Just Housing

A new conception of housing justice grounded in moral principles that appeal to the home's special connection to American life. In response to the twin crises of homelessness and housing insecurity, an emerging “housing justice” coalition argues that America's apparent inability to provide decent housing for all is a moral failing. Yet if housing is a right, as housing justice advocates contend, what is the content of that right? In a wide-ranging examination of these issues, Casey Dawkins chronicles the concept of housing justice, investigates the moral foundations of the US housing reform tradition, and proposes a new conception of housing justice that is grounded in moral principles that appeal to the home's special connection to American life. Dawkins examines the conceptual foundations of justice and explores the social meaning of the American home. He chronicles the evolution of American housing reform, showing how housing policy was pieced together from layers of housing and land-use policies enacted over time, and investigates the endurance—from the founding of the republic through the postwar era—of the owned single-family home as the embodiment of national values. Finally, Dawkins considers housing justice, drawing on elements of liberalism, republicanism, progressivism, and pragmatism to defend a right-based conception of housing justice grounded in the ideal of civil equality. Arguing that any defense of private property must appeal to the interests of those whose tenure is made insecure by the institution of private property, he proposes a “secure tenure” property regime and a “negative housing tax” that would fund a guaranteed housing allowance

Urban containment and neighborhood quality in Florida

Book ChapterRapid suburbanization since World War II in America has created many of the challenges we face today. Roads intended to relieve congestion have become congested. Cookie-cutter subdivisions have replaced scenic landscapes. Once-vital downtown stores have been abandoned as shoppers transferred their allegiance to convenient suburban malls. The spread of low-density residential development made public transit impractical, making the automobile virtually the only choice for transportation. Automobile dependence has degraded the air in some places to alarming levels. Once-tranquil communities with their own unique character have been overwhelmed by more people, automobiles, and shopping centers. But the problem is not growth per se; the problem is how to manage growth in ways that minimize costs and maximize benefits to both individuals and the public at large. Urban containment is an attempt to confront the reasonable development needs of the community, region, or state, and accommodate them in a manner that preserves public goods, minimizes fiscal burdens, minimizes adverse interactions between land uses while maximizing positive ones, improves the equitable distribution of the benefits of growth, and enhances quality of life. At its heart, urban containment aims to achieve these goals by choreographing public infrastructure investment, land use and development regulation, and deployment of incentives and disincentives to influence the rate, timing, intensity, mix, and location of growth. Broadly speaking, urban containment programs can be distinguished from traditional approaches to land use regulation by policies that are explicitly designed to limit the development of land outside a defined urban area, while encouraging infill development and redevelopment inside it

Transit-Induced Gentrification: Who Will Stay, and Who Will Go?

Transit-Oriented Development (TOD) has been promoted by planners and policy advocates as a solution to a variety of urban problems, including automobile traffic congestion, air pollution, and urban poverty. This paper addresses the question: How do TOD-based affordable housing policies influence the intra-urban location of low income households over time? This paper examined historical descriptive evidence along with land use forecasts generated by the Simple Integrated Land-Use Orchestrator (SILO) land use model to examine the impact of housing policies on patterns of sorting by income within the Washington, D.C. metropolitan area. The historical evidence suggests that in most decades when Metro stations were opened, census tracts near transit stations saw higher increases in median household income than other census tracts. We also find evidence that income growth around stations constructed in the 1970s and 1980s persisted over time, while income growth around stations constructed during the 1990s was largest in the following decade. Consistent with other studies (Kahn 2007), we interpret these findings as evidence that some degree of transit-induced gentrification has been occurring in the Washington, D.C. region

Barriers to Development Inside Maryland's Priority Funding Areas: Perspectives of Planners, Developers, and Advocates

