Skip to main content
SpringerLink
Log in

Mental health and prolonged exposure to unaffordable housing: a longitudinal analysis

Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Cite this article

Abstract

Purpose

When housing is insufficient, or poor quality, or unaffordable there are well established health effects. Despite the pervasiveness of housing affordability problems (widely referred to as Housing Affordability Stress—HAS), little quantitative work has analysed long-term mental health effects. We examine the mental health effects of (prolonged and intermittent) patterns of exposure to housing affordability problems.

Methods

We analysed a large, nationally representative longitudinal population sample of individuals, following them over five-year periods to assess the relative mental health effects of different patterns of exposure to housing affordability problems. To maximise the number of observations and the robustness of findings, we used 15 years (2002–2016) of data, across three pooled exposure windows. Longitudinal regression analysis with Mundlak adjustment was used to estimate the association between prolonged (constant over a 5-year period) and intermittent exposure to HAS, and mental health (as measured using the SF-36 MCS).

Results

We found that, on average, both prolonged and intermittent exposure were associated with lower mental health (Beta = − 1.338 (95% CI − 2.178–0.488) and Beta = − 0.516 (95% CI − 0.868–0.164), respectively). When we additionally adjusted for baseline mental health, thereby accounting for initial mental health status, coefficients were attenuated but remained significant.

Conclusions

Both prolonged and intermittent exposure to HAS negatively impact mental health, irrespective of baseline mental health. Interventions that target affordable housing would benefit population mental health. Mental health interventions should be designed with people’s housing context in mind.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Desmond M (2018) Heavy is the house: rent burden among the American urban poor. Int J Urban Reg Res 42(1):160–170

    Article  Google Scholar 

  2. Wetzstein S (2017) The global urban housing affordability crisis. Urban Stud 54(14):3159–3177

    Article  Google Scholar 

  3. Snow J (1855) On the mode of communication of cholera: John Churchill.

  4. Taylor MP, Pevalin DJ, Todd J (2007) The psychological costs of unsustainable housing commitments. Psychol Med 37:1027–1036

    Article  Google Scholar 

  5. Free S, Howden-Chapman P, Pierse N, Viggers H (2010) More effective home heating reduces school absences for children with asthma. J Epidemiol Community Health 64:379–386

    Article  CAS  Google Scholar 

  6. Mason KE, Baker E, Blakely T, Bentley RJ (2013) Housing affordability and mental health: does the relationship differ for renters and home purchasers? Soc Sci Med 94:91–97

    Article  Google Scholar 

  7. Pollack CE, Griffin BA, Lynch J (2010) Housing affordability and health among homeowners and renters. Am J Prev Med 39:515–521

    Article  Google Scholar 

  8. Waldron R, Redmond D (2017) “We’re just existing, not living!” Mortgage stress and the concealed costs of coping with crisis. Hous Stud 32:584–612

    Article  Google Scholar 

  9. Baker E, Bentley R, Lester L, Beer A (2016) Housing affordability and residential mobility as drivers of locational inequality. Appl Geogr 72:65–75

    Article  Google Scholar 

  10. Meltzer R, Schwartz A (2016) Housing affordability and health: evidence From New York city. Hous Policy Deb 26:80–104

    Article  Google Scholar 

  11. Boymal J, de Silva A, Pomeroy J (2013) Quantity and quality estimates of changes in dwelling affordability in metropolitan Melbourne. Aust J Reg Stud 19:4

    Google Scholar 

  12. Cai W, Lu X (2015) Housing affordability: beyond the income and price terms, using China as a case study. Habit Int 47:169–175

    Article  Google Scholar 

  13. Bentley R, Baker E, Mason K (2012) Measuring the dose-dependent mental health effect of poor housing affordability for men and women. J Epidemiol Community Health 66:761–766

    Article  Google Scholar 

  14. Clair A, Loopstra R, Reeves A, McKee M, Dorling D, Stuckler D (2016) The impact of housing payment problems on health status during economic recession: A comparative analysis of longitudinal EU SILC data of 27 European states, 2008–2010. SSM-Popul Health 2:306–316

    Article  Google Scholar 

  15. Bentley RJ, Pevalin D, Baker E, Mason K, Reeves A, Beer A (2016) Housing affordability, tenure and mental health in Australia and the United Kingdom: a comparative panel analysis. Hous Stud 31:208–222

    Article  Google Scholar 

  16. Bentley R, Baker E, Mason K, Subramanian S, Kavanagh AM (2011) Association between housing affordability and mental health: a longitudinal analysis of a nationally representative household survey in Australia. Am J Epidemiol 174:753–760

    Article  Google Scholar 

  17. Baker E, Mason K, Bentley R, Mallett S (2014) Exploring the bi-directional relationship between health and housing in Australia. Urban Policy Res 32(1):71–84

    Article  Google Scholar 

  18. Bentley R, Baker E, Aitken Z (2019) The ‘double precarity’of employment insecurity and unaffordable housing and its impact on mental health. Soc Sci Med 225:9–16

    Article  Google Scholar 

  19. Yates J, Gabriel M. Housing Affordability in Australia; National Research Venture 3: Housing Affordability for Lower Income Australians, Research Paper 3. AHURI Melbourne 2006.

