Low-income families seeking housing must figure out how to make the most of a limited budget, while also trying to ensure their health and safety. This task is especially challenging given the inadequate housing choices and poor neighborhood conditions poor families face, so much so that the constrained decision-making itself may create or exacerbate health risks. This article illustrates how low-income families navigate and balance housing decisions, and the health implications of their choices. The qualitative study described here uses indepth interviews and ethnographic observations to explore the links between housing, neighborhood, and health for 72 low-income families in the inner-city neighborhood of Dorchester, Massachusetts. The low-income inner-city residents included in this study devised a variety of strategies in response to neighborhood safety risks, many of which led to them spending more time at home. This reliance on the home environment exposed residents to other health and safety risks within their homes. Based on results from the in-depth interviews as well as ethnographic observations, I propose two alternate approaches that may more effectively address the conditions poor families face in their homes and neighborhoods.