Housing instability and health: Findings from the Michigan recession and recovery study
Highlights
► Housing instability was not rare in the recent recession; about one third of respondents overall and half of renters reported some instability. ► Moves for cost, delinquent housing payments, foreclosure and homelessness were associated with poorer health. ► Doubling up, eviction, and frequent moves were not associated with health after multivariate adjustment. ► It is useful to distinguish various types of housing instability and use appropriate risk groups and comparison categories.
Introduction
The “Great Recession” that began in 2007 has raised the profile of housing instability as an important social issue (Bennett, Scharoun-Lee, & Tucker-Seeley, 2009; Pollack & Lynch, 2009; Robertson, Egelhof, & Hoke, 2008). Changes in macroeconomic conditions and increases in instability in other domains, most notably employment (Kalleberg, 2009), mean that a broader range of individuals in the United States may face financial risks (Gosselin, 2008) that could lead to housing instability. The number of Americans who have lost or otherwise changed their place of residence for financial reasons increased dramatically in the last few years, and while some of the increases appear to be concentrated among those facing serious hardships like families with children experiencing homelessness (National Center for Homeless Education, 2011), individuals buying homes have also faced greater risks than in earlier times. Whether due to mortgage problems linked to income loss, problems meeting payments for loans with adjustable interest rates, or other factors, the number of foreclosures increased 127 percent between 2007 and 2009 (Wong, 2010).
While the potential ramifications of housing instability are numerous, one important consideration is its association with health. Previous studies considering particular kinds of housing instability have shown poorer health among those with varying forms from foreclosure (Pevalin, 2009) to homelessness (Shaw, 2004). However, few studies have been able to consider multiple types of housing instability, and there is reason to expect that not all housing instability experiences are associated with health. Moving frequently because of typical educational, employment, and family changes in early adulthood or moving in with others because of financial problems could both be considered housing instability. However, the first scenario probably involves more voluntary choices and may be less likely to harm health or to be driven by financial hardship.
It has not been possible to assess whether different experiences of housing instability are associated with health in the general population because many studies (with only a few exceptions, see Pevalin, 2009) have focused on selected segments of the housing market, such as homeowners (Pollack & Lynch, 2009) or renters (e.g., March et al., 2011). Additionally, many prior studies have examined only those experiencing one form of housing instability. The comparison groups in such studies are people not suffering from the focal type of housing instability, but comparison group members may have experienced other types of housing insecurity that were not measured.
Using new data from the Michigan Recession and Recovery Study (MRRS), a sample of working-aged adults drawn from the general population, we examine the associations between many different types of housing instability and several measures of health. Respondents were interviewed a few months after the official end of the Great Recession, providing new and timely data for the historically long and weak recovery period (Greenstone & Looney, 2012) in which housing instability has been substantial. We consider instability experiences of individuals from a variety of socioeconomic circumstances and housing statuses, and examine specific housing problems only for those who are at risk – for example, only current renters are at risk of being behind on rent payments. For each risk group, we construct a comparison category of individuals with no experiences of housing instability on any of the other types of housing instability we measure. Finally, we explore respondents' detailed characteristics including their human capital and prior housing and health problems, as housing instability may be a link on the pathway between these factors and subsequent health, rather than a precipitating factor for health decline.
Section snippets
Prior research
In previous studies, the term “housing instability” has characterized a range of housing problems, from frequent moves or difficulty paying rent to being evicted or homeless (Gilman, Kawachi, Fitzmaurice, & Buka, 2003; Kushel, Gupta, Gee, & Haas, 2006; Ma, Gee, & Kushel, 2008; Phinney, Danziger, Pollack, & Seefeldt, 2007; Tsemberis, McHugo, Williams, Hanrahan, & Stefanic, 2007). Prior to the recent recession, much of the research focused on the health consequences of severe forms of housing
Results
Tables 2 and 3 compare the characteristics of respondents who reported each type of housing instability to others who were at risk for that type but reported no housing instability. Table 2 considers the four types of housing instability measured for all respondents, while Table 3 presents findings for the renter-specific, renter-and-other-specific, mortgage-holder-specific, and ever-owner-specific types of instability. The percentage of respondents in the appropriate risk group reporting no
Discussion
In this study, we used a unique new population-based sample of Southeastern Michigan residents surveyed in the wake of the Great Recession to measure a wide variety of their housing instability experiences that were ongoing in late 2009 or early 2010, or had occurred within the past three years. We also assessed the association between these housing problems and self-rated health, depression, anxiety and problematic alcohol use. Our study addresses several key limitations of prior studies: we
Acknowledgments
Data collection for this study was supported by funds provided to the National Poverty Center (NPC) by the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services, the Office of the Vice-President for Research at the University of Michigan, the John D. and Catherine T. MacArthur Foundation, and the Ford Foundation. The analyses presented in this paper were supported by a generous grant from the John D. and Catherine T. MacArthur
References (41)
- et al.
Chronic stress and psychological well-being: evidence from Thailand on household crowding
Social Science & Medicine
(1996) - et al.
Is shared housing a way to reduce homelessness? The effect of household arrangements on formerly homeless people
Journal of Housing Economics
(2010) - et al.
Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the hospital anxiety and depression scale, the patient health questionnaire, a screening question, and physicians' diagnosis
Journal of Psychosomatic Research
(2003) - et al.
Associations between housing instability and food insecurity with health care access in low-income children
Ambulatory Pediatrics
(2008) - et al.
The alcohol use disorders identification test (AUDIT) and the SMAST-13: predictive validity in a rural primary care sample
Alcohol and Alcoholism
(1993) - et al.
Will the public's health fall victim to the home foreclosure epidemic?
PLoS Med
(2009) - et al.
Recent changes in U.S. family finances: evidence from the 2001 and 2004 survey of consumer finances
Federal Reserve Bulletin
(2006) Program to help prevent foreclosures falls short
(21 July 2010)- et al.
Rising foreclosures in the United States: a perfect storm
Economic Review
(2007) - et al.
Residential density and psychological health: the mediating effects of social support
Journal of Personality and Social Psychology
(1989)