HHS: Housing's Close Link to Health Status

Regulation | October 30, 2020 | by Linda Couch

A new report from HHS’s Health Resources and Services Administration (HRSA), the HRSA 2019-2020 Report on Health Equity: Special Feature on Housing and Health Inequalities, takes a deep dive into the connections between housing and health.

A new report from HHS’s Health Resources and Services Administration (HRSA), the HRSA 2019-2020 Report on Health Equity: Special Feature on Housing and Health Inequalities, takes a deep dive into the connections between housing and health.

The new HRSA report focuses on housing and health inequalities and shows how critical housing status and housing conditions are to health.

The report notes that much research has been done on housing tenure (i.e., homeowners vs. renters) and health, little has been done on the type of rental housing. The report’s data describe health differences for housing-assisted renters, non-housing-assisted renters, and owners.

“Homeowners and renters vary substantially in terms of demographic, socioeconomic, psychological, and neighborhood characteristics. Homeowners are more likely to be male, married, have higher incomes, life satisfaction and self-esteem. However, renters, particularly those receiving rental assistance or living in subsidized housing, are more likely to be female, ethnic minorities, and report marital disruption, living alone, higher unemployment, lower education and incomes, and problems with their neighborhood,” the report says.

On overall health status, housing-assisted renters are worse off than homeowners and non-housing-assisted renters, but the report digs deeper to compare the health status of renters with housing assistance and renters without. “Compared with homeowners and non-rental assistance renters, public housing residents and rental assistance renters have higher rates of obesity, smoking, secondhand smoke exposure at home, asthma, poorer health status, depressive symptoms, and hypertension,” the report says.

Among the report’s other findings:

  • Higher housing cost concerns were strongly related to worsening health status; those who were very worried about housing costs were three times more likely to experience worsening health than those who were not worried at all. According to the report, adults with high housing cost concerns are three times more likely to experience worsening health than those without such concerns.
  • Compared with homeowners, those receiving rental assistance or living in subsidized housing had 2.0-3.4 times higher risks of diabetes, COPD, kidney disease, smoking, and activity limitation.
  • “Housing instability, defined in terms of being unable to pay rent, overcrowding, housing cost burden, and frequent residential moves, is strongly linked to poor physical and mental health and reduced access to health care,” the report says. As an example, the report sites data from the Ryan White HIV/AIDS Program showing that patients with temporary or unstable housing have the lowest percentages of viral suppression.”
  • On the prevalence of serious psychological distress (SPD) among U.S. adults, the report found that renters were two times more likely to report experiencing SPD than homeowners. Renters receiving rental assistance or living in subsidized housing were 3.9 more likely to experience SPD than homeowners (9.80% vs. 2.54%). And, adults aged 65 and older who were very concerned about housing costs were 12.0 times more likely to report experiencing SPD than those who were not worried at all (15.76% vs. 1.31%), according to the report.

The report is an important addition to volumes of research clearly connecting housing to health.