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Health Inequalities in Housing: Housing cost burden, Housing assets, and MortalityPark, Gum-Ryeong January 2023 (has links)
Despite a growing body of studies on the relationship between housing and health, it is
unclear whether and how (a) the housing cost burden deteriorates health and whose health
it deteriorates, (b) housing assets interact with income in influencing one’s health, and (c)
protective policy measures alleviate mortality risks predicted by housing cost burden.
This thesis aims to reduce these knowledge gaps. First, in Chapter two, I synthesize prior
literature that focused on the association between housing cost burden and health and
discussed methodological issues. Also, the chapter proposes future research directions.
Chapter three, co-authored with Dr. Michel Grignon, Dr. Marisa Young, and Dr. James R.
Dunn, assesses the potential moderating effect of housing asset level on the link between
income and mortality. Although housing assets and income are independently related to
mortality risks, the value of housing assets did not significantly moderate the link
between income and mortality. Income-related inequalities in mortality are observed
among each group of housing asset level. Our findings offer insight into the importance of
redistribution of resources that can reduce risks of premature mortality and achieve
healthy aging. Chapter four documents that housing cost burden was significantly
associated with preventable mortality, treatable mortality, and suicide during post-Global
Financial crisis (2009-2017). Also, in countries with an increased level of social spending,
higher levels of social housing stock, and rent control, the observed association was
substantially attenuated. Taken together, the findings of the three chapters contribute to understandings about the link between housing and health by (a) synthesizing the prior
literature and mechanisms, (b) estimating housing inequalities in health, and (c)
highlighting the protective roles of social and housing policies that reduce health
inequalities. / Thesis / Doctor of Philosophy (PhD) / This thesis aims to investigate housing inequalities in health and the roles of protective
social and housing policies in reducing health inequalities. The second chapter, as a
scoping review, synthesizes prior literature that estimates the association between housing
cost burden and health, and explores potential mechanisms linking housing cost burden to
health. Chapter three relies on one of the nationally representative linkage datasets in
Canada in order to estimate the association between housing asset, income, and mortality
in Canadian older adults. It reveals that the value of housing assets and income predicts
mortality risks, but housing assets do not significantly change the link between income
and mortality. The fourth chapter examines whether and how housing cost burden is
associated with avoidable mortality in OECD countries. Also, the roles of preventive
measures including social spending and housing policies are revisited. The thesis
strengthens the rationale for identifying housing as one of the important social
determinants of health.
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