The Relationship between Housing Precarity and Health of Older Adults

Background: Understanding the challenges of aging in place is critical as the population ages. Housing is central to well-being late in life, yet adults are entering old age with lower homeownership rates, more mortgages and debt, and higher housing costs than previous generations. This study aims to 1) determine if an association exists between housing tenure and housing precarity after controlling for demographic and economic characteristics, and 2) assess the relationship between housing precarity and self-reported health among older adults.

Methods: The 2021 Central Ohio Regional Assessment on Aging was conducted to understand the experiences, perceptions, and opinions of adults over the age of 50 living in central Ohio. A random sample stratified by race, age, and county was mailed the survey packet resulting in 1417 responses (15% response rate). Descriptive statistics for variables related to demographic, economic, housing, and health characteristics were tabulated and compared across the housing tenure groups of renter, owner with a mortgage, and owner without a mortgage. The item “Do you have concerns about your ability to pay your rent, mortgage, or utilities?” (Yes/No) was used as a proxy variable for housing precarity. Logistic regression models were fit and analyzed to measure the association between tenure and housing precarity. To address aim 2, linear regression models were fit to a five-level self-rated health item and analyzed to measure the association between housing precarity and health.

Results: A final sample of 1340 usable responses were included in this analysis. Respondents had an average age of 70 years. 85% of respondents owned their homes, 45% of which had a mortgage. All variables except for gender differed significantly across the tenure groups. Results from the logistic regression analysis found age and income to be associated with a reduced likelihood of housing precarity while housing cost burden was associated with an increased likelihood. Owners with a mortgage and renters were estimated to be 3.1 (95% CI = 1.69, 5.83, p < .001) and 2.6 (95% CI = 1.32, 5.43, p < .01) times more likely to report housing precarity than homeowners without a mortgage. The inclusion of housing tenure significantly improved the fit of the housing precarity model. The self-rated health regression analysis found income and exercise frequency to be associated with a significant increase in mean self-rated health while housing precarity was associated with a significant decrease (β = -0.42, p < .001). The inclusion of housing precarity significantly improved the fit of the health model.

Conclusions: Results from this study demonstrate how experiences of housing precarity differ across tenure groups even after controlling for income, housing cost burden, and demographic characteristics. Housing precarity was associated with lower self-rated health when the effects of age, income, and exercise when controlled. This study informs how social workers understand and promote well-being in later life. Uncertainty about where and how one will live may function as a unique health indicator among older adults, and future research should explore how the nuances of various housing tenures drive that uncertainty.