Housing-related payment hardship and associations with health and well-being: a 15-year longitudinal study in a National Sample of U.S. adults

Many U.S. households face growing difficulty affording housing and related costs, with some missing payments for housing or utilities due to limited resources. Sparse research has examined how housing-related payment hardship relates to well-being over the life course. We used three waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 7673) to estimate associations of two housing-related payment hardship exposures (inability to pay rent/mortgage and utilities) in early adulthood (Wave IV; 2008-2009) with 36 health and well-being outcomes 15 years later (Wave VI; 2022-2025). We used an outcome-wide analytic approach, adjusting for sociodemographic characteristics and prior values of outcomes and exposures (Wave III; 2001-2002). Results after Bonferroni correction indicated both exposures were associated with worse outcomes in physical health (eg, self-rated health), health behavior (eg, smoking), psychological distress (eg, anxiety), psychological well-being (eg, life evaluation), social distress (eg, discrimination), and socioeconomic factors (eg, financial distress). Associations with social well-being and prosocial outcomes were weaker. Our findings strengthen evidence that housing-related payment hardship is both an economic and public health concern. Policies and interventions that reduce housing payment difficulties in early adulthood before severe instability or homelessness emerges may promote longer-term health, well-being, and socioeconomic stability.