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. 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.

The purpose of this project was 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 also identified rural-specific housing issues and innovative policy solutions to address housing challenges in order to improve rural health.

Publications

• Key Informant Perspectives on Rural Housing and Health
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 10/2023
  In this policy brief, using content analysis of interview data, researchers share rural-specific housing barriers, including those that are related to health, as well as policy recommendations for addressing housing challenges to improve rural health.
• Rural-Urban Differences in Housing Cost Burden Across the U.S.
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 03/2024
  Housing is closely tied to health and well-being, but affordable housing is out of reach for many households. This policy brief examines the proportion of households who are housing cost burdened by rural-urban location across different U.S. geographic spaces in order to identify how housing affordability varies by location.