The proposed project will provide a comprehensive analysis of the link between the current foreclosure crisis, Emergency Room (ER) visits, and hospitalizations for specific stress-related conditions. Foreclosure represents a stressful event that is often the culmination of a period of financial stress. Despite mounting evidence pointing to a link between stressful life events and adverse health outcomes, the potential health implications of the foreclosure crisis have received little attention. The current foreclosure epidemic presents a unique opportunity to study the impact of foreclosures on health care utilization because the recent massive rise in foreclosures is arguably due to the recession rather than to personal characteristics of those affected. The project will bring together data on all of the foreclosures, ER visits, and hospitalizations from 2005 to 2009 in three states that are among the 10 that have been most affected by the crisis (Arizona, Florida, and New Jersey). Data on various stages of foreclosure will come from RealtyTrac. Administrative data on ER visits and hospitalizations will come from Health Care Utilization Project. These two data sets will be merged to create a single data base of foreclosures, ER visits and hospitalizations at the zip code level with a monthly frequency. This large and high frequency data set offers great variation in foreclosure rates across time and neighborhoods, which will be utilized to determine whether ER visits for stress related disorders rise faster than visits for other disorders in areas where foreclosures have been rising. Our analysis will distinguish between those visits/admissions that are most likely to be due to stress-related and those which are less likely to be related to the immediate stress of foreclosure. Furthermore, we will conduct separate analyses for males and females as well as different age groups. In particular, children may be differentially affected by foreclosure and our analysis will be the first to examine the effects of foreclosure on children. We will investigate the potential role of financial distress in mediating the relationship between foreclosure and utilization by examining ambulatory care sensitive conditions, and by comparing those just below and just above the age 65 cutoff for Medicare eligibility. Finally, we will estimate separate models for minority and low income individuals in an attempt to determine the extent to which they are at double jeopardy from foreclosure: Both at higher risk of losing their homes, and at higher risk of negative health consequences from these losses.
The project aims to assess the extent to which the current foreclosure crisis represents a threat to public health. The findings have the potential to inform policy makers of a currently underappreciated consequence of the current crisis. Our findings may provide a further basis for assessing the benefits of government efforts to reduce foreclosures and stabilize the housing market. The results will also add to the literature regarding the effects of stress on health.