  20. Yates J, Milligan V, Berry M, et al. Housing affordability: a 21st century problem. National research venture 2007; 3.

  21. Nepal B, Tanton R, Harding A (2010) Measuring housing stress: how much do definitions matter? Urban Policy Res 28:211–224

    Article  Google Scholar 

  22. Daniel, L., Baker, E. and Lester, L., 2018. Measuring Housing Affordability Stress: Can Deprivation Capture Risk Made Real?. Urban Policy and Research, pp.1–16.

  23. Rowley S, Ong R, Haffner M (2015) Bridging the gap between housing stress and financial stress: the case of Australia. Hous Stud 30:473–490

    Article  Google Scholar 

  24. Commonwealth of Australia (1991) The affordability of Australian housing. National Housing Strategy, Issues papers 2.

  25. Baker E, Mason K, Bentley R (2015) Measuring housing affordability: a longitudinal approach. Urban Policy Res 33:275–290

    Article  Google Scholar 

  26. Seelig T, Phibbs P (2006) Beyond the normative: low income private renters’ perspectives of housing affordability and need for housing assistance. Urban Policy Res 24:53–66

    Article  Google Scholar 

  27. Borrowman L, Kazakevitch G, Frost L. How long do households remain in housing affordability stress? Housing Studies 2017: 1–18.

  28. Kahn JR, Pearlin LI (2006) Financial strain over the life course and health among older adults. J Health Soc Behav 47(1):17–31

    Article  Google Scholar 

  29. Pevalin DJ, Reeves A, Baker E, Bentley R (2017) The impact of persistent poor housing conditions on mental health: a longitudinal population-based study. Prev Med 105:304–310

    Article  Google Scholar 

  30. Evans GW, Cassells RC (2014) Childhood poverty, cumulative risk exposure, and mental health in emerging adults. Clin Psychol Sci 2(3):287–296

    Article  Google Scholar 

  31. Seelig HJ, O'Flaherty M, Short P, Haynes MA, Baum SW, Western MC, Jones A (2005) Housing consumption patterns and earnings behaviour of income support recipients over time. Australian Housing and Urban Research Institute (AHURI), Melbourne

  32. Summerfield M, Freidin S, Hahn M et al (2011) HILDA user manual–release 10. University of Melbourne Melbourne Institute of Applied Economic and Social Research, Melbourne

    Google Scholar 

  33. Coons SJ, Rao S, Keininger DL, Hays RD (2000) A comparative review of generic quality-of-life instruments. Pharmacoeconomics 17:13–35

    Article  CAS  Google Scholar 

  34. McCallum J (1995) The SF-36 in an Australian sample: validating a new, generic health status measure. Aust N Z J Public Health 19:160–166

    Article  CAS  Google Scholar 

  35. Pirkis J, Burgess P, Kirk P, Dodson S, Coombs T (2005) Review of standardised measures used in the National Outcomes and Casemix Collection (NOCC). Sydney, NSW

  36. Allison PD (2009) Fixed effects regression models. SAGE publications, Thousand Oaks

    Book  Google Scholar 

  37. Ware JE, Gandek B (1998) Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol 51:903–912

    Article  Google Scholar 

  38. Ware JE, Keller SD, Kosinski M (1994) SF-36: Physical and mental health summary scales: a user’s manual: Health Assessment Lab.

  39. Baker E, Pham NTA, Daniel L, Bentley R (2020) New evidence on mental health and housing affordability in cities: a quantile regression approach. Cities 96:102455

    Article  Google Scholar 

  40. Watson N, Wooden M (2010) Data survey: the HILDA survey: progress and future developments. Australian Econ Rev 43(3):326–336

    Article  Google Scholar 

  41. Baker E, Lester L (2017) Multiple housing problems: a view through the housing niche lens. Cities 62:146–151

    Article  Google Scholar 

Download references

Acknowledgements

This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either DSS or the Melbourne Institute

Author information

Authors and Affiliations

  1. School of Architecture and the Built Environment, University of Adelaide, Adelaide, Australia

    Emma Baker & Laurence Lester

  2. Department of Public Health and Policy, University of Liverpool, Liverpool, UK

    Kate Mason

  3. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

    Rebecca Bentley

Authors
  1. Emma Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laurence Lester
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kate Mason
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rebecca Bentley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emma Baker.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baker, E., Lester, L., Mason, K. et al. Mental health and prolonged exposure to unaffordable housing: a longitudinal analysis. Soc Psychiatry Psychiatr Epidemiol 55, 715–721 (2020). https://doi.org/10.1007/s00127-020-01849-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-020-01849-1

Keywords

search

Navigation