Key Citations:
1. Jelleyman T, Spencer N. Residential mobility in childhood and health outcomes: a systematic review. Journal of Epidemiology and Community Health. 2008. 62(7): 584–592.
2. Robert Wood Johnson Foundation. Social Determinants of Health. Published 2011. Accessed December 27, 2013. Available at: www.rwjf.org/en/research-publications/find-rwjf-research/2011/06/what-sh....
3. Kushel MB, Gupta R, Gee L, Haas JS. Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of General Internal Medicine. 2006; Jan;21(1):71-7
4. Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambulatory Pediatrics. 2008; Jan-Feb;8(1):50-7. doi: 10.1016/j.ambp.2007.08.004.
5. McLaughlin KA, Nandi A, Keyes KM, Uddin M, Aiello AE, Galea S, Koenen KC. Home foreclosure and risk of psychiatric morbidity during the recent financial crisis. Psychol Med. 2012; 42(7):1441-8. doi: 10.1017/S0033291711002613. Epub 2011 Nov 21.
6. Ford JL, Browning CR. Neighborhood social disorganization and the acquisition of trichomoniasis among young adults in the United States. Am J Public Health. 2011; Sep;101(9):1696-703. doi: 10.2105/AJPH.2011.300213. Epub 2011 Jul 21.
7. Reid KW, Vittinghoff E, Kushel MB. Association between the level of housing instability, economic standing and health care access: a meta-regression. J Health Care Poor Underserved. 2008; Nov;19(4):1212-28. doi: 10.1353/hpu.0.0068.
8. Stone, Michael E, “Shelter Poverty: New Ideas on Housing Affordability”, Temple University Press, 1993.
Excessive Housing Cost Burden
Housing costs have increased significantly, and account for an increasing proportion of household budgets. These increased housing costs are particularly burdensome to low-income households that pay more than 35% of their gross income on housing. The Excessive Housing Cost Burden indicator measures the proportion of all neighborhood households, both homeowners and renters, paying more than 35% of their gross income for housing, regardless of income levels. These housing costs often force families to choose between paying for shelter and other essential goods and services. Low-income individuals who struggle to pay high housing costs are less likely to have a usual source of medical care, and are more likely to postpone medical treatment and end up in the emergency room. Lack of affordable housing is associated with emotional, behavioral and academic problems among children, and with increased risk of teen pregnancy, early drug use, and depression during adolescence. These impacts can have long-term health consequence. This is an “inverse” measure: the higher the proportion of neighborhood residents paying excessive housing costs, the higher the negative impact on community health. Listed under the Housing domain, the Excessive Housing Cost Burden indicator is also relevant to the Economic Health, Employment Opportunities, Health Systems and Public Safety, Educational Opportunities and Neighborhood Characteristics domains. Data for this indicator can be found in the U.S. Census.