1
|
Roberts MK, Bhat AC, Fenelon A. The long-term effects of housing insecurity in young adulthood on subsequent material hardship, physiological and mental health. Soc Sci Med 2025; 367:117761. [PMID: 39874838 PMCID: PMC11854551 DOI: 10.1016/j.socscimed.2025.117761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 01/20/2025] [Accepted: 01/22/2025] [Indexed: 01/30/2025]
Abstract
Economic and material hardship, including housing insecurity - limited or uncertain availability or access to safe, quality, and affordable housing - is strongly linked to negative physical and mental health outcomes among adolescents and adults. However, data limitations and the inherent selectivity of housing insecurity have hindered comprehensive analysis of its long-term effects on physiological and mental health. This study uses data from The National Longitudinal Study of Adolescent to Adult Health (Add Health) to construct a sample of participants who experienced housing insecurity between the ages of 18-26 (Wave III) to a suitable control group using propensity score matching. We assess the effects of housing insecurity on (1) material hardship at Wave IV (ages 24-32), (2) allostatic load (AL) and depression symptoms at Waves IV and V (ages 33-43), and (3) the change in allostatic load and depression symptoms from Wave IV to V. Further, we evaluate whether effects differ by sex. Experiencing housing insecurity is associated with a significantly higher likelihood of experiencing material hardship at Wave IV and significantly worse depressive symptoms at both Waves IV and V. The treatment effects are more pronounced among women, with housing insecurity being linked to a significant increase in allostatic load from Wave IV to Wave V exclusively for women. Our results provide crucial support that housing insecurity is not just an outcome of economic hardship but a cause of it in the future, with downstream effects on health and well-being, particularly for women.
Collapse
Affiliation(s)
- Mary K Roberts
- Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, 42-43 Park End Street, Oxford, OX1 1JD, UK.
| | - Aarti C Bhat
- Population Research Institute, The Pennsylvania State University, 601 Oswald Tower, University Park, PA, 16802, USA; Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA; Center for Healthy Aging, The Pennsylvania State University, 4th Floor Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Andrew Fenelon
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. 2(n,d) St., Minneapolis, MN, 55454, USA
| |
Collapse
|
2
|
Bhat AC, Fenelon A, Almeida DM. Housing insecurity pathways to physiological and epigenetic manifestations of health among aging adults: a conceptual model. Front Public Health 2025; 13:1485371. [PMID: 39916715 PMCID: PMC11799248 DOI: 10.3389/fpubh.2025.1485371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 01/09/2025] [Indexed: 02/09/2025] Open
Abstract
Introduction Housing insecurity is a social determinant of health, as evidenced by its associations with mental, physical, and biological outcomes. The scientific understanding of the mechanisms by which housing insecurity is associated with health is still limited. This review adapts existing stress process models to propose a conceptual model illustrating potential pathways linking the specific stressor of housing insecurity to physiological and epigenetic manifestations of stress among aging adults. Methods This narrative review examines literature across multiple fields, including public health, psychology, and sociology. The literature selected for this review was identified through scientific databases including Web of Science, PubMed, JSTOR, and Google Scholar; primarily peer-reviewed empirical studies, literature reviews, and research reports published in English between 1981 and 2024; and principally based in the United States context. A synthesis of this literature is presented in a proposed conceptual model. Results The literature supports the existence of two main predictors of housing insecurity: sociodemographic characteristics and the historical/current context. The main mediating pathways between housing insecurity and manifestations of stress include health behaviors, psychosocial resources, and structural resources. Moderating factors affecting the associations between housing insecurity and manifestations of stress include government assistance, chronic discrimination/unfair treatment, and individual differences. These interdependent mediating and moderating mechanisms affect stressor reactivity, a proximal manifestation of stress, which contributes to the physiological and epigenetic distal manifestations of stress in aging adults. Discussion and implications The prevalence of housing insecurity among aging adults is growing in the United States, with significant implications for public health and health disparities, given the growing percentage of aging adults in the population. Further empirical testing of the mediating and moderating mechanisms proposed in the conceptual model will elucidate how housing insecurity is connected to health and provide insight into preventive strategies to ameliorate the adverse effects of housing insecurity on biological health among aging adults.
