The 4Cs of Housing: Resident Perspectives on Cost, Conditions, Consistency, and Context in a Public Housing Neighborhood.

The residential environment, encompassing housing and neighborhood of residence, is a critical context shaping health and well-being. The 4Cs model delineates four pathways through which residential environments affect health including cost, conditions, consistency, and context, all of which are often compromised for low-income individuals. Affordable housing programs, like public housing, should mitigate negative exposures across the 4Cs but disinvestment has left many public housing developments with maintenance deficiencies and disadvantaged contexts. Through analysis of qualitative interviews with 61 residents of a large urban public housing development, we elucidate residents' perspectives of the ways the 4Cs shape experiences and well-being in contemporary public housing. Findings suggest that the 4Cs are interrelated and mutually reinforcing. Participants endured poor conditions and viewed them as a necessary trade-off to maintain consistency, because moves are cost prohibitive and may require moving outside of their neighborhood, losing the amenities and kinship they valued in the context. Impending redevelopment increased fears of disrupted consistency, overshadowing hoped-for improvements in context and conditions. These findings hold important policy implications, as such trade-offs may undermine the goals of the public housing program to provide decent, stable, affordable housing.