Struggles with housing costs during pandemic linked to lack of health care for many Californians

UCLA survey finds one-third of those with housing affordability issues delayed needed medical care

couple sitting on the floor looking at bills

One of California’s ongoing challenges that was magnified by the COVID-19 pandemic was the lack of affordable housing. Now, a report published by the Fielding School's UCLA Center for Health Policy Research (CHPR) draws a strong connection between residents’ struggle to pay for housing and a lack of access to health care.   

The report is based on responses to the 2021 California Health Interview Survey (CHIS), which is conducted by UCLA CHPR. 

Across the state, the CHIS found that 1 in 10 adults — or 3 million people — had difficulty paying to keep a roof over their heads in 2021. While 5.0% of homeowners said they had difficulty making mortgage payments, the situation was more dire for renters, 18.6% of whom said they had trouble paying their landlords. In addition, housing instability — caused by overcrowded living situations or a need to move frequently, for example — was an issue for 4.4% of California adults, or about 1.39 million people. 

The report suggests that those factors negatively affected people’s use of health care resources. The survey also found that 33.6% of adults who faced housing affordability issues delayed needed medical care.

And 15.5% of adults who struggled to afford housing reported that they did not have health insurance, compared with 6.8% of those adults who did not experience challenges with housing costs.

“Housing issues are public health issues because of how they affect people’s health and well-being,” said Sean Tan, a senior public administration analyst at UCLA CHPR. “People struggling to pay for housing have been shown to cut back on health care and basic necessities, leading to poorer overall health.”  

In addition, 10.0% of those who struggled with housing costs said they cut back on purchasing healthy and nutritious food.

Among the other findings:

  • 18.8% of noncitizen residents struggled to pay for housing, versus 9.1% of citizens. (In 2021, about two-thirds of noncitizens rented their homes, while one-third of California adults who are U.S. citizens rented their homes.)
  • 14.2% of Latinos and 14.0% of Black or African American adults struggled with housing costs, versus 6.7% of white adults.
  • 14.7% of lesbian, gay and bisexual adults struggled with housing costs, versus 9.8% of heterosexual adults.
  • 21.6% of transgender or gender-nonconforming adults struggled to pay for housing, compared with 10.2% of cisgender adults.

“There is an urgent need to address the issue of housing affordability in California,” said Dr. Ninez A. Ponce, director of UCLA CHPR, principal investigator of CHIS, and professor and chair of the Department of Health Policy and Management. “State representatives and policymakers must prioritize California’s marginalized communities, who are struggling to gain access to basic human needs.”

The study’s authors write that the situation could be improved with a combination of measures, including strengthening renter eviction protections, funding more affordable housing developments and eliminating barriers to building affordable housing.  

By Vanessa Villafuerte