Collapse
Affiliation(s)
- Aarti C. Bhat
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
- Population Research Institute, The Pennsylvania State University, University Park, PA, United States
| | - Andrew Fenelon
- School of Public Health, University of Minnesota-Twin Cities, Minneapolis, MN, United States
- Minnesota Population Center, University of Minnesota-Twin Cities, Minneapolis, MN, United States
- Life Course Center, University of Minnesota-Twin Cities, Minneapolis, MN, United States
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
- Population Research Institute, The Pennsylvania State University, University Park, PA, United States
| |
Collapse
|
3
|
Bhat AC, Diaz JA, Lee SA, Almeida DM, Lee S. Associations between Recession Hardships and Subjective and Objective Sleep Measures in the Midlife in the United States Study: Race and Gender Differences. FRONTIERS IN SLEEP 2024; 3:1403818. [PMID: 39583086 PMCID: PMC11580659 DOI: 10.3389/frsle.2024.1403818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2024]
Abstract
Objectives This study investigates the associations of retrospective reports of Recession hardships with 10-year changes in subjective and objective indicators of sleep, and whether these associations differ by race and gender. Methods 501 adults (14.57% Black; 54.49% female) from the Midlife in the United States (MIDUS) study reported on the subjective Pittsburgh Sleep Quality Index (PSQI) across two waves (pre-Recession, collected 2004-2009; post-Recession, collected 2017-2022), as well as Recession hardships since 2008. A sub-sample of 201 adults (25.37% Black; 58.21% female) provided objective actigraphy-measured sleep data (total sleep time, sleep onset latency, sleep efficiency) across the two waves. Results Descriptive analyses revealed Black participants had higher average Recession hardships, poorer post-Recession PSQI scores, and poorer post-Recession actigraphy sleep quantity and quality compared to white participants. Females had higher average Recession hardships compared to males; and reported poorer post-Recession PSQI, but had better objective post-Recession sleep quantity and quality compared to males. Regression models showed Recession hardships (across overall events, and sub-domains of financial and housing hardships) were associated with poorer PSQI and actigraphy-measured sleep efficiency following the Recession, adjusting for sociodemographic covariates, corresponding pre-Recession sleep variables, and pre-Recession chronic conditions. There was no evidence for significant moderation by race on sleep outcomes. However, gender moderation indicated associations between housing hardships and poorer actigraphy-measured sleep efficiency were more apparent for females than for males. Conclusions Findings indicate that Recession hardships (particularly in financial and housing domains) may be manifested in poor sleep. Racial and gender groups may have differential exposure and sleep-related reactivity to Recession hardships.
Collapse
Affiliation(s)
- Aarti C. Bhat
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
- Population Research Institute, The Pennsylvania State University, University Park, PA, United States
| | - Jose A. Diaz
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Sun Ah Lee
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - David M. Almeida
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
- Population Research Institute, The Pennsylvania State University, University Park, PA, United States
| | - Soomi Lee
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| |
Collapse
|
4
|
Hogendoorn B, Kalmijn M. Does Ethnicity Moderate the Union Dissolution Penalty for Women? A Register-based Analysis of Changes in Income Components. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2024; 40:29. [PMID: 39388039 PMCID: PMC11467139 DOI: 10.1007/s10680-024-09714-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 08/06/2024] [Indexed: 10/15/2024]
Abstract
Union dissolution has severe consequences for women's economic well-being. Theoretical work links these consequences to ethnic inequality. Ethnic groups vary in terms of separation rates, female employment, repartnering trajectories, kin support, and reliance on welfare benefits. The current study examines whether ethnicity moderates the dissolution penalty. To do so, the authors draw on register data, covering women from five major ethnic groups in the Netherlands: Dutch, Antillean, Surinamese, Moroccan, and Turkish. The authors describe women's income trajectories from 1 year before to 5 years after union dissolution. Using decomposition techniques, changes in household income are decomposed into changes in six underlying income sources (i.e., earnings, benefits, alimony, partner income, and coresident family income). The results show that ethnicity moderates the dissolution penalty and, especially, the contribution of the various income sources when recovering from dissolution.
Collapse
Affiliation(s)
| | - Matthijs Kalmijn
- Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), The Hague, The Netherlands.
- University of Groningen, Groningen, The Netherlands.
| |
Collapse
|
5
|
Lin KH, Dominguez G. The Rising Importance of Stock-Linked Assets in the Black-White Wealth Gap. Demography 2023; 60:1877-1901. [PMID: 37975566 DOI: 10.1215/00703370-11067778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Studies have examined the racial disparities in household characteristics, homeownership, and familial transfer as primary drivers of the Black-White wealth gap in the United States. This study assesses the importance of stock-linked assets in generating wealth inequality. As financial assets become a growing component of household portfolios, the Black-White wealth gap is increasingly associated with the racial disparity in stock-linked assets. Using data from the Survey of Consumer Finances and the Panel Study of Income Dynamics, this study shows that the contribution of stock-linked assets to the Black-White wealth gap has expanded in both absolute and relative terms, surpassing those of homeownership and business equity. Furthermore, a substantial disparity in financial wealth exists even for otherwise similar Black and White households. Although the disparity is larger among those with more economic resources, a gap remains among those with less. Lastly, our analysis shows that the combination of lower ownership levels and lower returns on financial wealth among Black households could account for a quarter of the Black-White wealth accumulation gap, net of differences in current net worth and household characteristics. Our findings suggest that considering financial assets is critical for understanding contemporary racial wealth inequality.
