title: Foreclosure and Health in Southern Europe: Results from the Platform for People Affected by Mortgages.
abstract: Housing instability has been shown to be related to poorer health outcomes in various studies, mainly in the USA and UK. Affected individuals are more prone to psychiatric (e.g., major depression, anxiety) and physical disorders (e.g., hypertension). This situation has deteriorated with the onset of the economic crisis. One of the most affected countries is Spain, which has high rates of foreclosure and eviction that continue to rise. In response, a civil movement, The Platform for People Affected by Mortgages (PAH), works to provide solutions to its members affected by foreclosure and advocates for the right to decent housing. The aims of this study ware to describe and compare the health status of PAH members from Catalonia to a sample of the general population and to analyze the association between health status and mortgage status, foreclosure stage, and other socioeconomic variables, among members of the PAH. We conducted a cross-sectional study using a self-administered online questionnaire (2014) administered to 905 PAH members in Catalonia (>18 years; 559 women and 346 men). Results were compared with health indicators from The Health Survey of Catalonia 2013 (n = 4830). The dependent variables were poor mental health (GHQ 12 ≥ 3), and poor self-reported health (fair or poor). All analyses were stratified by sex. We computed age-standardized prevalence and prevalence ratios of poor mental and self-reported health in both samples. We also analyzed health outcomes among PAH members according to mortgage status (mortgage holders or guarantors), stage of foreclosure, and other socioeconomic variables by computing prevalence ratios from robust Poisson regression models. The prevalence of poor mental health among PAH members was 90.6 % in women and 84.4 % in men, and 15.5 and 10.2 % in the general population, respectively. The prevalence of poor self-reported health was 55.6 % in women and 39.4 % in men from the PAH, and 19.2 and 16.1 % in the general population, respectively. These health inequalities were independent of socioeconomic status. The prevalence of poor mental health was higher among individuals in the non-payment stage of foreclosure than among those who were up to date with their payments (e.g., PRc = 1.16 [95 % CI 1.04-1.28]). In contrast, self-reported poor health was more prominent in later stages of foreclosure, such as in post-eviction without dation in payment stage in men (PRc = 2.24 [95 %CI = 1.35-3.72]). We observed a considerably higher prevalence of poor mental and self-reported health among male and female PAH members than in the general population. Public policies that tackle housing instability and its consequences are urgently needed in Spain.
authors.affiliation: Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.|Agència de Salut Pública de Barcelona, Barcelona, Spain.|Centro de Estudios para la Equidad en Salud, Universidad de La Frontera, Temuco, Chile.
authors.forename: Hugo
authors.initials: H
authors.lastname: Vásquez-Vera
authors.affiliation: Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.|Agència de Salut Pública de Barcelona, Barcelona, Spain.|CIBER de Epidemiología y Salud pública (CIBERESP), Madrid, Spain.|Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez-Sanz
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain.|CIBER de Epidemiología y Salud pública (CIBERESP), Madrid, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Palència
authors.affiliation: Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain. cborrell@aspb.cat.|Agència de Salut Pública de Barcelona, Barcelona, Spain. cborrell@aspb.cat.|CIBER de Epidemiología y Salud pública (CIBERESP), Madrid, Spain. cborrell@aspb.cat.|Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain. cborrell@aspb.cat.|Agència de Salut Pública de Barcelona, Avinguda Lesseps 1, ES-08023, Barcelona, Spain. cborrell@aspb.cat.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D057172:Economic Recession; D005260:Female; D006304:Health Status; D006798:Housing / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Crisis; Evictions; Foreclosure; Health; Housing instability