By Janice Neumann
(Reuters Health) – People who develop a debilitating or chronic illness could be at least twice as likely to default on their homes or risk foreclosure, a recent U.S. study suggests.
Most research on links between financial troubles and illness has focused on poverty or declining income as a cause of poor health, rather than the other way around, the study team notes.
That work is important, said Danya Keene, an author of the new report, but “it tends to miss that there can be huge social consequences of becoming sick, disabled, or more generally having poor health.”
Keene, an epidemiologist at the Yale School of Public Health in New Haven, Connecticut, and a coauthor looked at a sample of more than ten thousand people who were interviewed in 1979 when they were between the ages of 14 and 22. The participants were re-interviewed annually until 1994 and then every two years after that.
The study group reported any health limitations that prevented them from working in 2006 and in 2008. They were also asked about life-threatening and disabling chronic conditions that they had at age 40 and at age 50. The chronic illnesses included heart disease and heart failure, lung disease, stroke, cancer, diabetes, hypertension, arthritis, asthma, joint pain and osteoporosis.
For their analysis, the researchers focused on a group of 2,066 people who owned a home between 2007 and 2010 and who had completed their age-50 interview.
The researchers also asked the study participants if their homes had gone into default or if they were risking default in the next six months, and if they had faced foreclosure in the past three years.
“By following people over time, and looking at how changes in health status influence later mortgage default and foreclosure, we’re able to provide some insight into how this process unfolds over time,” said Keene’s coauthor Jason Houle, a sociologist at Dartmouth University in Hanover, New Hampshire, in an e-mail
People who developed a new debilitating health problem between 2006 and 2008 had about 1.63 times the risk of defaulting on their homes and 2.65 times the risk of foreclosure compared to people without new serious health problems.
The people who developed a new chronic illness between ages 40 and 50 faced almost double the risk of default and 2.6 times the risk of foreclosure compared to those without chronic illnesses, according to the results in the Journal of Epidemiology and Community Health.
Loss of health insurance or a drop in income accounted for about 15 to 20 percent of the link between illness and mortgage problems, the authors calculate.
Several studies have suggested the large numbers of foreclosures in recent years, which can be harder on middle-aged and older people at a higher risk for chronic illness than their younger counterparts, could spell a public health problem, the authors write.
The study found an important link between worsening health and risk of foreclosure, according to Christopher G. Hudson, a professor in the School of Social Work at Salem State University in Massachusetts, who added that he was generally impressed with the report.
But it would be improved by examining the effect of health on finances and the effect of declining finances on poor health simultaneously, noted Hudson, who was not involved in the study.
“Certainly in the area of mental health, there is a huge amount of research that strongly establishes that economic distress . . . has very strong effects on the development of many mental health problems, as well as physical health problems,” Hudson told Reuters Health.
He noted that illness and finances could be so intertwined, more research was needed to find out how much impact one had on the other.
“To me it’s obviously an interactive relationship, both things are going on. When things fall apart, they tend to fall apart on a number of different fronts,” Hudson said.
Houle said policy makers already knew that illness could decimate finances. That fact was “one of the key talking points during the implementation of the Affordable Care Act (ACA),” he pointed out.
“Therefore, if we want to reduce the financial devastation associated with illness, a sensible way to do it would be to strengthen the social safety net and reduce the cost of health care,” Houle said.
“The ACA tries to do both of these things, though we would need more evidence to know whether policies like the ACA can break the link between becoming ill and foreclosure,” he said.
SOURCE: http://bmj.co/1vCNO4y Journal of Epidemiology and Community Health, online November 27, 2014.