Housing insecurity is associated with increased risk of geriatric conditions and mortality

1. Poor housing affordability and poor housing quality were associated with the development of geriatric conditions and mortality over 5 years.

Evidence Rating Level: 2 (Good)

Housing insecurity is defined by a lack of housing affordability, quality, and stability, and is an important modifiable social determinant of health (SDOH). It is estimated that over 1 in 3 community-living older individuals in the US are experiencing housing insecurity. Yet, research examining the association between housing insecurity and health outcomes among persons aged >65 years is lacking. This study thus examined associations between different forms of housing insecurity and the development of geriatric conditions and mortality. This prospective cohort study used data from the National Health and Aging Trends Study (NHATS) from 2015 to 2020 and included community-living persons aged >65 years in the US. Three forms of housing insecurity were assessed: poor housing affordability, poor housing quality, and poor neighborhood quality. The primary outcomes were time to onset of frailty, disability, and dementia, and time to death over 5 years. In total, 7,499 participants were included in the study (mean [SD] age, 78.2 [7.8] years; 4335 [55.3%] female). After adjusting for covariates, poor housing affordability was associated with a 23% higher risk of frailty (relative risk ratio [RRR], 1.23; 95% CI, 1.01-1.49), 24% higher risk of disability (RRR, 1.24; 95% CI, 1.01-1.54), 37% higher risk of dementia (RRR, 1.37; 95% CI, 1.11-1.69), and 51% higher hazard of mortality (hazard ratio [HR], 1.51; 95% CI, 1.34-1.70). Similarly, poor housing quality was associated with 30% higher risk of frailty (RRR, 1.30; 95% CI, 1.04-1.62), 33% higher risk of disability (RRR, 1.33; 95% CI, 1.13-1.57), and 15% higher hazard of mortality (HR, 1.15; 95% CI, 1.01-1.32), but not significantly associated with dementia (RRR, 1.16; 95% CI, 0.90-1.49). No association was found between poor neighborhood quality and any outcome in the adjusted analyses. Overall, this study found that poor housing affordability and poor housing quality were associated with the development of geriatric conditions and mortality over 5 years among older persons. These findings indicate that housing insecurity is a clinically relevant social determinant of health among this population.

Click here to read this study in JAMA Network Open

Image: PD

©2026 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.