The Effects of Housing Cost Burden and Housing Tenure on Moves to a Nursing Home Among Low- and Moderate-Income Older Adults

Abstract

Background and Objectives In the United States, a growing number of older adults struggle to find affordable housing that can adapt to their changing needs. Research suggests that access to affordable housing is a significant barrier to reducing unnecessary nursing home admissions. This is the first empirical study we know of to examine whether housing cost burden (HCB) is associated with moves to nursing homes among older adults. Research Design and Methods Data include low- and moderate-income community-dwelling older adults (N = 3,403) from the nationally representative 2015 National Health and Aging Trends Study. HCB (≥30% of income spent on mortgage/rent) and housing tenure (owner/renter) are combined to create a 4-category housing typology. Multinomial logistic regression models test (a) if renters with HCB are most likely (compared with other housing types) to move to a nursing home over 3 years (2015–2018) and (b) if housing type interacts with health and functioning to predict moves to a nursing home. Results Across all models, renters with HCB had the greatest likelihood of moving to a nursing home. Moreover, self-rated health, physical capacity, and mental health were weaker predictors of nursing home moves for renters with HCB. Discussion and Implications Results suggest that older renters with HCB are most likely to experience unnecessary nursing home placement. The growing population of older renters experiencing HCB may not only signal a housing crisis, but may also challenge national efforts to shift long-term care away from nursing homes and toward community-based alternatives.

Enhancing Well-Being and Social Connectedness for Māori Elders Through a Peer Education (Tuakana-Teina) Programme: A Cross-Sectional Baseline Study

“…Problems with current housing was negatively associated with self-rated health, HRQOL and life satisfaction. Having a stable and positive housing situation is important for older people who desire to age in place and to age well ( 59 , 60 ). These factors are particularly important for people who are retired and living on a pension or other retirement income ( 60 ).…”

“…Having a stable and positive housing situation is important for older people who desire to age in place and to age well ( 59 , 60 ). These factors are particularly important for people who are retired and living on a pension or other retirement income ( 60 ). This is a key element in Aotearoa as Māori home ownership is lower than that of Pākehā [New Zealand European and there are escalating rental prices ( 61 )].…”

Inequality in housing transitions during cognitive decline

“…Homeowners have greater security of tenure than renters, and so are often able to remain longer in their homes [22,49]. Prior studies have found that renters have an increased likelihood of transitioning to a nursing home or assisted living [50,51] and people who live in their homes longer are less likely to move in older age [52]. Older homeowners who have paid off their mortgages bear minimal housing costs, and also may have substantial home equity which can be used to finance moves and/or long-term care [53,54].…”

He kāinga pai rawa: Te Kete Mātauranga mō te hanga whare tino pai rawa: a knowledge basket to support building affordable and safe housing for kaumātua

“…In addition, housing cost burden (e.g. 30% or more of income on housing) increases the likelihood of a shift to a nursing home (Jenkins Morales & Robert, 2020). Furthermore, lack of age-friendly housing is a barrier to ageing in place (Frochen & Pynoos, 2017; Luciano et al, 2020).…”