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Housing Quality, Housing Instability, and Maternal Mental Health


Poor housing conditions and residential instability have been associated with distress among women; however, this association could be the result of other social factors related to housing, such as intimate partner violence (IPV) and economic hardship. We examined associations of housing conditions and instability with maternal depression and generalized anxiety disorder (GAD) while accounting for IPV and economic hardship in the Fragile Families and Child Wellbeing Study (N = 2,104). In the third study wave, interviewers rated indoor housing quality, including housing deterioration (e.g., peeling paint and holes in floor) and housing disarray (e.g., dark, crowded, and noisy). Mothers reported whether they had moved more than twice in the past two years, an indicator of housing instability. A screening for depression and GAD was obtained from questions derived from the Composite International Diagnostic Interview-Short Form in the second and third study waves. IPV and economic hardship were assessed through questionnaire. In this sample, 16% of women were classified as having probable depression and 5% as having probable GAD. In adjusted analyses, mothers experiencing housing disarray (odds ratio [OR], 1.3 [95% confidence interval (CI), 1.0, 1.7]) and instability (OR, 1.4 [95% CI, 1.2, 2.3]) were more likely to screen positive for depression. In addition, those experiencing housing instability were more likely to screen positive for GAD (OR 1.9 [95% CI, 1.2, 3.0]) even after adjusting for other social factors. No associations were noted between housing deterioration and maternal mental health. Similar associations were noted when incident cases of probable depression and GAD were examined. Housing instability and disarray, but not deterioration, are associated with screening positive for depression and generalized anxiety among women regardless of other social stressors present in their lives. Housing could potentially present a point of intervention to prevent mental health consequences among mothers and possibly their children.

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Intimate partner violence


Generalized anxiety disorder


  1. 1.

    Shaw M. Housing and public health. Annu Rev Public Health. 2004; 25: 397–418.

    PubMed  Article  Google Scholar 

  2. 2.

    Dunn JR. Housing and inequalities in health: a study of socioeconomic dimensions of housing and self reported health from a survey of Vancouver residents. J Epidemiol Community Health. 2002; 56(9): 671–681.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Weich S, Blanchard M, Prince M, Burton E, Erens B, Sproston K. Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression. Br J Psychiatry. 2002; 180: 428–433.

    PubMed  Article  Google Scholar 

  4. 4.

    Evans GW, Wells NM, Moch A. Housing and mental health: a review of the evidence and a methodological and conceptual critique. J Soc Issues. 2003; 59(3): 475–500.

    Article  Google Scholar 

  5. 5.

    Sandel M, Wright RJ. When home is where the stress is: expanding the dimensions of housing that influence asthma morbidity. Arch Dis Child. 2006; 91(11): 942–948.

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Shenassa ED, Daskalakis C, Liebhaber A, Braubach M, Brown M. Dampness and mold in the home and depression: an examination of mold-related illness and perceived control of one’s home as possible depression pathways. Am J Public Health. 2007; 97(10): 1893–1899.

    PubMed  Article  Google Scholar 

  7. 7.

    Elton PJ, Packer JM. A prospective randomised trial of the value of rehousing on the grounds of mental ill-health. J Chronic Dis. 1986; 39(3): 221–227.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Halpern D. Mental Health and the Built Environment. London, England: Taylor & Francis; 1995.

    Google Scholar 

  9. 9.

    Evans GW. The built environment and mental health. J Urban Health. 2003; 80(4): 536–555.

    PubMed  Article  Google Scholar 

  10. 10.

    Dunn JR, Hayes MV. Identifying social pathways for health inequalities. The role of housing. Ann NY Acad Sci. 1999; 896: 399–402.

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Evans GW, Lepore SJ, Allen KM. Cross-cultural differences in tolerance for crowding: fact or fiction? J Pers Soc Psychol. 2000; 79(2): 204–210.

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Elliott M. The stress process in neighborhood context. Health Place. 2000; 6(4): 287–299.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Munoz M, Crespo M, Perez-Santos E. Homeless effects on men’s and women’s health. Int J Ment Health. 2005; 34(2): 47–61.

    Google Scholar 

  14. 14.

    Phinney R, Danziger S, Pollack HA, Seefeldt K. Housing instability among current and former welfare recipients. Am J Public Health. 2007; 97(5): 832–837.

