One of the tragedies of last week’s fire in a Fairmount rowhouse is how many people were in its deadly path.

Twenty people were registered as living in the duplex at 869 N. 23rd St. where a fire killed 12. In the four-bedroom upper unit, a woman lived with her three adult daughters and 10 grandchildren ranging in age from 2 to 16. It was unclear how many people were inside at the time of the early morning fire. Fire officials initially said 26.

Karyn Laury, the grandmother of the eldest son of one of the daughters, Rosalee McDonald, said she knows some people may judge the family’s situation.

» READ MORE: Fatal Fairmount fire was a once-in-a-generation tragedy. Here’s how it unfolded.

“I understand how people can look at a document and think she wasn’t a good mother because there were so many people living there. But she was a great mother,” Laury said, choking through tears. “She had six children, and she was taking care of each and every one of them, and she would take care of other people’s children as well.”

The sisters supported each other, she said.

Across Philadelphia and the nation, families and friends are packed into homes beyond capacity and comfort for one simple reason: It’s their only option.

“Who makes a choice to be in that type of situation?” asked Judith Jones, vice president of the Philadelphia Tenant Support Organization. “They did what they had to do, you know? What’s the alternative? Being in the street.”

The Philadelphia Housing Authority is obligated to find larger units for families that outgrow their homes or to find separate units, according to PHA policies. PHA had placed the family on a wait list to get different housing, an agency spokesperson said Monday, but when a family outgrows their home, the lack of affordable housing means “it may take years to find a more appropriately sized unit.”

“In an ideal world, PHA would have housing for every low-income family that needs it,” the spokesperson said, “but that is not the reality.”

» READ MORE: Low incomes make Philadelphia homes less affordable, Pew study finds

Philadelphia’s housing is relatively affordable compared to other big cities, but the city’s high poverty rate and residents’ low incomes mean many options are out of reach. The number of available public subsidies can’t meet the immense need. Nationwide, for every five households eligible for a federal housing voucher that pays a portion of rent, one receives and uses it, according to the Housing Initiative at Penn. In the Philadelphia metropolitan area, about 41,000 vouchers were available in 2020 for more than 206,000 eligible households. Wait lists for public housing are years long.

Add the rising costs of food and other goods and COVID-19 threatening lives and livelihoods, and people are struggling. Many are forced to make impossible choices between paying for housing and other necessities such as health care and child care.

Many situations arise that require families to double up. Some households need to pool several adults’ incomes to afford their home or to move to a safer neighborhood with better schools and amenities. Tenants leave unsafe housing and need somewhere they can move into quickly and cheaply. Domestic violence survivors and their children seek shelter with family or friends. Adults move in with parents to make the most of houses that are already paid off or to take care of sick or elderly parents. Grandparents bring grandchildren into their homes.

» READ MORE: Affordable housing must be included in new developments in some Philly neighborhoods, Council says

Housing advocates point to a lack of adequate housing that people can afford, underfunded public housing, and insufficient support for cost-burdened tenants. About 40% of Philadelphia households are cost burdened — meaning they spend 30% or more of their incomes on housing — according to the Pew Charitable Trusts. More than two-thirds of these households earn annual incomes below $30,000. The city has nearly twice the number of households earning less than $30,000 than it has rental units they can afford.

“Even if families are looking for another place to live, it’s hard to find because the rents are astronomical,” Jones said. The median rent for a two-bedroom apartment in Philadelphia is $1,277, according to Apartment List.

“If they’re low income,” Jones said, “they’re not gonna be able to pay $1,000 a month or more.” And they would need triple that amount up front for first and last months’ rent and a security deposit.

» READ MORE: Rents are expected to grow faster than home prices in 2022

Philadelphia is among the cities where a monthly payment for a house is often lower than rent, but many people with low incomes cannot raise the initial down payment or qualify for a mortgage.

Margaret Wayne, grandmother of Virginia Thomas’ children, said that in a conversation the night before the fire, Thomas said she wanted to move out with her children. Thomas had recently asked a Facebook friend she hadn’t spoken to in three years whether he knew of a place she could stay.

The family did not ask PHA to be moved, according to Kelvin Jeremiah, PHA’s president and chief executive officer. But even if it had, it would have been no closer to receiving new housing, since the city doesn’t have enough for everyone who needs it.

In 2011, the authority moved the family — which then totaled six — to Fairmount into a bigger unit to accommodate its size. The family added children through the years until the number of people on the lease grew to 14.

» READ MORE: ‘A beautiful soul,’ a basketball star: Mourners remember teenagers and their family members killed in Fairmount fire

At a news conference last week, Jeremiah said the cramped conditions of the apartment highlight “the housing crisis that confronts Philadelphia, and frankly, that confronts the United States.”

In addition to the immediate danger of having too many people living in a home, tenants forced into these situations may also be reluctant to flag potential safety concerns if they have people living with them who aren’t on their lease, said Rasheedah Phillips, director of housing at PolicyLink and a former housing attorney at Community Legal Services of Philadelphia.

The Fairmount family’s living circumstances “are really indicative of the really dire conditions families are living in terms of not being able to afford housing,” she said.

» READ MORE: Philadelphia’s affordable housing strategy depends on repairing existing homes

Policymakers need to move beyond short-term outrage about individual incidents “to really learn from these lessons and really make the bold and necessary changes to make sure people are safe in their homes” and address underlying issues that put families in dangerous living conditions, she said.

“The city needs to continue to look for ways to prioritize the ability of everyone to have access to safe and habitable housing,” Phillips said.

It comes down to giving Philadelphians better access to economic opportunities and quality housing, so their choices aren’t taken from them, said Andrew Frishkoff, executive director at LISC Philadelphia, a community development support nonprofit.

“People are doing exactly what they have to,” he said.

» READ MORE: It’s no easier for Black Philadelphians to become homeowners now than it was 30 years ago

Frishkoff said people with low incomes need rental subsidies so they can rent appropriately sized homes on their own, especially if they have children.

Homes with too few bedrooms may be all families can afford. A lot of the new housing units developers are building throughout the city have one or two bedrooms — too small to comfortably fit larger families, Frishkoff said. And properties originally sized for single families are being divided to fit more people to try to maximize rental income.

“We’re not producing enough housing that is more than two bedrooms,” he said.

It all comes back to the gap between resources and need, especially for the city’s most vulnerable residents, said Vincent Reina, associate professor and faculty director of the Housing Initiative at Penn.

Philadelphia’s high poverty rate, large inventory of old homes in need of rehabilitation, and limited local resources and federal support, he said, “creates a scenario where households are left to do all they can to create stability and ensure they can be housed during these challenging times.”

“We need to be making better policy decisions,” Reina said, “because the consequences are dire and tragic.”

Staff writer Ellie Rushing contributed to this article.

The Philadelphia Inquirer is one of more than 20 news organizations producing Broke in Philly, a collaborative reporting project on solutions to poverty and the city’s push toward economic justice. See all of our reporting at brokeinphilly.org.