High Housing Costs Have Long-Lasting Impacts on Mental Health of Renters

A study published in Housing Studies, “Housing cost, consistency, and context and their relationship to health,” examines the relationship between renters’ health and three of the four “C’s” of housing insecurity: cost, consistency, and context. The authors find that the inability of renters to pay for housing costs has a direct and significant impact on both their current and future mental health. The authors also find that both prior affordability challenges and the lack of residential stability increase the likelihood of future affordability challenges, indirectly impacting health outcomes.

The authors analyzed data from 11,303 respondents who participated in each of three waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) survey. Basic demographic information on respondents was gathered from wave I of the survey (1994 to 1995), while information on respondents’ housing insecurity and health was collected from wave III (2001 to 2002) and wave IV (2008) of the survey. Both waves III and IV of the survey provided data on “cost,” or respondents’ ability to pay for housing costs, including rent/mortgage and utilities, in the past 12 months. Data about respondents’ “consistency,” or residential instability, was drawn from wave III of the survey and included the number of times a respondent moved in the prior six years, experiences with homelessness, and their use of homeless shelters. “Context” data on the conditions of neighborhoods in which respondents lived was derived from wave IV and included neighborhood demographics, vacancy rates, and the percentage of housing units that had incomplete plumbing or kitchens. Health outcomes were measured only in wave IV of the survey through self-reported scoring of general health and responses to questions designed to measure depressive symptoms.

By comparing each individual’s responses from wave III of the survey with those from wave IV, the authors demonstrate that prior instances of housing insecurity are associated with future instances of housing insecurity. For example, respondents who reported difficulties paying housing costs and a lack of residential stability in wave III were significantly more likely to report difficulties paying housing costs in wave IV. Further, respondents who reported difficulties paying housing costs in wave III were significantly more likely to live in lower quality neighborhoods in wave IV.

The relationships between different forms of housing insecurity and health outcomes were also examined. The authors found that inability to pay rent and utilities negatively impacted short-term (within 12 months) and medium-term (within 7 to 8 years) mental health outcomes. In wave IV, respondents who reported struggling to afford rent and utilities in the prior year were significantly more likely to concurrently report signs of depression or poor mental health. The authors likewise found that respondents who reported struggling with housing costs in wave III were significantly more likely to report signs of depression or poor mental health in wave IV, signaling that housing cost insecurity can have lasting mental health consequences. The authors note that the relationship between cost and poor mental health is likely due to stress.

When considering the impact of different forms of housing insecurity on general health, the authors found that only short-term housing cost insecurity had a significant and direct relationship with general health. Respondents who had difficulty paying rent and utilities in wave IV were significantly more likely to concurrently report being in poor health. Although the authors found no direct association between other types of housing insecurity and general health, they explain that a lack of residential stability is indirectly associated with general health by increasing the likelihood of future cost insecurity.

The authors suggest that their findings may underestimate the association between housing insecurity and poor health outcomes because questions about a respondent’s recent inability to pay rent and mental health questions are time-bound in the survey to the past 12 months or the past 7 days, respectively. The authors recognize the importance of policies that reduce rent and utility insecurity, prevent evictions, and prevent or end homelessness in improving health outcomes but note that these programs often have long wait times and fall short of serving all the people who need them. They explain, for example, that most low-income people who are homeless or struggling to pay housing costs qualify for but do not receive federal rental assistance. They suggest the need to provide housing assistance as an entitlement, meaning that no qualifying individual can be denied assistance. Additionally, they propose that cash assistance can enable families to quickly use money to meet their specific needs, rather than requiring families to find and apply for a program that meets those needs.

Read the article at: https://bit.ly/3MswWPE