Housing Conditions and Mental Health: Moderation Effects of Disability and Racial Minority Status

Background/Purpose: Environmental hazards have not been distributed equally across different neighborhoods, causing or aggravating health problems, such as mental health, asthma, cancer, and heart diseases disproportionately across communities (Morello-Frosch et al., 2011). Environmental hazards include air or water pollution, inappropriately built environments, and hazardous toxic sites (Morello-Frosch et al., 2011). This study examines built environments, in particular, the age of housing and its association with mental health in Texas.

There are studies that have examined mental health in relation to environmental factors in Texas. Some focused only on urban areas (Makram et al., 2025). Some studies have not specifically examined housing conditions (Ganju, 2008). Thus, to address these gaps, the current research aims to study Texas using the most recent data, including both rural and urban areas, and specifically in terms of housing conditions.

Methods: Data and samples: The study applied the Census Bureau American Community Survey (2018-2022) to measure the percentage of occupied housing units built before 1980 (as an independent variable), the percentage of households with a disability, and the percentage of racial categories except white, non-Hispanic (as control and moderator variables). The study also used data from the U.S. Centers for Disease Control and Prevention (2024) to measure the prevalence of poor mental health for two weeks or more among adults (as a dependent variable). All the data was collected at the geographical tract level, which included 6,819 Census tracts in the State of Texas after removing tracts with zero population.

Analysis: The study ran two multiple regression analyses, one to examine the effects of independent and control variables on mental health and the other to investigate the moderation effects. Both regression models were significant.

Results: Running a multiple regression analysis, the study found a significant direct association between the percentage of houses built before 1980 (M = 38.13; SD = 28.47) and the prevalence of poor mental health (M = 18.09; SD = 3.36), while controlling for two variables of households with a disability and racial/ethnic minority status. The study also investigated the moderator effects of these two variables and reported that both significantly, although slightly, aggravate the association between housing conditions and mental health. This is consistent with the existing research conducted by Chang et al. (2020), Mascarenhas et al. (2021), and Downey and Van Willigen (2005), who explained how negative personal perceptions of the neighborhood and poor sleep due to poor environmental quality, worsened by racial/ethnic residential segregation, negatively affect the quality of life. The current study is limited in establishing causality.

Conclusions and Implications: The implications of this study for public health advocates and policymakers are to prioritize communities with more racial/ethnic minorities and with more households with disabilities in the interventions related to sustainable and quality housing, as this can improve mental health equity.