How Housing Quality Affects Child Mental Health

October 26, 2017

by Will Schupmann

Homes are where people expect to be safe, comfortable, and healthy. But this is not the case for millions of children who are at risk of poor health outcomes because of problems with housing quality, housing instability, and unaffordability. Although more than a century of observation and research have documented how household triggers affect children’s physical health, poor housing can be equally destructive to their emotional, psychological, and behavioral health and development. Because so many critical developmental periods are concentrated in early childhood, young children may be most at risk, although research finds connections between housing and mental health during other periods of life as well. As researchers strive to understand the reasons for these complex psychological effects, policymakers, housing developers, advocates, and funders should note that housing quality lays the foundation for children’s mental health.

What connections have researchers found between child mental health and housing quality?

Whether in a city with concentrated poverty or in a rural community, studies have tracked children’s housing environments, psychological health, and development over time, finding connections for children of all ages.

Using data on children ranging widely in age, a team of child development researchers found that children from low-income households living in concentrated poverty were more developmentally harmed by poor housing quality than by residential instability, unaffordability, or other housing factors. Children who lived with leaking roofs, exposed wires, pest infestation, and other problems were more likely to exhibit emotional and behavioral problems, which manifested themselves through anxiety, depression, and other internalizations in some children, and more outwardly aggressive behaviors and rule breaking in others. By adolescence, poor-quality housing was associated with lower reading and math scores on standardized tests.

Another study, which tracked children in rural areas beginning at age 9, found after 15 years that poor housing conditions—including physical quality, home hazards, crowding, and clutter—were associated with worse psychological health immediately and over time. Similar to the study above, kids expressed poor psychological health in both internal and external ways. Housing quality deficiencies were also associated with feelings of helplessness over the short term.

Why do homes affect children’s mental well-being?

The path from a physical hazard to a physical harm is straightforward, but what’s behind the association between poor housing quality and poor child mental health? In part, maternal psychological distress. Researchers have found that poor-quality housing may create stress for parents, increase their own mental health problems, and limit their ability to regulate family activities. A policy research brief on the topic clearly states how housing problems can convert a home from a safe haven to a mental hazard: “Thus, rather than being a source of security and escape from life’s pressures, a home with quality deficiencies may add to other stresses experienced by poor families, leading to a cumulative negative impact on well-being.”

Poor living conditions can also prevent children from engaging in playful and social activities, which are beneficial to their cognitive, social, and emotional well-being. Cramped or unsafe environments restrict children from exploring, interacting with, and learning from the world around them. As one researcher writes, “play helps children develop new competencies that lead to enhanced confidence and the resiliency they will need to face future challenges.”

What are the broader impacts and societal costs of poor housing quality?

Having thousands of children living in poor-quality homes leads to detrimental effects for society. When housing problems exacerbate children’s depressive or aggressive behavior, it can affect their peers, contribute to teacher burnout, reduce school performance ratings, and lead to behavior-based calls that pull parents out of work and hinder productivity. And that’s just in the short term.

Evidence shows that psychological problems experienced during childhood can reduce adult earnings (by one-fourth by age 50) and decrease one’s chances of establishing long-term, stable relationships. Furthermore, anxiety, depression, and aggression in children can lead to lifelong mental illness, and the economic burden of mental illness is large: the World Health Organization estimated that by 2030, the global cost of mental illness will be over $6 trillion.

Poor housing quality is thus a collective problem. Ensuring adequate housing conditions supports children’s healthy development, helps their schools and classrooms succeed, strengthens the economy, and reduces current and future health care costs.

What can be done?

Although the problem originates in the home, solutions are not confined to the home’s four walls. As the most frequent providers of mental health services, schools are a vital partner for reaching children. Recent efforts by some school districts to strengthen their mental health services should be replicated in other communities. As part of a neighborhood revitalization plan, the Philadelphia Housing Authority has invested millions of dollars into Vaux Big Picture High School in North Philadelphia,developing individualized wellness plans alongside education plans for its students. In South Los Angeles, Crete Academy, a new charter school geared to meet the needs of homeless and low-income children, provides mental health services on-site, has formed relationships with social service resources within the community, and works with nonprofits to get families stably housed. Housing providers and schools can look at these and other models to develop effective housing and education partnerships.

In addition to using schools to address issues associated with child mental health, steps can be taken to reduce the number of families living in poor-quality housing and alleviate the harmful effects of such housing on children.

Programs such as the US Department of Housing and Urban Development’s Healthy Homes Program and similar local efforts to address in-home toxins and asthma triggers should be continued and prioritized.
The infrastructure for early child development and parental supports should be strengthened. Services such as nurse home visiting can bolster low-income mothers’ confidence and parenting skills and can have positive impacts on children’s IQ scores, behavior, and socioemotional development.
For maximum benefits, policymakers at all levels of government should ensure that families of all income levels can afford decent-quality housing to set the nation’s children on a course for a successful future.

The ripple effects when children live in substandard home environments extend to housing, health care, schools, and more. This calls for partnerships, mutual advocacy, and innovation—an all-hands-on-deck approach for a large, but solvable, problem.