The Effect of the Foreclosure Crisis on Health
- Author(s): Downing, Janelle
- Advisor(s): Rodriguez, Hector
- et al.
Foreclosure rates reached unprecedented levels in the United States during the Great Recession. During 2010, one in 45 housing units nationwide received a foreclosure filing. Residents who lived near properties in foreclosure from 2007 to 2012 lost an estimated collective $2.2 trillion in property values, local governments tax base declined, and affected communities experienced an increase in crime and blight. In the aftermath of the foreclosure crisis, little is known about how the foreclosure crisis affected the health of homeowners who lost their homes to foreclosure and the health of residents living in communities hit hard by the crisis. This dissertation, made up of three papers, first explores the explicit and implicit theories evoked by the literature in this space, and then empirically tests the hypothesis that the foreclosure crisis had spillover effects on health. The first paper systematically reviews the existing, early-stage research on foreclosures and health by presenting an organizational schema based on level of analysis, type of housing distress measure, and health outcome. In addition, the review describes the specific mechanisms linking foreclosures and health, and how this field aligns and departs from the larger body of work on recessions and health. The second and third papers empirically test if the foreclosure crisis has an impact on glycemic control (hemoglobin A1c) and weight change of patients in a large clinical population of continuously insured patients with diabetes living in the Bay Area of California during 2007 to 2010. The three primary conclusions from this work are: 1) there was no evidence of a spillover effect of the foreclosure crisis on A1c or weight change among patients in a managed care system; 2) the pathways by which health is influenced by experiencing a foreclosure compared to living near a foreclosure are distinct and vary based on the manner in which the exposure and outcome are operationalized; 3) housing and labor market factors appear to have related yet discrete repercussions on health and healthcare.