Housing Quality Metric (HQM): Neighborhood-Level Data, Housing Quality, and Population Health.

Abstract

<b>Objectives.</b> To develop a national, tract-level measure of neighborhood housing quality and test its validity by examining associations with population health metrics. <b>Methods.</b> Using microdata from the 2021 American Housing Survey postfit to the 2018-2022 American Community Survey, we developed the Housing Quality Metric (HQM), which predicts the likelihood that a US census tract contains a large share of poor-quality housing units across 3 domains: physical inadequacy, housing cost burden, and poor neighborhood perception. We then used regression models to assess the ecological association between HQM and area-level measures of adult population health (fair or poor general health, poor mental health, and poor physical health) from the PLACES data set. <b>Results.</b> Census tract HQM score was significantly associated with a higher predicted proportion of adults self-reporting all 3 examined negative health status outcomes in both unadjusted and adjusted models. <b>Conclusions.</b> HQM presents the first national, tract-level measure of poor housing quality that has significant associations with adult population health status. <b>Public Health Implications.</b> HQM can be used to target resources and interventions in ways that may better capture the complex relationship between housing quality and population health than existing measures of housing quality. (<i>Am J Public Health</i>. 2025;115(5):780-788. https://doi.org/10.2105/AJPH.2024.307962).