Racism, Power, And Health Equity: The Case Of Tenant Organizing

Introduction

Despite the significant role that power asymmetries play in driving health inequities, there is a dearth of research on the intersection of power, racism, and health equity. In this article, Michener argues that housing is a driver of racial health inequity and that tenants play a significant and overlooked role in combating health-threatening housing conditions. The author highlights two primary channels through which tenants nationwide have organized to improve housing and health equity: 1) direct action that places pressure on key stakeholders who have the power to improve housing conditions, and 2) local policy change to address housing conditions. In examining these channels, the author discusses the importance of understanding the role of power in health equity research and argues that centering tenants and their power as solutions to health equity challenges is necessary for institutional change.

Jamila Michener is an Assistant Professor of Government at Cornell University. Her work focuses on unpacking the political causes and impacts of racial inequities, and her most recent book, Fragmented Democracy: Medicaid, Federalism and Unequal Politics, explores how having Medicaid affects political participation.

Methods and Findings

The author conducted 79 semi-structured interviews with tenants nationwide over four years. Interviewees were asked to share their housing experiences, and the majority discussed the negative consequences of inequitable housing policies on their health. The interviews with tenant organization members, which comprised the majority of those interviewed, shed light on how these organizations have built and wielded power to fight against the political, economic, and racial systems that produce health-threatening housing conditions.

On the intersection of race, housing, and health equity

Michener discusses how health-threatening housing conditions disproportionately affect racially marginalized communities and argues that collective power is needed to address these conditions. Firstly, the author establishes the link between race and housing inequality. Michener references decades of research to highlight how substandard housing conditions can result in respiratory illnesses and other severe health risks. The author argues that these conditions disproportionately affect racially marginalized communities due to the role of structural racism, which manifests as policies and practices that normalize decayed housing and limit the supply of affordable housing for racially marginalized communities. Key mechanisms of structural racism in this case include discriminatory financial lending practices and underfunded public housing programs.

Michener posits that racially marginalized communities require collective power to confront these systemic barriers. Collective power can enable tenants “to identify the systemic failures underlying their individual problems and to strategically channel their collective energies through concerted social and political action.” The interviewed tenants wielded their collective power through two main mechanisms: 1) organizing to pressure key stakeholders such as landlords, property management companies, and government officials, and 2) driving local policy change to improve housing conditions.

Organizing to pressure critical stakeholders

In interviews, tenants shared examples of how they pressured landlords, government officials, and other stakeholders through protests, rallies, and rent strikes. For instance, in Texas, rent strikes were used to pressure the management company of an apartment complex without running water.

Lessons learned when organizers apply pressure:

• Many tenants viewed the ability to pressure institutions through collective power as particularly important in the context of racism.  Tenants convey how they see their own struggles with housing conditions connected to historically racist laws and policies. 
• Effectively applying pressure requires understanding the political context. In the example of the water shortage in an apartment complex in Texas, an interviewee highlights how the tenant organization deprioritized putting pressure on elected officials, given that management companies had more immediate ability to address the water shortage.
• Events like protests and rallies can create opportunities to negotiate with elected officials for more direct policy change.  For example, one tenant organization in the Deep South successfully changed eviction policies through sustained protests and negotiations with elected officials at City Hall.

Organizing to drive local policy change

Michener focuses on the example of two tenant organizers, Joe and Jocelyn, from a Southern city to highlight the potential for organizing to drive local policy change. 80-90% of the members of this tenant union were Black, and the primary objective of this organizing effort was to remove an extractive property management company that contractually oversaw the city’s public housing properties.

Lessons learned when organizers drive policy change:

• The tenant organizers were particularly successful in this example because they sought to understand the role of race in the city’s power structures. The organizers identified that the elected official was unlikely to take action to break the contract with the management company because these city officials were largely insulated from the harm that was disproportionately affecting Black women in the city. Recognizing this power structure enabled the tenant organization to develop an effective negotiation strategy that brought together tenants, union members, the city council, and the management company and focused on public testimonies.
• The tenant organizers engaged in strategic institutional negotiations centered around tenant testimonies and highlighted the imbalanced power dynamic between the management company and tenants. After organizing hundreds of the city’s tenants, the union met with the city council through a committee hearing. Tenants shared their experiences with housing related health risks, and the management company’s egregious public dismissal of their responses led to the cancellation of their contract.

Conclusions

The author argues that organizing and driving local policy change can potentially improve the health equity of racially marginalized populations. Through examples from tenant organizers, Michener highlights how collective action requires understanding the racial and political contexts of the most affected. Furthermore, driving local policy change requires understanding the city’s power structure and corresponding power dynamics. 

The author suggests that further research should focus on better understanding the ways in which power operates at the intersection of race, health, and housing equity. This study argues that health equity researchers should move towards a theory of change that highlights the political agency of racially marginalized communities. These organizing efforts underscore the potential for tenant and other forms of organizing to drive sustained institutional change in health.