Poster Topical Area: Community and Public Health Nutrition

Location: Auditorium

Poster Board Number: 136

P06-115 - Home Not-Sweet Home: US families behind on mortgage payments are also in danger of food insecurity and health problems.

Monday, Jun 11
8:00 AM – 3:00 PM

Introduction: In 2015, 15.5% of US renter households were food insecure compared to 4.9% of homeowners, suggesting homeownership may protect against food insecurity. However, economic stress due to housing cost is not limited to renter households. Children and caregivers in renter households behind on rent are known to have worse health and experience more material hardships, but these outcomes have not been examined among homeowners.

Objectives: To identify child and caregiver health and hardship outcomes associated with being behind on mortgage payments (BOM).


Methods: From 2009 to 2017, 29,470 caregivers of children younger than 4 years were interviewed at five urban teaching hospitals. Interviews included socioeconomic, demographic, and health items. Housing stability (HS) was defined as: 1) not being behind on mortgage or rent in the past 12 months, 2) having fewer than two residential moves in the past 12 months, and 3) no history of homelessness. Multivariable logistic regression tested associations of BOM with health of children and caregivers and household material hardships<./p>


Results: Among homeowners, 17.8% reported being BOM in the past 12 mos. Compared to children and caregivers with HS, those BOM had higher aORs of household food insecurity [aOR: 5.17 (95% CI: 4.21-6.34)], child food insecurity [aOR: 4.55 (95% CI: 3.51-5.89)], household forgone healthcare [aOR: 3.09 (95% CI: 2.52-3.78)], and child forgone care [aOR: 2.27 (95% CI: 1.53-3.38)]. Those BOM also had significantly greater adjusted odds ratios (aORs) for child lifetime hospitalizations [aOR: 1.22 (95% CI: 1.01-1.47)], child developmental risk [aOR: 1.38 (95% CI: 1.04-1.82)], caregiver fair/poor health status [aOR: 2.25 (95% CI: 1.84-2.76)], and maternal depressive symptoms [aOR: 2.28 (95% CI: 1.85-2.81)].


Conclusions: Families achieving the American dream of owning a home, but falling behind on mortgage payments, demonstrate worse health and hardship outcomes, similar to housing cost-stressed renter families. A home of one's own may not be protective against adverse health outcomes and household hardships. Public health providers and policy makers must consider housing cost stress, among both renters and homeowners, in strategies for addressing food insecurity and other social determinants of health.




Funding Source: Anonymous donor.

CoAuthors: Diana Cutts, MD – Children's HealthWatch; Stephanie Ettinger de Cuba, MPH – Children's HealthWatch; Megan Sandel, MD, MPH – Children's HealthWatch; Sharon Coleman, MS, MPH – Children's HealthWatch; John Cook, PhD, MAEd – Children's HealthWatch

Ana Poblacion

Postdoctoral Fellow
Children's HealthWatch
Cambridge, Massachusetts