Severe Housing Problems in Montana

Montana

Housing influences health and well-being. Those lacking at least one basic household necessity (bathtub/shower, sink with faucet, stove or refrigerator) have higher rates of being uninsured. Poor quality of housing can cause disease and injury, while other housing-related factors such as neighborhood environment and overcrowding can lead to mental and physical health problems. 

Housing issues that can impact health include, but are not limited to:

• Affordability: Cost-burdened families may have difficulty affording other basic needs such as health care, food and heat. Individuals who have difficulty affording housing are more likely to report fair or poor health, certain chronic conditions and nonadherence to prescriptions due to cost.
• Hazards: Hazards in the home, such as lead paint, allergens, water leaks, poor ventilation and inadequate heating, cooling or plumbing, are associated with poor respiratory health and disease, increased risk of cardiovascular conditions and developmental delays in children. 
• Overcrowding: Defined as housing with multiple occupants per room, overcrowding is associated with an increased risk of poor mental health and infectious disease.

Those with a greater risk of experiencing housing-related health conditions include: 

• Low-income families and individuals.
• Racial/ethnic minorities.
• Renters.
• Children and older adults.

Evidence supports various interventions to prevent and minimize the impact of housing problems on health. Healthy Home programs have improved health by remedying hazardous housing conditions, such as lead hazards, inadequate ventilation and excess moisture. The Centers for Disease Control and Prevention offers more information and guidelines in their Healthy Housing Reference Manual, a comprehensive resource for public health and housing professionals. The National Low Income Housing Coalition provides additional resources and policy recommendations for housing challenges.

Increasing affordable housing options through local and national housing development policies, rental vouchers and subsidized housing programs can help cost-burdened individuals afford housing. More collaboration between the housing and health sectors is needed to promote healthy home environments and to better integrate health care into public housing systems, particularly for those with chronic health needs.

Healthy People 2030 identifies the quality of housing as a key issue in the neighborhood and built environment domain and has a goal to reduce the proportion of families who spend more than 30% of their income on housing.

Braveman, Paula, Mercedes Dekker, Susan Egerter, Tabashir Sadegh-Nobari, and Craig Pollack. “Housing and Health.” Issue Brief #7: Exploring the Social Determinants of Health. Robert Wood Johnson Foundation Commission to Build a Healthier America, May 2011. https://www.rwjf.org/en/library/research/2011/05/housing-and-health.html.

Donald, Ian P. “Housing and Health Care for Older People.” Age and Ageing 38, no. 4 (July 1, 2009): 364–67. https://doi.org/10.1093/ageing/afp060.

Gibson, Marcia, Mark Petticrew, Clare Bambra, Amanda J. Sowden, Kath E. Wright, and Margaret Whitehead. “Housing and Health Inequalities: A Synthesis of Systematic Reviews of Interventions Aimed at Different Pathways Linking Housing and Health.” Health & Place 17, no. 1 (January 2011): 175–84. https://doi.org/10.1016/j.healthplace.2010.09.011.

Marcia Fernald, ed. “The State of the Nation’s Housing 2022.” Cambridge, MA: Joint Center for Housing Studies of Harvard University, 2022. https://www.jchs.harvard.edu/sites/default/files/reports/files/Harvard_JCHS_State_Nations_Housing_2022.pdf.

Pollack, Craig, Susan Egerter, Tabashir Sadegh-Nobari, Mercedes Dekker, and Paula Braveman. “Where We Live Matters for Our Health: The Links Between Housing and Health.” Issue Brief 2: Housing and Health. Robert Wood Johnson Foundation Commission to Build a Healthier America, September 2008. http://www.commissiononhealth.org/PDF/e6244e9e-f630-4285-9ad7-16016dd7e493/Issue Brief 2 Sept 08 - Housing and Health.pdf.

Pollack, Craig Evan, Beth Ann Griffin, and Julia Lynch. “Housing Affordability and Health Among Homeowners and Renters.” American Journal of Preventive Medicine 39, no. 6 (December 2010): 515–21. https://doi.org/10.1016/j.amepre.2010.08.002.

Sandel, Megan, and Matthew Desmond. “Investing in Housing for Health Improves Both Mission and Margin.” JAMA 318, no. 23 (December 19, 2017): 2291–92. https://doi.org/10.1001/jama.2017.15771.

Swope, Carolyn B., and Diana Hernández. “Housing as a Determinant of Health Equity: A Conceptual Model.” Social Science & Medicine 243 (December 2019): 112571. https://doi.org/10.1016/j.socscimed.2019.112571.

Taylor, Lauren. “Housing and Health: An Overview of the Literature.” Health Affairs Health Policy Brief. Robert Wood Johnson Foundation, June 7, 2018. https://doi.org/10.1377/hpb20180313.396577.