ($51,740), childcare providers ($33,000), and firefighters
<br /> ($36,230), so our civil servants cannot live where they work8; and
<br /> WHEREAS, unstable housing significantly harms individual health:
<br /> • Living unhoused disrupts access to sanitation and supplies9, increases social isolation and stigma9, impedes
<br /> access to healthcare9,10,11, and increases exposure to hazards such as heat, cold, and physical and sexual
<br /> violence9,10,11. These effects accelerate aging, with premature onset of chronic medical conditions, functional and
<br /> cognitive impairments, and increase mortality12,13Individuals who are unhoused have 7 times the mortality rate
<br /> from all causes and 14 times the overdose mortality rate compared with their housed counterparts14;
<br /> • Children who move frequently are more likely than stably housed children to experience chronic health conditions,
<br /> poor physical health, and to have less consistent health insurance coverage15, and efforts to improve housing are
<br /> one of the most promising interventions to prevent adverse childhood experiences16; and
<br /> WHEREAS, lack of housing causes significant adverse impacts to public health for communities:
<br /> • Communities lacking adequate housing experience disproportionate levels of incarceration 17,18,19,20,21 increased
<br /> levels of drug use'4,22,23,24and overuse of hospitals and emergency medical services, straining medical providers
<br /> and increasing wait times'0,25,26,27,28,29,30,31,32•
<br /> • Investments in permanent supportive housing decrease emergency room visits by 70%33 and annual healthcare
<br /> utilization costs by an average of$48,510 per person34;
<br /> • Failure to house community members costs more than providing adequate housing due to the expense of
<br /> supplementing emergency healthcare and incarceration costs20,35,36,37. "housing first" strategies save $900 to
<br /> $29,400 per person housed per year38, returning $1.80 for every $1.00 invested34; and
<br /> WHEREAS, zoning and land use policies profoundly shape our built environment:
<br /> • Deficits in affordable housing reflect longstanding zoning policies39,40 that have had an exclusionary effect,
<br /> including limits on small-scale multifamily housing41, commonly known as "Missing Middle" housing42;
<br /> • Best practices such as APA's Equity in Zoning Policy Guide43 can help correct these harms;
<br /> • Orange County and the Towns of Carrboro, Chapel Hill, and Hillsborough are engaged in the process of
<br /> developing new land use plans and/or zoning ordinances.
<br /> NOW, THEREFORE, BE IT RESOLVED on this 29th of October, 2025, that we the Orange County Board of Health
<br /> recognize the lack of affordable housing in Orange County as a threat to public health. To address this, the Board of
<br /> Health recommends that the Orange County Board of County Commissioners and the governing bodies of Carrboro,
<br /> Chapel Hill, and Hillsborough incorporate the following in their land use plans and zoning ordinances:
<br /> a Peer counties are other NC counties with similar population size,age distribution,racial composition,income,and education levels as compared to Orange County.
<br /> 919 245 2405 > 300 West Tryon Street > Hillsborough, NC 27278 > orangecountync.gov
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