Home is where the heart is: Housing and heart health

There's plenty of evidence that the physical state of housing has implications for physical and mental health: if your home is too cold in winter, or is falling apart around you, it's bad for your health. But, perhaps surprisingly, recent research is finding linkages between health and other aspects of housing — such as affordability

The research

One US study looked at data from the National Longitudinal Survey of Youths 1979, a longitudinal study of people born between 1957 and 1964. They looked at risk factors for cardiovascular disease (hypertension, obesity, diabetes, and depressive symptomology) and how these changed from the 2000-2008 period to the 2008-2014 period. The study also looked at changes in area-level housing affordability, in terms of the percentage of income spent on housing costs.

The researchers found a positive relationship between more income spent on housing (ie, worse housing affordability) and more likelihood of cardiovascular risk factors. This relationship was stronger (ie, worse outcomes) for renters vs home-owners. The study also found that although the likelihood of hypertension was higher with worse housing affordability, the likelihood of taking medication for it was lower.

This research shows correlation, but how exactly does worse housing affordability lead to cardiovascular disease? Drawing on other research, the researchers suggest a number of pathways:

  • Material/effect-budgeting. You spend more on housing, so you have less money for health promoting goods. Maybe you also end up working more hours, so you have less time for healthy behaviours. This is perhaps why people who were more likely to have hypertension were less likely to be taking medication for it.
  • Psychosocial stress. Worry and stress about housing costs or potential eviction worsens health.
  • Displacement. Housing costs may push people into disadvantaged neighbourhoods with less access to healthcare.

It's a bit odd to think that housing costs can make you sick. But it shouldn't be a surprise. Your home is central to your life, and so it has a big impact on your health. Cost pressures adversely effect this experience of home, and so affect other things — in this case, the risk of cardiovascular disease.

The implications

The study notes: "[o]verall, the findings from our study suggest that policies designed to constrain housing costs may lead to meaningful improvements in cardiovascular risk."

This makes sense. It suggests that anything governments can do to reduce rents will have positive impacts on cardiovascular health. This can include rent stabilisation measures, preventing rent-bidding, and building more low-cost rental housing for people on low-incomes.

But that's only one part of the picture. The study looked at housing costs as a percentage of income. So we should reduce costs, but we should also increase incomes.

We saw the Commonwealth do this during COVID-19 in 2020 when, almost overnight, people on JobSeeker were finally able to live above the poverty line, if only for a short while. Many of these people spoke about how this boost meant they could afford to eat healthy food, or visit a doctor. Poverty is a policy choice in Australia, and this research suggests that ending poverty will reduce the risk of cardiovascular disease. Other measures to improve incomes would include increasing Commonwealth Rent Assistance, and making sure it is available to more households currently in rental stress. This would reduce cardiovascular risk.

The more we learn about housing and health, the clearer it is that the relationship is holistic. A good-quality, affordable, secure home is a healthy home. And a healthy home is essential for a healthy life. Improving housing affordability is part of enabling healthier communities.