Housing status, mortgage debt and financial burden as barriers to health among older adults in the U.S

ABSTRACT We examine relations between housing status, mortgage, financial burden, and healthy aging among older U.S. adults. We combine cross-sectional data from 2012 to 2014 Health and Retirement Study cohorts. Using regression models, we examined associations between owners and renters, mortgage and non-mortgage holders, financial strain, and difficulty paying bills, and poor self-rated health (SRH), heart condition (HC) and hospitalization (past two years). We find that compared to owners, renters had greater likelihood of poor SRH and hospitalization. Regardless of tenure, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Mortgage holders had lower likelihood of poor SRH. Accounting for mortgage status, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Associations between tenure or mortgage status and health were not modified by either financial burden factors. We conclude that there need to be more robust and inclusive programs that assist older populations with housing could improve self-rated health, with particular attention to renters, mortgage holders and those experiencing financial burden.

[1]  R. Mehdipanah,et al.  ‘It’s like they make it difficult for you on purpose’: barriers to property tax relief and foreclosure prevention in Detroit, Michigan , 2020, Housing studies.

[2]  P. Whelton,et al.  High Blood Pressure and Cardiovascular Disease , 2019, Hypertension.

[3]  C. Quinn,et al.  The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care. , 2019, Health affairs.

[4]  G. Marshall,et al.  The association between hardship and self-rated health: does the choice of indicator matter? , 2018, Annals of epidemiology.

[5]  F. Alpass,et al.  Loneliness, socio-economic status and quality of life in old age: the moderating role of housing tenure , 2017, Ageing and Society.

[6]  Clara H. Mulder,et al.  Housing and subjective well-being of older adults in Europe , 2017 .

[7]  Sarah D. Asebedo,et al.  Does How We Feel About Financial Strain Matter for Mental Health , 2017 .

[8]  J. Singh,et al.  Emergency Department and Inpatient Healthcare utilization due to Hypertension , 2016, BMC Health Services Research.

[9]  Z. Aitken,et al.  Housing tenure and affordability and mental health following disability acquisition in adulthood. , 2016, Social science & medicine.

[10]  P. Siegel,et al.  Housing Insecurity and the Association With Health Outcomes and Unhealthy Behaviors, Washington State, 2011 , 2015, Preventing chronic disease.

[11]  Amanda Sonnega,et al.  Cohort Profile: the Health and Retirement Study (HRS). , 2014, International journal of epidemiology.

[12]  J. Dowd,et al.  Housing wealth, psychological well-being, and cognitive functioning of older Americans. , 2014, The journals of gerontology. Series B, Psychological sciences and social sciences.

[13]  J. Iveniuk,et al.  The onset of depression during the great recession: foreclosure and older adult mental health. , 2014, American journal of public health.

[14]  E. Iecovich,et al.  Aging in place : From theory to practice , 2014 .

[15]  A Profile of Housing and Health Among Older Americans , 2013 .

[16]  J. Rouwendal,et al.  Homeownership and Long-Term Care , 2013 .

[17]  S. Burgard,et al.  Housing instability and health: findings from the Michigan Recession and Recovery Study. , 2012, Social science & medicine.

[18]  Alan L. Gustman,et al.  How Did the Recession of 2007–2009 Affect the Wealth and Retirement of the Near Retirement Age Population in the Health and Retirement Study? , 2011, Social security bulletin.

[19]  S. Kirkpatrick,et al.  Housing Circumstances are Associated with Household Food Access among Low-Income Urban Families , 2011, Journal of Urban Health.

[20]  Beth Ann Griffin,et al.  Housing affordability and health among homeowners and renters. , 2010, American journal of preventive medicine.

[21]  Physical Home Environment as a Determinant of Aging in Place for Different Types of Elderly Households , 2010 .

[22]  D. Asch,et al.  Material resources and population health: disadvantages in health care, housing, and food among adults over 50 years of age. , 2009, American journal of public health.

[23]  C. Pollack,et al.  Health status of people undergoing foreclosure in the Philadelphia region. , 2009, American journal of public health.

[24]  Philippa Clarke,et al.  Environments for healthy ageing: a critical review. , 2009, Maturitas.

[25]  Eliyahu V. Sapir,et al.  Perceived income adequacy among older adults in 12 countries: findings from the survey of health, ageing, and retirement in Europe. , 2009, The Gerontologist.

[26]  T. VanderWeele,et al.  Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: a randomized trial. , 2009, JAMA.

[27]  N. Krause,et al.  Financial strain, negative social interaction, and self-rated health: evidence from two United States nationwide longitudinal surveys , 2008, Ageing and Society.

[28]  D. Feeny,et al.  Socioeconomic status and health-related quality of life among elderly people: results from the Joint Canada/United States Survey of Health. , 2008, Social science & medicine.

[29]  J. Mackenbach,et al.  A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe. , 2006, Social science & medicine.

[30]  Anne B. Shlay Low-income Homeownership: American Dream or Delusion? , 2006 .

[31]  V. Freedman,et al.  Persistent and growing socioeconomic disparities in disability among the elderly: 1982-2002. , 2005, American journal of public health.

[32]  Michael H. Boyle,et al.  Home ownership, mortgages and psychological distress , 2004 .

[33]  R. Angel,et al.  Financial strain and health among elderly Mexican-origin individuals. , 2003, Journal of health and social behavior.

[34]  R. Dietz,et al.  The social and private micro-level consequences of homeownership , 2003 .

[35]  W. Rohe,et al.  Home Ownership and Access to Opportunity , 2002 .

[36]  Nandinee K. Kutty,et al.  The Scope for Poverty Alleviation among Elderly Home-owners in the United States through Reverse Mortgages , 1998 .

[37]  William M. Rohe,et al.  Homeownership and neighborhood stability , 1996 .