title: The health effects of the foreclosure crisis and unaffordable housing: A systematic review and explanation of evidence.
abstract: The foreclosure crisis was detrimental to the financial well-being of many households, yet the non-economic consequences are still poorly understood. This systematic review aims to understand the direct and spillover effect of foreclosures on several health-related outcomes by synthesizing evidence from 40 studies. First, this study identifies research gaps using a schema to organize studies by line of inquiry, health-related outcome, and measure of homeowner financial distress. In order to provide context for the findings, four pathways - stress, effect-budgeting, frustration-aggression, and trust - evoked in the literature are described to explain the relationship between foreclosures and health. The research suggests that experiencing a foreclosure and living near foreclosures are associated with poor psychological and behavioral morbidities, namely anxiety and violent behavior, and declining health utilization. Evidence is sparse on suicide, substance abuse, somatic morbidities, and mortality. Future research is needed to fill the gaps and explicitly test the mechanisms proposed.
authors.affiliation: Department of Community Health and Human Development, School of Public Health, University of California, Berkeley, CA 94720-7360, USA. Electronic address: jdowning@berkeley.edu.
authors.forename: Janelle
authors.initials: J
authors.lastname: Downing
mesh_terms: D057172:Economic Recession / Q000639:trends*; D062489:Health Impact Assessment / Q000379:methods*; D006798:Housing / Q000191:economics* / Q000592:standards* / Q000639:trends; D006801:Humans; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology
keywords: Financial strain; Foreclosure; Housing; Pathways; Recession; Systematic review