Housing, Health, and Health Disparities

Abstract

Abstract This chapter examines the connections between housing, health, and health disparities. Housing can influence health in many ways, including exposure to crowding, toxins, and other physical hazards; and effects of lack of affordability, such as stress, residential instability, homelessness, and inability to pay for other necessities. Differential exposure to substandard housing is a major cause of racial disparities in asthma, the most common chronic disease in children. Housing is considered unaffordable when its cost represents 30% or more of household income. Lack of affordable housing is associated with multiple adverse health outcomes, including poor self-rated health, hypertension, arthritis, and poor mental health. High housing costs can lead families to make potentially health-harming trade-offs such as being unable to purchase adequate nutritious food, heat, or needed medical care and medications. Unaffordable housing is a major cause of homelessness, along with lack of adequate social, economic, and mental health safety nets.. In addition to homelessness, lack of housing security (residential instability) is associated with emotional, behavioral, and school problems in children and with teen pregnancy, early drug use, and depression in adolescence. Racial discrimination in mortgage lending has excluded many people of color from homeownership and therefore the opportunity to accumulate wealth. Racial discrimination in housing has been illegal since 1964, but evidence indicates this bias persists, although to a lesser degree than before 1964. Initiatives to make housing healthier and more affordable are discussed in this chapter.