Housing and Health: A Social Ecological Perspective on the US Foreclosure Crisis

Abstract

This study adds to the literature linking housing and health by illustrating how poor health can increase the risk of foreclosure, and how the threat of foreclosure can negatively affect mental health. Our findings support the social ecological model of health and housing disparities and point to health care, employment, and social welfare policies as fundamental social causes that place populations at risk for foreclosure and illness. Medical debt, illness and injury, lack of adequate health insurance, as well as caring for extended family are triggers for mortgage delinquency and risk of home loss. Poor health becomes a key point of entry into mortgage delinquency and foreclosure. Changes in mental health may result from the stress and anxiety of financial hardship, from efforts to remedy the situation, and from loss of ontological security. These effects may worsen prospects for avoiding foreclosure by impairing decision-making, straining marriages to the point of divorce, and reducing homeowners’ earning capacities. These findings are based on a secondary analysis of data from 14 focus groups conducted with low- and moderate-income homeowners threatened with foreclosure and foreclosure intervention professionals in five cities in the USA.

Keywords:

• Foreclosure
• Housing
• Health
• Social ecology
• Neoliberalism

Acknowledgements

The authors acknowledge Francine Justa, Heléne Clark, Jared Becker and Brion Paul for their support and assistance in conducting this research. We also thank Terry Hartig for his editorial comments on earlier drafts of this work. This study received financial support from: Freddie Mac, Neighborworks America, The Heron Foundation, Federal Home Loan Bank of New York, M and T Charitable Trust, St. Paul-Travelers, State Farm Insurance, BPD Bank, Washington Mutual, Sterling National Bank and Ridgewood Savings Bank. However the findings and views expressed are those of the authors; they do not necessarily reflect, and are not based on, the views of our sponsors.

Notes

1. We have written extensively on the contributions of neoliberal practice to the expansion of homeownership and the foreclosure crisis. In Saegert, Fields & Libman (2009) we highlight the contradictions between the rhetorical goals of homeownership and the lived experiences of homeowners. And in Fields, Libman & Saegert (2010) we revisit these themes in the context of a review of the policies, programs and legal processes that structure the experience of mortgage delinquency and foreclosure in the USA. In an international context, the application of neoliberalism to US housing and financial policy may be relatively extreme in that it incentivizes lenders to repossess homes in lieu of timely mortgage payments and leaves homeowners and foreclosed households without protection from homelessness and the long term negative financial impacts of losing their homes.

2. The cost of such an ad in New York City is prohibitive and the response to our initial mailing in St. Louis was so strong that an ad was not required there.

3. Because this study did not initially set out to examine the relationships between health, mortgage delinquency and foreclosure, health-specific questions were not included in the data collection protocols. Thus we cannot determine and describe how people decided on whether to prioritize paying health or housing debts.