A Case Control Study of Home Foreclosure, Health Conditions, and Health Care Utilization

Foreclosure is a significant threat for many properties in the United States. Health effects related to foreclosure are not fully understood. This study examines the relationship between foreclosure and health.

Using computerized medical record data, the authors conducted a case-control study to better understand health status and health care utilization before foreclosure. Data from January 2005 to April 2008 was used to link foreclosure notices in the city of Philadelphia to electronic medical record data and billing claims from the University of Pennsylvania Hospital System (UPHS). Health and health care utilization for these cases, and for controls receiving care from UPHS and living in same zip code, were examined from 24 to 6 months prior to foreclosure notice and from 6 months to foreclosure notice.

Key Findings:

  • Age, gender, and insurance status were similar for cases and controls. They were significantly more likely, however, to be African American.
  • Those experiencing foreclosure had higher rates of hypertension, renal disease and Charlson comorbidity indices.
  • Both cases and controls were equally likely to see a primary care physician 24 to 6 months before foreclosure notice, but cases were significantly less likely to visit a primary care physician between six months and foreclosure notice.
  • People undergoing foreclosure were more likely to have emergency department and outpatient visits in the two years prior to foreclosure.

These findings suggest health care utilization changes before foreclosures, although more research is needed to understand further health care utilization of those experiencing home foreclosure. Additionally, further social and medical interventions should be considered to assist those experiencing foreclosure.