Health Inequalities in Housing: Housing cost burden, Housing assets, and Mortality

Abstract

Despite a growing body of studies on the relationship between housing and health, it is unclear whether and how (a) the housing cost burden deteriorates health and whose health it deteriorates, (b) housing assets interact with income in influencing one’s health, and (c) protective policy measures alleviate mortality risks predicted by housing cost burden. This thesis aims to reduce these knowledge gaps. First, in Chapter two, I synthesize prior literature that focused on the association between housing cost burden and health and discussed methodological issues. Also, the chapter proposes future research directions. Chapter three, co-authored with Dr. Michel Grignon, Dr. Marisa Young, and Dr. James R. Dunn, assesses the potential moderating effect of housing asset level on the link between income and mortality. Although housing assets and income are independently related to mortality risks, the value of housing assets did not significantly moderate the link between income and mortality. Income-related inequalities in mortality are observed among each group of housing asset level. Our findings offer insight into the importance of redistribution of resources that can reduce risks of premature mortality and achieve healthy aging. Chapter four documents that housing cost burden was significantly associated with preventable mortality, treatable mortality, and suicide during post-Global Financial crisis (2009-2017). Also, in countries with an increased level of social spending, higher levels of social housing stock, and rent control, the observed association was substantially attenuated. Taken together, the findings of the three chapters contribute to understandings about the link between housing and health by (a) synthesizing the prior literature and mechanisms, (b) estimating housing inequalities in health, and (c) highlighting the protective roles of social and housing policies that reduce health inequalities.