President Donald Trump’s recently released “skinny” budget, while a long way from being enacted, is a step in the direction of fulfilling his campaign promises. In addition to providing for increases in defense spending  and immigration enforcement as well as increases in funding for violent crime prevention and addressing opioid abuse, the budget takes a $6.2 billion (13.2 percent) bite out of the budget for Housing and Urban Development (HUD).

The proposed budget only addresses discretionary spending. The full budget is expected to be released later this spring and will, of course, be debated and amended by Congress.

The National Housing Conference (NHC), an affordable housing advocacy group, said in a statement that the cuts would devastate the housing and community development efforts that are currently building and rebuilding neighborhoods for millions of Americans.

“President Trump’s budget for HUD would severely limit the ability of state and local governments to meet their communities’ housing and infrastructure needs,” Chris Estes, president and CEO of NHC, said in a statement. “The president’s proposed budget sacrifices the security of older adults and people with disabilities, and will actually make it harder for President Trump to bring opportunity to urban and rural America as promised.”

Housing Correlates To Health, Economics

The proposed HUD cuts are “penny-wise and pound-foolish,” said Dr. Megan Sandel, a pediatrician and assistant professor of pediatrics at Boston University School of Medicine. Sandel is also a trustee at Enterprise Community Partners, an affordable housing nonprofit organization. She has been working with HUD through various initiatives for 15 years.

“I’ve never seen a cut that large,” she said. “It’s really important to point out the health implication of such a budget. I think both this budget and a lot of the talk around the Affordable Care Act (ACA) are creating a lot of uncertainty in the market. That’s bad for my patients. If hospitals aren’t sure what will happen under the ACA, they’re not thinking about creative housing and health partnerships, that’s bad.”

Housing is a “strong forward indicator” of health, she said; stable housing, especially kids, results in better jobs and more contributions to the economy in the future. Using a medical analogy, she said the lack of stable housing is like a disease for families – and HUD funding is one of the medicines used to treat it.

“These cuts are just about cutting back the dose, instead of adjusting the dose up or down to be effective,” Sandel said. “People don’t realize how effective an investment affordable housing is. These people can become economically engaged for their lifetime.”

There’s no doubt, she said, that this budget will increase the number of homeless Americans. Continuing the medical analogy, she said HUD funding is often leveraged with other programs to maximize effectiveness of getting people and families into long-term, stable housing.

“With this budget, there’s the zeroing out of a lot of the flexible dollars that makes things work,” she said. “They’re really the connective tissue that makes the whole system function effectively.”

The budget also proposes to save $3 billion by eliminating all funding of the 43-year-old Community Development Block Grant, relegating “community and economic development activities to the state and local level” and redirecting federal funds elsewhere.

A statement accompanying Trump’s budget said it “recognizes a greater role for state and local governments and the private sector to address community and economic development needs” but did not specify which governments, agencies or private sector agencies would address those needs.

Massachusetts cities and towns have since 2007 distributed $237 million in CDBG funding to 44 percent of the 314 eligible cities and towns in the commonwealth. In addition to building things like senior centers and playgrounds, the money was used to rehabilitate more than 3,000 units of housing and repair or replace more than 55 miles of public infrastructure.

Officials from Boston Mayor Marty Walsh’s administration stressed that if enacted the cuts would impact Boston’s fiscal 2019 budget, so it’s still too early to talk about the full impact in a granular way. They said the cuts send the wrong message: that it’s not a federal priority to invest in small businesses and residents of neighborhoods.

“The president’s budget proposal puts cities across America and our residents last,” Walsh said in a statement. “The drastic cuts proposed would destabilize our efforts to increase economic mobility and housing stability in every Boston neighborhood. Our community will be hit hard by the proposed elimination of help for households in immediate danger of being without heat and Community Development Block grants that support the production of affordable housing and the revitalization of our Main Streets. This proposal denies the real risks we face relative to climate change and puts vital health and life sciences research in jeopardy. I call on Congress to reject this proposal and any others that put our cities, and most importantly, our residents, at risk.”

Using CDBG funding, the Walsh administration recently helped a West African immigrant open a restaurant on Dudley Street in Roxbury, a neighborhood the official said badly needs new businesses. The administration also used CDBG funding to replace the old, inefficient heating system in a 90-year-old Hyde Park man’s home.

“The administration is committed to its underserved neighborhoods and residents,” the official said. “We’ve seen the trend of decreasing federal funding. There are a lot of really smart people working for the city making sure our citizens are well-served. It’s easy to feel like this is a bureaucratic issue. But these are irreplaceable opportunities for individuals. It’s essential, not just about an inefficiency. It’s about how our city can live and thrive.”