Poor health could be linked to unaffordable housing

People who cannot afford their housing are more likely to suffer from poor health, according to a new study, which also found that renters consider themselves less healthy than homeowners.

“People are dealing with a lot of competing costs in life and often have limited financial means in order to cover those costs,” said Craig Pollack, M.D., lead study author and an assistant professor at Johns Hopkins University School of Medicine. “What we worry about is when housing costs are high, some of the health care may suffer.”

The study, which appears online and in the November issue of the American Journal of Preventive Medicine, analyzed data from the 2008 Southeastern Pennsylvania Household Survey of just more than 10,000 participants. Nearly half reported struggling to meet the cost of their home and, of that group, more than a quarter reported poor or fair self-rated health.

Those who struggled to afford their home had a significantly higher incidence of hypertension and arthritis. However there was no significant association between housing affordability and heart disease, diabetes, asthma, psychiatric conditions or being a smoker.

Most notable in their findings was the distinct difference in health among subjects who rented versus owned their property.

“If you were a renter, you were more likely to report poor self-rated health,” Pollack said.

He attributes this to the fact that renters tend to have a lower socioeconomic status and thus have limited means to pay for health needs. Even so, the current mortgage crisis has made the stress of keeping up with housing costs a global issue.

Government programs to make housing more affordable, such as housing vouchers, might have a positive influence on personal health, the study authors write, and could “help lessen the potential trade-offs that individuals and families make between housing and health.”

In analyzing the data, the researchers accounted for income differences as well as neighborhood quality differences, because many people opt to spend more money on housing in order to live in a better area. The goal of this analysis was to determine what would happen if the people were able to meet their housing costs comfortably.

Still, one public health expert believes that this study — which analyzed the data using a method known as causal inference — provides more questions than answers.

“It’s almost impossible — even if you use the best statistical pools — to tease apart health and housing without longitudinal data,” said E. Michael Foster, a professor at Gillings School of Global Public Health at the University of North Carolina, Chapel Hill who applies causal inference to much of his own research. “Good causal inference always has to make an assumption and you want that assumption to be plausible.”