• Geoffrey Gusoff, Katherine Chen, Gerardo Moreno, Joann G Elmore, and Frederick J Zimmerman.
• National Clinician Scholars Program at UCLA (University of California, Los Angeles), 1100 Glendon Avenue, Suite 900, Los Angeles, CA, 90024, USA. ggusoff@mednet.ucla.edu.
• J Gen Intern Med. 2023 Sep 1; 38 (12): 271827252718-2725.

BackgroundUS housing policy places a high priority on homeownership, providing large homeowner subsidies that are justified in part by homeownership's purported health benefits. However, studies conducted before, during, and immediately after the 2007-2010 foreclosure crisis found that while homeownership is associated with better health-related outcomes for White households, that association is weaker or non-existent for African-American and Latinx households. It is not known whether those associations persist in the period since the foreclosure crisis changed the US homeownership landscape.ObjectiveTo examine the relationship between homeownership and health and whether that relationship differs by race/ethnicity in the period since the foreclosure crisis.DesignWe conducted a cross-sectional analysis of 8 waves (2011-2018) of the California Health Interview Survey (n = 143,854, response rate 42.3 to 47.5%).ParticipantsWe included all US citizen respondents ages 18 and older.Main MeasuresThe primary predictor variable was housing tenure (homeownership or renting). The primary outcomes were self-rated health, psychological distress, number of health conditions, and delays in receiving necessary medical care and/or medications.Key ResultsCompared to renting, homeownership is associated with lower rates of reporting fair or poor health (OR = 0.86, P < 0.001), fewer health conditions (incidence rate ratio = 0.95, P = 0.03), and fewer delays in receiving medical care (OR = 0.81, P < 0.001) and medication (OR = 0.78, P < 0.001) for the overall study population. Overall, race/ethnicity was not a significant moderator of these associations in the post-crisis period.ConclusionsHomeownership has the potential to provide significant health-related benefits to minoritized communities, but this potential may be threatened by practices of racial exclusion and predatory inclusion. Further study is needed to elucidate health-promoting mechanisms within homeownership as well as potential harms of specific homeownership-promoting policies to develop healthier, more equitable housing policy.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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