Collapse
Affiliation(s)
- Ken-Hou Lin
- Department of Sociology and Population Research Center, University of Texas at Austin, Austin, TX, USA
| | | |
Collapse
|
6
|
Fenelon A. Race, housing policy, and the demographic and spatial structure of modern housing programs: Who receives rental assistance and where do they live? JOURNAL OF URBAN AFFAIRS 2022; 46:944-961. [PMID: 39045095 PMCID: PMC11262546 DOI: 10.1080/07352166.2022.2103426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Housing policy in the United States has long been characterized by unequal investment in homeownership and low-income rental assistance, with implications for racial (and ethnic) inequality in access to stable housing. In this study, I examine socioeconomic status and neighborhood characteristics of non-Hispanic White and non-Hispanic Black adults with children receiving HUD rental assistance using a nationally representative linked survey-administrative dataset. Results show that Black and White adults who receive rental assistance tend to have similar (low) incomes, yet Black adults experience significantly higher levels of neighborhood disadvantage than White adults. Furthermore, living in poverty is a substantially stronger predictor of receiving HUD rental assistance for White than Black adults. The results support the notion that rental assistance programs are a last resort for White households, many of whom may benefit from historical federal government support for homeownership. Rental assistance serves as an important safety net for Black families but fails to provide significant improvement in the neighborhood environment. The results contribute to a comprehensive understanding of racial inequality in the impacts of U.S. rental housing policy and the historical legacy of racial exclusion in U.S. homeownership programs.
Collapse
|
7
|
Bhat AC, Almeida DM, Fenelon A, Santos-Lozada AR. A longitudinal analysis of the relationship between housing insecurity and physical health among midlife and aging adults in the United States. SSM Popul Health 2022; 18:101128. [PMID: 35652088 PMCID: PMC9149198 DOI: 10.1016/j.ssmph.2022.101128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/26/2023] Open
Abstract
Rationale A large body of work demonstrates the impact of housing instability on health by exploring the effects of evictions and homelessness on psychological wellbeing of young adults and children. However, limited research leverages national longitudinal data to examine whether and how experiences of a range of housing insecurity events, rather than just eviction or homelessness, affect physical health among midlife and older adults. Objective The current study examines (1) prevalence of housing insecurity among midlife and older adults by age and race, (2) linkages between housing insecurity experiences and facets of physical health, and (3) age and race moderations on these effects. Method This study employs regression models to examine whether experiences of housing insecurity affect self-rated physical health and chronic physical conditions among midlife and older adults (N = 2598) leveraging two waves of the National Study of Midlife in the United States (MIDUS). Results Models revealed that housing insecurity experiences predicted poorer self-rated physical health and additional chronic conditions, even when controlling for previous physical health. Moderation analyses indicated that housing insecurity has a stronger relationship with chronic conditions among midlife adults as compared to older adults, and among Black adults as compared to white adults. These results suggest that experiences of housing insecurity leave adults vulnerable to compromised physical health, and that housing insecurity experiences may be particularly detrimental to the health of midlife Black adults. Conclusions This research adds to the extant literature by introducing a comprehensive measure of housing insecurity experiences, and contributes to a life course perspective regarding how housing insecurity can affect physical health. This research has implications for policy that addresses housing insecurity as a public health concern, especially in the aftermath of the 2008 recession and the economic and housing crisis caused by the COVID-19 pandemic.
Collapse
Affiliation(s)
- Aarti C. Bhat
- Department of Human Development and Family Studies, The Pennsylvania State University, 405 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, 403 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Andrew Fenelon
- School of Public Policy and Department of Sociology and Criminology, The Pennsylvania State University, 331 Pond Laboratory, University Park, PA, 16802, USA
| | - Alexis R. Santos-Lozada
- Department of Human Development and Family Studies, The Pennsylvania State University, 226 Health and Human Development Building, University Park, PA, 16802, USA
| |
Collapse
|