Housing Cost Burden and Health Decline Among Low- and Moderate-Income Older Renters.

Objective: To examine the association between housing cost burden (HCB) and health decline among low- and moderate-income older renters in the United States.

Method: Baseline data include low- and moderate-income community-dwelling older renters (N = 1,064) from the nationally representative 2015 National Health and Aging Trends Study. HCB was defined as the percentage of monthly income spent on rent, categorized as "no HCB" (<30%), "moderate HCB" (30%-49%), and "severe HCB" (≥50%). We used weighted logistic regression models to estimate whether HCB status in 2015 and change in HCB between 2015 and 2017 were associated with self-rated health decline and developing a new limitation related to activities of daily living (ADL) or instrumental activities of daily living (IADL) between 2015 and 2017.

Results: Older renters with severe HCB in 2015 were the most likely to develop a new ADL/IADL limitation (63.4%) over time (p < .05). The association between HCB status in 2015 and self-rated health decline was not statistically significant, but older renters with persistent HCB had 1.64 times greater odds of self-rated health decline (p < .05) and 2.01 times greater odds of developing a new ADL/IADL limitation (p < .01), compared to older renters with no HCB at baseline and follow-up.

Discussion: Even in the short term, HCB contributes to health decline in later life. Efforts to promote equity and healthy aging in the community must consider how to best address housing affordability among the growing population of older renters.