Using a Public Health Lens to Understand and Address the Foreclosure Crisis

By Katherine Schaff, MPH

This is the first of a three-part series on foreclosure and health.

In 2006, the number of foreclosures began to rapidly increase across the United States, disproportionately affecting African-American and Latino communities. The effects of the crisis continue to reverberate across the nation. With over 13 million homes foreclosed on between 2008 and 2013, communities face blighted properties and a smaller tax base while speculators scoop up properties, contributing to gentrification and displacement. The origins of the sub-prime mortgage crisis, and resulting waves of foreclosures, are complex, as are the solutions. However, across the country, public health workers, researchers, and community-based organizations are becoming involved in using a public health lens to both understand the crisis and develop solutions, as well as organize for change across neighborhoods and sectors.

Many people facing a foreclosure drain their retirement and savings in an attempt to save their home and face profound grief, material hardships, and health problems. A growing body of research utilizing diverse methods show how foreclosures affect both individual and community health. A 2010 Causa Justa::Just Cause and Alameda County Public Health Department report on foreclosure and health summarizes much of this literature and provides an insightful diagram (see page 6) of the multiple pathways from foreclosure to health, supported by literature and local data.

How does foreclosure affect the health of individuals?

At the individual level, a homeowner going through foreclosure or a renter whose landlord undergoes foreclosure can face housing, work, and school instability, increased financial pressure, and a disruption of social networks. This can increase depression and stress; decrease housing options; increase the likelihood of moving to substandard housing; decrease the amount individuals are able to pay for food, medical care, and transportation; decrease individual and family wealth; and potentially lead to homelessness. These factors are, in turn, associated with statistically significant increases in: hypertension, heart disease, psychiatric conditions, renal disease, visits to the emergency room, cost-related healthcare non-adherence, and cost-related prescription non-adherence. A recent study suggests the foreclosure crisis may be partly responsible for a rise in suicides. In another study, 60% of respondents in the process of foreclosure had skipped or delayed meals because they couldn’t afford food and 48% had skipped filling a prescription. Residents in Oakland, CA experiencing foreclosure were 1.6 times more likely to report their physical health had become worse and two times more likely to report their mental and emotional health had worsened over the past two years than those not undergoing foreclosure.

How does foreclosure affect the health of communities?

Foreclosures affect more than the individuals that lose their homes. They impact communities. As foreclosure rates rise, negative health impacts are seen throughout the neighborhood. At the community level, foreclosures: decrease property values and tax revenue, which in turn, affects local governmental funding for services that affect health; degrade the social and physical infrastructure of neighborhoods; increase home vacancies and property abandonment, which is associated with a rise in crime and vector-borne illnesses, like West Nile; and affect community health for both those undergoing foreclosure and those who live nearby but are not undergoing foreclosure. Greenberg and Schneider studied the connection between abandoned sites, such as factories, warehouses, and project housing, and violent death. While they did not include foreclosed properties in their analysis, they did show a connection between abandoned sites and higher rates of violent death for neighborhood residents, including homicide, suicide, poisoning/drug abuse, falls, and fires. Recent research shows that residents in neighborhoods with higher rates of foreclosure are also more likely to have higher blood pressure and higher rates of obesity than in neighborhoods with lower rates of foreclosure, potentially due to heightened stress residents face in knowing that their neighbors and neighborhood are facing financial and housing crises.

What does this mean for public health practitioners and researchers?

Across the country, public health researchers and practitioners are becoming engaged in addressing the foreclosure crisis. Before focusing on solutions in the third blog of this series, tomorrow’s follow-up blog will summarize the link between foreclosure, wealth, and health.

Katherine Schaff, MPH, is a Doctor of Public Health candidate at UC Berkeley and is studying how local health departments are engaging in and communicating about the foreclosure crisis. She can be reached at