America's foreclosure epidemic is hitting homeowner's mental health as hard as their wallets, a new study finds.
Researchers at the University of Pennsylvania School of Medicine analyzed mental health factors of 250 Philadelphia homeowners undergoing foreclosure.
Nearly half of people studied reported depressive symptoms, and 37 percent met screening criteria for major depression. (Symptoms of major depression include trouble sleeping, feelings of hopelessness and worthlessness, irritability, trouble focusing, fatigue, and thoughts of suicide.)
Nearly 60 percent reported that they had skipped or delayed meals because they couldn't afford food. And 48 percent of people undergoing foreclosure reported having forgone filling a prescription because of the expense during the preceding year compared with only 15 percent of those who weren't being forcelosed upon.
The authors say their findings, detailed online in the American Journal of Public Health, should serve as a call for policy makers to tie health interventions into their response to the nation's ongoing housing crisis.
"The foreclosure crisis is also a health crisis," said lead author Dr. Craig E. Pollack, who conducted the research while working as an internist and Robert Wood Johnson Foundation Clinical Scholar at Penn. "We need to do more to ensure that if people lose their homes, they don't also lose their health."
Because the financial hardships of foreclosure may lead homeowners to cut back on health care spending that they consider "discretionary" — preventive care visits, healthy foods or drugs for chronic conditions like hypertension — Pollack worries that the prolonged period of time that most homeowners spend in foreclosure could have a serious effect on health outcomes.
The stress of undergoing foreclosure may exacerbate health-undermining behaviors, Pollack warned. Among the participants who smoke, for instance, 65 percent said they had been smoking more since they received notice of foreclosure.
The researchers also found that compared to a sample of residents in the general public, those in foreclosure were more likely to be uninsured (22 percent compared to 8 percent), though similar health problems were seen among both the insured and uninsured.
The study also revealed that for 9 percent of respondents, a medical condition in their family was the primary reason for the home foreclosure, and more than a quarter of those surveyed said they had significant unpaid medical bills. A separate study released in June found medical bills were behind nearly two-thirds of all U.S. bankruptcies in 2007.
The authors of the new study say that the data collected in Philadelphia may be only the tip of the iceberg when compared to other cities that have experienced even sharper spikes in housing foreclosures.
The study participants were recruited with the Consumer Credit Counseling Service of Delaware Valley, a non-profit, U.S. Housing and Urban Development-approved mortgage counselor.
To combat the health problems revealed in the study, Pollack and his colleagues suggest that health care workers and mortgage counseling agencies coordinate their efforts to help people at risk of foreclosure access both medical and housing help. Doctors, they suggest, should ask their patients about their housing situation and steer them toward mortgage relief resources.
Mortgage counselors, meanwhile, can provide information about how to access safety net health care, enroll in public insurance programs like SCHIP or Medicaid, or apply for nutritional assistance programs for pregnant and nursing mothers and their children.
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