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Housing code enforcement—the local government process of administering and enforcing housing codes designed to ensure safe and habitable housing conditions—is one of the primary strategies for connecting and improving our housing and our health.

But housing code enforcement is often structured to alleviate immediate safety concerns or easily visible problems rather than to address and improve residents’ long-term health. Additionally, code enforcement agencies often work separately from public health organizations, making it difficult to work across sectors to solve interrelated problems.

In this report, we examine how housing code enforcement in Memphis, Tennessee, could prioritize public health as a key outcome and better coordinate with public health agencies, community health nonprofits, and other health care institutions. We use both qualitative and quantitative data collection and analysis to explore how housing code enforcement works and how it might expand to address public health as a key outcome.

We explore these potential health impacts in Memphis as a model that other communities can apply and adapt.

What did we learn about city data and local code enforcement practices?  

• Most city housing code enforcement service requests are targeted at conditions outside the home, and there is little prioritization of service requests based on a violation’s severity.
• Bedbugs and mold are not directly addressed by any department and signify significant gaps in services.
• There is a low correlation between the density of code visits to houses and the number of houses with substandard conditions within a neighborhood, suggesting that code enforcement could better target neighborhoods with greater need.
• There is little relationship between the prevalence of neighborhood crime and the density of code service requests (and even a negative relationship between property crime and code), suggesting either that code enforcement is reducing crime or that it is not reaching high-crime neighborhoods.
• Code service requests are overconcentrated among single-family units and duplexes and do not target large apartments and other multifamily housing (i.e., structures with three or more units) as much as they could.

How can housing code enforcement influence health outcomes?

Based on these findings, we recommend that the Memphis City Housing Code Enforcement Department prioritize service requests to focus on violations that have a higher likelihood of causing serious health problems, expand coverage to undercovered areas and violations, make the inspection process more proactive, and increase collaboration between city code, county environmental health, and other health, housing, and financing organizations.

Memphis city and county code enforcement agencies could have a greater impact on resident health if they better incorporate public health perspectives, metrics, and strategies into their plans and actions and if they better coordinate with health care organizations and stakeholders. Many opportunities exist to better target and coordinate the city’s housing code enforcement function and county public health enforcement responsibilities in Memphis and beyond.