New study shows a link between housing lacking in basic amenities and health insurance

​There has been recent buzz around looking at how certain factors such as income, education, employment, and access to resources impact health. For example, recent studies have looked at the relationship between housing and health outcomes, positing that unstable housing relates to poor health. However, there is little evidence on the link between housing and health insurance coverage, as well as whether the passage of the Affordable Care Act (ACA) and Medicaid expansion plays a role in this relationship.

A recent fact sheet by researchers at the UCLA Center for Health Policy Research and Claremont Graduate University shows that people who have complete housing amenities are more likely to have health insurance than those who are missing at least one amenity, both before and after the ACA’s implementation and independent of income. Missing amenities include housing that lacks a bathtub or shower, sink with a faucet, stove or range, or refrigerator.

“We found that people who may otherwise have access to no-cost insurance such as Medicaid are struggling to maintain basic necessities,” said Deborah Freund, lead author of the study and an economic sciences professor at Claremont Graduate University.

Using data from the American Community Survey from 2013 to 2018, researchers looked at the percentage of adults up to 64 years old who were uninsured based on whether they had all basic home necessities versus people who were missing at least one of those features. They found that those missing at least one basic home necessity and having incomes less than 100% of the Federal Poverty Level (FPL) had the highest uninsured rates in 2013 (33.5%) and 2018 (23%) compared with those who had all basic necessities (27.4% in 2013 and 17% in 2018). The same trend was true for people with income levels of 100-399% FPL and 400% FPL – though the differences were not drastically different in the highest income category.

“Future research should look more closely at housing as a social determinant of health, especially in relation to insurance coverage, as there may be important factors – lack of awareness of available resources, life burdens, and other budget priorities – uncovered that should be addressed to bridge the gap in needs and services for underserved communities,” Freund said.

This study was conducted jointly by the UCLA Center for Health Policy Research and the Claremont Graduate University with support from the A-Mark Foundation. This is in addition to a fact sheet on the link between education and insurance coverage, and will be part of a larger report examining several other factors.

About the UCLA Center for Health Policy Research
The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.