An online survey conducted by Wakefield Research — said to be the first to examine the link between high rents and the ability to pay medical bills — found that more than half of all renters delay seeking medical care because they can’t afford it after paying such high rental costs.

Lew Sichelman is a seasoned writer with 50 years of covering the housing and mortgage markets under his belt. His biweekly Inman column publishes on Tuesdays.

It has long been reported that a significant percentage of renters pay more than a third of their income to put a roof over their head. Well, now comes another painful report — one that proves many renters are struggling to meet basic needs by proving that more than half of all renters delay seeking medical care because they can’t afford it.

The online survey was conducted by Enterprise Community Partners in partnership with Wakefield Research as part of a new initiative: Health Begins with Home. Some 1,000 renters took part, half of whom reported household incomes of less than $50,000.

Renters expression concerns

The survey — said to be the first to examine the link between high rents and the ability to pay for doctor and perhaps hospital visits as well as medications — also found that every one of the 500 medical professionals polled have some patients who express concerns about affordable housing.

Almost a third of the medical people queried reported that at least 25 percent of their patients spoke to them about their affordability problems — and among the doctors, nurses and physician’s assistants who worked with a larger low-income population, that figure swelled to 42 percent.

“No one should have to choose between paying rent and paying for health care,” Enterprise President Laurel Blatchford said.

The bigger picture

While the study covered only renters, it could easily be extrapolated to include families who stretch beyond their means to buy a house or suffer some life event that forces them to struggle to keep from losing their homes to foreclosure. If they put every nickle they earn into their homes, they too are likely to forgo seeking medical attention when it is warranted.

“There’s quite a bit of evidence out there already that shows financial stress leads to anxiety and depression among owners,” Brian Rahmer, the vice president in charge of Health and Housing at Enterprise, said in a telephone interview.

“The data certainly supports the position that when paying too much of their incomes to keep themselves housed, trade-offs have to be made. And those trade-offs become extra toxic when there is an emergency or unexpected medical cost. There is a constant interdependency.”

Although Enterprise’s renter survey didn’t ask, it’s even possible that financially strapped renters – and by extension, owners – delay seeing a doctor or filling a prescription even if they have medical insurance because of their co-pay requirements. And it’s likely some will allow their health insurance to lapse because of the high premiums.

Rahmer said most of the respondents did have coverage, especially in those states which expended their Medicaid program under the Affordable Care Act, otherwise known as Obamacare.

However, he added, “just because they have insurance may not mean they have the ability to take off to see a doctor or take off multiple days to care for a sick child, or that they have access to transportation to get to the doctor or hospital. All of these issues play into the responses we’re seeing.”

The survey found that the trade-offs between housing and health are even more disturbing among tenants who are the most extremely rent-burdened. Of those who pay more than half their monthly income for housing, 74 percent say that in sickness or in health, paying their rent is their top priority.

A mere 1 percent prioritize health care costs over rent.

Another sobering finding: 45 percent of the heavily rent-burdened did not follow a treatment plan set forth by a medical person because they couldn’t afford it. That compares to 34 percent of all renter respondents.

Also, 74 percent reported that they “strongly” or “somewhat” agree that financial stress plays havoc on their mental health. And as you might expect, they said housing related factors impact their health – only 53 percent are satisfied with their access to outdoor space and only 47 percent feel they are living free of indoor toxins.

Overall, it’s not a pretty picture, either. Among the 54 percent of all renters who delay medical care because of financial issues, 42 percent skip routine preventative check-ups, 38 percent don’t seek treatment when they are ill and 35 percent resort to doctoring themselves with over-the-counter medications rather than seeing a doctor.

Astonishingly, doctors reported that 46 percent of patients said they failed to seek treatment for chronic diseases such as diabetes and high blood pressure.

The survey is intended to help both the medical and housing sectors collaborate to save lives.

“Whether it’s housing that is poorly designed or maintained that makes its residents sick, stress from needing to move often or skipping needed care and medication in order to make rent, our health is inextricably linked to home,” said Rahmer. “The interdependence between the two must remain at the forefront of our collective health equity efforts.”

More about the initiative

Health Begins with Home is a national effort to harness the power of affordable houses to create healthier families and strong communities. It convenes cross-sector partners to promote health as a top priority in the development and preservation of affordable houses and to elevate housing as an essential tool for improving resident and community health.

Over its 35 years, Enterprise has built nearly 529,000 housing units and invested $36 billion in the sector. Originally known as the Enterprise Foundation, it was started by mortgage banker James Rouse (the creator of Columbia, Maryland) and his wife. Located midway between Washington, D.C. and Baltimore, Columbia is one of the country’s most successful new towns.

Lew Sichelman is a seasoned writer with 50 years of covering the housing and mortgage markets under his belt. His biweekly Inman column publishes on Tuesdays.

Editors note: Headline has been changed to better reflect the data.

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