Housing as a Social Determinant of Rural Health
Housing is a well-recognized social determinant of health, with direct impacts on health outcomes (e.g., mortality, disability, falls, and asthma), especially for lower-income individuals with fewer resources to afford safe, accessible, and high-quality housing. Housing is directly related to environmental exposures, including lead paint, mold, mildew, pests, air quality, access to cooking equipment and refrigeration, and water and sewage quality, all of which can have deleterious short and long-term health impacts. Housing is also directly related to financial stability, in that it constitutes both one of the largest regular household expenses that people have and that it can be a way to build financial stability, wealth, and equity for those who own property. In turn, the financial risks and rewards associated with housing can impact health and racial equity. Housing also takes on particular relevance for people with disabilities, for whom the home environment may inhibit or promote functional independence depending on its physical characteristics.
While housing has long been a focus of population health research, such research has rarely included or focused on rural populations. This is problematic on multiple levels. Rural areas have, on average, older and poorer quality housing stock, which may be perpetuating rural/urban health disparities via the direct and indirect mechanisms described above. Many rural areas also struggle to either provide adequate affordable housing for new residents and/or to manage vacant homes and properties in rural communities where the population is decreasing. Further, housing is deeply intertwined with structural racism, including racist zoning policies like redlining and the relocation of Indigenous populations onto reservation lands. Yet, while the most egregious racial and ethnic health inequities are found among rural residents, very little research focuses on racial differences in the connection between housing and health in rural areas.
The purpose of this project is to identify rural/urban and within-rural differences in housing quality and its relationship to health and disability status, especially for individuals living in poverty. We will also identify rural-specific housing issues and innovative policy solutions to address housing challenges in order to improve rural health.