Passed in 1997, Maryland’s Smart Growth and Neighborhood Conservation Initiative took a novel approach to growth management, utilizing the power of the purse to encourage sustainable development. The initiative seeks to discourage suburban sprawl through a targeted spending approach, while also allowing local governments to retain their land use decision-making authority. It required local governments to designate Priority Funding Areas (PFAs) where state infrastructure funding would be focused. Through this tool, the State aimed to promote development and revitalization within Maryland’s urbanized areas, while limiting the urbanization of Maryland’s rural areas and green spaces. Data from the Maryland Department of Planning, however, suggests that PFAs are having limited impacts. The percent of single-family acres developed outside of PFAs has risen steadily over time. Development densities have declined in PFAs, with the average parcel size inside PFAs increasing from 0.25 acres in 1990 to 0.28 acres in 2004. Despite their disappointing performance, PFAs are anticipated to play key roles in future policies regarding development on septic systems and in PlanMaryland, the state development plan. Given their growing prominence but questionable efficacy, PFAs warrant further examination. That is the purpose of this study, conducted by the Housing Strategies Group of the National Center for Smart Growth Research and Education at the University of Maryland, and funded by the Maryland State Builders Association and NAIOP Maryland chapters. The study relies upon responses to a telephone survey of forty-seven representatives from three key stakeholder groups—planners, policy advocates and consultants, and developers. HSG made every effort to obtain the perspectives of a variety of sources but it is important to note that the survey respondents could not be said to be randomly selected and the sample size is too small for rigorous statistical analysis. While not presenting new empirical analysis of the influence of PFAs on development patterns across the State, the study does produce new information on how critical stakeholders view the efficacy of PFAs and the barriers to development inside PFAs. Survey respondents identified a number of ways to improve development conditions in PFAs, ranging from limiting the length of APFO restrictions to reducing impact fees and lowering level of service requirements for certain types of infrastructure inside PFAs. Other recommendations included expediting the state agency review processes and lessening stormwater management and other environmental protection requirements for projects inside PFAs

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

The Enigma of Housing Choice

The U.S. faces a housing choice crisis. The growing shortage of affordable rental homes and looming mismatch between the homes offered for sale by baby boomers and the homes sought by the next generation of homeowners point to a need to fundamentally reshape the extent and diversity of the nation’s housing options. Housing and land-use policy experts have appealed to the aim of expanding housing choice to justify the removal of regulatory restrictions on certain housing types, the construction of affordable rental housing in transit-adjacent neighborhoods, the elimination of housing market discrimination on the basis of race and ethnicity, and the expansion of tenant-based rental vouchers in low-poverty neighborhoods. Housing choice expansion is a battle being waged on multiple fronts in defense of a variety of causes, but conceptual confusion threatens to erode the foundation of this fragile alliance. This paper brings clarity to the cause by exploring the concept of housing choice, evaluating the normative arguments in favor of expanding housing choice, and proposing a refined conception of the goal to expand housing choice. I defend a conception of housing choice expansion that prioritizes effective housing choice and tenure and type neutrality. This conception provides a justification for several policy reforms, including an expanded demand-side housing subsidy funded by eliminating homeownership tax incentives, enhancements to renters’ rights of occupancy, expansion of flexible tenure arrangements, and reform of local land-use practices

The Enigma of Housing Choice

The U.S. faces a housing choice crisis. The growing shortage of affordable rental homes and looming mismatch between the homes offered for sale by baby boomers and the homes sought by the next generation of homeowners point to a need to fundamentally reshape the extent and diversity of the nation’s housing options. Housing and land-use policy experts have appealed to the aim of expanding housing choice to justify the removal of regulatory restrictions on certain housing types, the construction of affordable rental housing in transit-adjacent neighborhoods, the elimination of housing market discrimination on the basis of race and ethnicity, and the expansion of tenant-based rental vouchers in low-poverty neighborhoods. Housing choice expansion is a battle being waged on multiple fronts in defense of a variety of causes, but conceptual confusion threatens to erode the foundation of this fragile alliance. This paper brings clarity to the cause by exploring the concept of housing choice, evaluating the normative arguments in favor of expanding housing choice, and proposing a refined conception of the goal to expand housing choice. I defend a conception of housing choice expansion that prioritizes effective housing choice and tenure and type neutrality. This conception provides a justification for several policy reforms, including an expanded demand-side housing subsidy funded by eliminating homeownership tax incentives, enhancements to renters’ rights of occupancy, expansion of flexible tenure arrangements, and reform of local land-use practices