Housing is a well-recognized social determinant of health, with direct impacts on health outcomes (e.g., mortality, disability, falls, and asthma), especially for lower-income individuals with fewer resources to afford safe, accessible, and high-quality housing. Housing is directly related to environmental exposures, including lead paint, mold, mildew, pests, air quality, access to cooking equipment and refrigeration, and water and sewage quality, all of which can have deleterious short and long-term health impacts. Housing is also directly related to financial stability, in that it constitutes both one of the largest regular household expenses that people have and that it can be a way to build financial stability, wealth, and equity for those who own property. In turn, the financial risks and rewards associated with housing can impact health and racial equity. Housing also takes on particular relevance for people with disabilities, for whom the home environment may inhibit or promote functional independence depending on its physical characteristics.

While housing has long been a focus of population health research, such research has rarely included or focused on rural populations. This is problematic on multiple levels. Rural areas have, on average, older and poorer quality housing stock, which may be perpetuating rural/urban health disparities via the direct and indirect mechanisms described above. Many rural areas also struggle to either provide adequate affordable housing for new residents and/or to manage vacant homes and properties in rural communities where the population is decreasing. Further, housing is deeply intertwined with structural racism, including racist zoning policies like redlining and the relocation of Indigenous populations onto reservation lands. Yet, while the most egregious racial and ethnic health inequities are found among rural residents, very little research focuses on racial differences in the connection between housing and health in rural areas.

The purpose of this project was to identify rural/urban and within-rural differences in housing quality and its relationship to health and disability status, especially for individuals living in poverty. We also identified rural-specific housing issues and innovative policy solutions to address housing challenges in order to improve rural health.

Publications

• Crowded Housing and Housing Cost Burden by Disability, Race, Ethnicity, and Rural-Urban Location
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 03/2023
  Housing is closely tied to health outcomes and well-being; however, little research examines housing factors by location. In this policy brief, we examine rates of crowded housing and housing cost burden by rural-urban location, as well as at the intersections of race, ethnicity, and disability status.
• Differences in Residential Stability by Rural/Urban Location and Socio-Demographic Characteristics
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 08/2023
  This policy brief identifies rural/urban differences in residential stability and examines rural/urban differences in regional, socio-demographic, and health characteristics associated with living in the same home for more than 20 years.
• Housing for Rural Residents Recovering from Substance Use Disorders
  University of Minnesota Rural Health Research Center
  Date: 05/2024
  The purpose of this case series is to highlight organizations providing housing for individuals in recovery from substance use disorders in rural communities. These may serve as examples to others considering this work.
• Housing Quality by Disability, Race, Ethnicity, and Rural-Urban Location: Findings From the American Community Survey
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 07/2023
  In this policy brief, researchers examine rates of two key housing quality indicators (having incomplete plumbing and incomplete kitchen facilities) by rural-urban location, as well as at the intersections of racial/ethnic identity and disability status.
• Key Informant Perspectives on Rural Housing and Health
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 10/2023
  In this policy brief, using content analysis of interview data, researchers share rural-specific housing barriers, including those that are related to health, as well as policy recommendations for addressing housing challenges to improve rural health.
• Rural-Urban Differences in Housing Cost Burden Across the U.S.
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 03/2024
  Housing is closely tied to health and well-being, but affordable housing is out of reach for many households. This policy brief examines the proportion of households who are housing cost burdened by rural-urban location across different U.S. geographic spaces in order to identify how housing affordability varies by location.
• Rural/Urban Differences in Housing Quality and Adequacy: Findings From the American Housing Survey, 2019
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2024
  In this policy brief, researchers identify rural/urban differences in various measures of housing quality using a nationally representative survey.
• Rural/Urban Differences in Receipt of Governmental Rental Assistance: Relationship to Health and Disability
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 10/2023
  Housing is a vital component of health, and governmental rental assistance is one avenue of increasing access to affordability. In this paper, researchers examined rural/urban and within-rural differences in receipt of governmental rental assistance, with a focus on differences by health and disability.