Excessive Housing Cost Burden

Low-income households that pay more than 35 percent of their gross income for housing are considered to have an excessive housing cost burden. The HCI excessive housing cost burden indicator measures the proportion of neighborhood households, both homeowners and renters, paying more than 35 percent of their gross income for housing; however it is important to note that the HCI measure does not distinguish between low, medium or high income households. High housing costs, especially for moderate to low-income households, often force families to choose between heating, eating, and filling prescriptions. Low-income people struggling to pay high housing costs are less likely to have a usual source of medical care and are more likely to postpone medical treatment and end up in the emergency room. Lack of affordable housing is associated with emotional, behavioral and academic problems among children, and with increased risk of teen pregnancy, early drug use, and depression during adolescence. These impacts can have long-term health consequence. This is an “inverse” measure: the higher the proportion of neighborhood residents paying excessive housing costs, the higher the negative impact on community health. Listed under the Housing domain, excessive housing cost burdens is also relevant to economic health, employment, health systems and public safety, education and neighborhood characteristics. Data for this indicator can be found in the U.S. Census.

Neighborhoodsort descending Indicator Value Rank
Blackstone 22.4% 2
Charles 38.2% 10
College Hill 34.9% 8
Downtown 30.5% 5
Elmhurst 28.7% 3
Elmwood 51.5% 23
Federal Hill 36.5% 9
Fox Point 40.3% 13
Hartford 41.7% 14
Hope 20.1% 1
Lower South Providence 54.2% 25
Manton 45.9% 18
Mount Hope 33.3% 7
Mount Pleasant 29.9% 4
Olneyville 51.1% 22
Reservoir 32.2% 6
Silver Lake 43.7% 15
Smith Hill 44.8% 17
South Elmwood 48.2% 19
Upper South Providence 40.1% 12
Valley 53.6% 24
Wanskuck 48.8% 20
Washington Park 50.6% 21
Wayland 43.7% 15
West End 39.5% 11

Key Citations:
1. Jelleyman T, Spencer N. Residential mobility in childhood and health outcomes: a systematic review. Journal of Epidemiology and Community Health. 2008. 62(7): 584–592.
2. Robert Wood Johnson Foundation. Social Determinants of Health. Published 2011. Accessed December 27, 2013. Available at: www.rwjf.org/en/research-publications/find-rwjf-research/2011/06/what-sh....
3. Kushel MB, Gupta R, Gee L, Haas JS. Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of General Internal Medicine. 2006; Jan;21(1):71-7
4. Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambulatory Pediatrics. 2008; Jan-Feb;8(1):50-7. doi: 10.1016/j.ambp.2007.08.004.
5. McLaughlin KA, Nandi A, Keyes KM, Uddin M, Aiello AE, Galea S, Koenen KC. Home foreclosure and risk of psychiatric morbidity during the recent financial crisis. Psychol Med. 2012; 42(7):1441-8. doi: 10.1017/S0033291711002613. Epub 2011 Nov 21.
6. Ford JL, Browning CR. Neighborhood social disorganization and the acquisition of trichomoniasis among young adults in the United States. Am J Public Health. 2011; Sep;101(9):1696-703. doi: 10.2105/AJPH.2011.300213. Epub 2011 Jul 21.
7. Reid KW, Vittinghoff E, Kushel MB. Association between the level of housing instability, economic standing and health care access: a meta-regression. J Health Care Poor Underserved. 2008; Nov;19(4):1212-28. doi: 10.1353/hpu.0.0068.
8. Stone, Michael E, “Shelter Poverty: New Ideas on Housing Affordability”, Temple University Press, 1993.