This predictor assessment describes the effect that housing instability and homelessness can have on a stable and healthy living environment, as well as mental and physical health. Housing stability is important for the predictability of day-to-day life. Housing instability means needing to adjust to different communities and institutions. Children may need to change schools and establish new peer groups, which can make doing well in school difficult. Adults have different commutes to work and face barriers to maintaining stability for themselves and their family as they adjust to establishing a new routine and managing the emotional disruption of a new home and neighborhood environment. This compromises the economic success of the household and the economic prospects of the children. Experiencing homelessness can be stressful and traumatic for a household. Possessions must be limited, and concerns about meeting basic human needs, such as securing food and having a safe space to sleep, become daily emergencies, leading to a loss of power and autonomy.

Evidence of the Relationship between Predictor and Related Outcomes

• Experiencing an eviction leads to financial instability. “The likelihood of being laid off is 15 percent higher for workers who have experienced an eviction,” compared with those who have never been evicted (Desmond 2016, 296). After experiencing a period of housing instability, households are often forced into lower-income communities with higher crime rates and fewer employment opportunities (Desmond 2016; Kull, Coley and Lynch 2016).
• Residential stability is the basis of psychological stability, which allows people to invest in their social relationships, communities, health, and education (Desmond 2016).
• Kull, Coley, and Lynch (2016) find that after experiencing housing instability and homelessness, low-income households with children in the Three-City Study (Boston, Chicago, and San Antonio) were more likely to experience additional periods of housing instability. Controlling for family characteristics, housing problems—such as peeling paint and exposed wires—were positively associated with residential moves, with each additional housing problem predicting a 6 percent increase in the rate of residential moves. Compared with families who lived in private-market rental units, families who moved into assisted housing experienced a 14 percent decrease in the rate of residential moves. Families who moved into owned homes experienced a 37 percent decrease in the rate of mobility. This suggests that assisted housing can create a more stable living environment. Kull, Coley, and Lynch (2016) note a body of literature that demonstrates that frequent residential moves are associated with lower cognitive and social functioning among children, higher maternal psychological distress, and heightened parenting stress.
• Renters who have been evicted are 25 percent more likely to experience long-term housing instability (Desmond 2016).
• Housing instability was also associated with barriers to health care and the increased use of emergency services (Kushel et al. 2006). Suicides attributed to evictions and foreclosures doubled between 2005 and 2010 in the wake and aftermath of the Great Recession (Desmond 2016).
• Living in a crowded home in Los Angeles has statistically significant negative effects on children’s math and reading scores, internal and external behavioral problems, and physical health, controlling for parents’ education, income, and demographic characteristics (Solari and Mare 2012).
• Burgard, Seefeldt and Zelner (2012) find that many, but not all, types of housing instability are associated with poorer health. After controlling for sociodemographic characteristics and earlier health, people who had moved for cost reasons in the previous three years were nearly two and a half times as likely to report a recent anxiety attack as those who had not moved for cost reasons. People who had experienced homelessness in the previous year were nearly four times as likely to report “fair” or “poor” health and were more than six times as likely to meet criteria for major or minor depression as their counterparts who had not experienced homelessness. Renters behind on rental payments were more than three and a half times as likely to meet criteria for depression as those not behind on their payments. Mortgage holders behind on their mortgages or in foreclosure were about three times as likely to report “fair” or “poor” health and more than three and a half times as likely to report a recent anxiety attack. Among respondents who had ever owned a home, those who had recently completed a foreclosure were more than five and a half times as likely to report major or minor depression and about three and half times as likely to report an anxiety attack. However, frequent moves were not associated with poorer health, and doubling up and eviction were not associated with poorer health after adjustments for characteristics that sort people into different housing instability experiences.

How Investments Can Influence the Predictor at State or Local Levels

To prevent homelessness before it starts, communities can identify households and neighborhoods with high rates of housing instability and offer them resources and supports. Successful, evidence-based approaches to homelessness prevention include eviction prevention and early interventions to reconnect people with relatives (Oudshoorn et al. 2020). Other local prevention strategies include screening people as they exit local programs to assess their housing needs and ensure they have a housing placement (Cunningham et al. 2021; Ecker et al. 2019; Pergamit, McDaniel, and Hawkins 2012; Solari, DuBois, and Morales-Burnett 2020). The local programs may be health-related programs, such as overnight substance use treatment; programs geared toward people in transition out of foster care or people exiting jail or prison; or any other programs with participants who may face housing instability or homelessness. Localities can also assess the rent burden of their area to set rent-controlled units and increase the supply of affordable housing. Zoning laws can be changed to facilitate construction of affordable housing, and funds can be set aside to restore existing housing that will be reserved for those experiencing rent burden.

References

The primary reference is marked with an asterisk.

Burgard, Sarah A., Kristin S. Seefeldt, and Sarah Zelner. 2012. “Housing Instability and Health: Findings from the Michigan Recession and Recovery Study.” Social Science & Medicine 75 (12): 2215–24.

Cunningham, Mary, Devlin Hanson, Sarah Gillespie, Michael Pergamit, Alyse D. Oneto, Patrick Spauster, Tracey O’Brien, Liz Sweitzer, and Christine Velez. 2021. Breaking the Homelessness-Jail Cycle with Housing First: Results from the Denver Supportive Housing Social Impact Bond Initiative. Washington, DC: Urban Institute.

* Desmond, Matthew. 2016. Evicted: Poverty and Profit in the American City. New York: Crown.

Ecker, John, Pamela Sariyannis, Sarah Holden, and Elisa Traficante. 2019. Bridging the Gap’s Host Homes Program: Process and Outcomes Evaluation. Toronto: Canadian Observatory on Homelessness; Raising the Roof.

Kull, Melissa A., Rebekah Levine Coley, and Alicia Doyle Lynch. 2016. “The Roles of Instability and Housing in Low-Income Families’ Residential Mobility.” Journal of Family and Economic Issues 37 (3): 422–34.

Kushel, Margot B., Reena Gupta, Lauren Gee, and Jennifer S. Haas. 2006. “Housing Instability and Food Insecurity as Barriers to Health Care among Low-Income Americans.” Journal of General Internal Medicine 21 (1): 71–77.

Oudshoorn, Abe, Erin Dej, Colleen Parsons, and Stephen Gaetz. 2020. “Evolving an Evidence-based Model for Homelessness Prevention.” Health and Social Care in the Community 28 (5): 1754–63.

Pergamit, Michael R., Marla McDaniel, and Amelia Hawkins. 2012. Housing Assistance for Youth Who Have Aged Out of Foster Care: The Role of the Chafee Foster Care Independence Program. Washington, DC: US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.

Solari, Claudia D., Nicole DuBois, and Jorge Morales-Burnett. 2020. Community Strategies to Understand and Reduce Veteran Inflow into Homelessness. Washington, DC: Urban Institute.

Solari, Claudia D., and Robert D. Mare. 2012. “Housing Crowding Effects on Children’s Wellbeing.” Social Science Research 41 (2): 464–76.