    PubMed  Article  Google Scholar 

  15. 15.

    Magdol L. Is moving gendered? The effects of residential mobility on the psychological well-being of men and women. Sex Roles. 2002; 47: 553–560.

    Article  Google Scholar 

  16. 16.

    Davey-Rothwell MA, German D, Latkin CA. Residential transience and depression: does the relationship exist for men and women? J Urban Health. 2008; 85(5): 707–716.

    PubMed  Article  Google Scholar 

  17. 17.

    Reading R, Reynolds S. Debt, social disadvantage and maternal depression. Soc Sci Med. 2001; 53(4): 441–453.

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Lahelma E, Laaksonen M, Martikainen P, Rahkonen O, Sarlio-Lahteenkorva S. Multiple measures of socioeconomic circumstances and common mental disorders. Soc Sci Med. 2006; 63(5): 1383–1399.

    PubMed  Article  Google Scholar 

  19. 19.

    Benson M, Fox G. Concentrated Disadvantage, Economic Distress, and Violence against Women in Intimate Relationships. Washington, DC: National Institute of Justice; 2004.

    Google Scholar 

  20. 20.

    Benson M, Fox G. Economic Distress, Community Context and Intimate Violence: An Application and Extension of Social Disorganization Theory, Final Report. Washington, DC: National Institute of Justice; 2001.

    Google Scholar 

  21. 21.

    Pavao J, Alvarez J, Baumrind N, Induni M, Kimerling R. Intimate partner violence and housing instability. Am J Prev Med. 2007; 32(2): 143–146.

    PubMed  Article  Google Scholar 

  22. 22.

    Reichman N, Teitler J, Garfinkel I, McLanahan S. Fragile families: sample and design. Child Youth Serv Rev. 2001; 23(4/5): 303–326.

    Article  Google Scholar 

  23. 23.

    Evans GW, Wells NM, Chan HY, Saltzman H. Housing quality and mental health. J Consult Clin Psychol. 2000; 68(3): 526–530.

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    Suglia SF, Duarte C, Sandel M, Wright R. Social and environmental Stressors in the home and childhood asthma. J Epidemiol Community Health. 2010; 64(7): 636–642.

    Article  Google Scholar 

  25. 25.

    Kessler R, Andrews G, Mroczek D, Ustun T, Wittchen H. The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF). Int J Meth Psychiatr Res. 1998; 7: 171–185.

    Article  Google Scholar 

  26. 26.

    Kessler RC, Wittchen H-U, Abelson JM, et al. Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US National Comorbidity Survey. Int J Meth Psychiatr Res. 1998; 7: 33–55.

    Article  Google Scholar 

  27. 27.

    Fragile Families and ChildWellbeing Study web site. Accessed June 03, 2011.

    Article  Google Scholar 

  28. 28.

    American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

  29. 29.

    Galea S, Ahern J, Rudenstine S, Wallace Z, Vlahov D. Urban built environment and depression: a multilevel analysis. J Epidemiol Community Health. 2005; 59(10): 822–827.

    PubMed  Article  Google Scholar 

  30. 30.

    Matheson FI, Moineddin R, Dunn JR, Creatore MI, Gozdyra P, Glazier RH. Urban neighborhoods, chronic stress, gender and depression. Soc Sci Med. 2006; 63(10): 2604–2616.

    PubMed  Article  Google Scholar 

  31. 31.

    Miller KE, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med. 2010; 70(1): 7–16.

    PubMed  Article  Google Scholar 

  32. 32.

    Evans GW. Child development and the physical environment. Annu Rev Psychol. 2006; 57: 423–451.

    PubMed  Article  Google Scholar 

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Dr. Suglia was supported by grant number K01HL 103199-01. Dr. Duarte was supported by grant number R21HD056170 from NICHD. Dr. Sandel was supported by grant number 1K23 ES013173-02. The Fragile Families and Child Wellbeing Study was supported by grant number R01HD36916 from the National Institute of Child Health and Human Development. The contents of the paper are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Health.

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Correspondence to Shakira Franco Suglia.

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Suglia, S.F., Duarte, C.S. & Sandel, M.T. Housing Quality, Housing Instability, and Maternal Mental Health. J Urban Health 88, 1105–1116 (2011).

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  • Housing
  • Depression
  • Anxiety
  • Residential instability
  • Stress
  • Housing quality