Housing Status and Health in the United States: A National Study of Homeownership, Health Outcomes, and Access to Care.

Abstract

<b>Objectives.</b> To examine the impact of homeownership across multiple health and behavioral domains in the United States. <b>Methods.</b> Using 2023 Behavioral Risk Factor Surveillance System data, I examined associations between homeownership and health across 5 domains, applying weighted logistic regression with sequential sociodemographic adjustments. <b>Results.</b> Among 407 916 adults representing 235 million US residents, 72.3% reported living in owner-occupied housing. Renters were significantly younger, racially diverse, and twice as likely to report low income. Compared with homeowners, renters exhibited higher health risks, reduced health care access, and lower engagement in preventive services. Renters had higher odds of current smoking (adjusted odds ratio [AOR] = 1.17; 95% confidence interval [CI] = 1.13, 1.21), binge drinking (AOR = 1.08; 95% CI = 1.04, 1.13), poor or fair health (AOR = 1.21; 95% CI = 1.17, 1.26), and depression (AOR = 1.17; 95% CI = 1.13, 1.22) and lower odds of physical activity (AOR = 0.86; 95% CI = 0.84, 0.89). Health care access was more limited among renters, with lower odds of having health insurance (AOR = 0.75; 95% CI = 0.72, 0.78) or a personal doctor (AOR = 0.65; 95% CI = 0.63, 0.68). Preventive care gaps were pronounced between the 2 groups: renters had lower odds of receiving colonoscopy and sigmoidoscopy (AOR = 0.74; 95% CI = 0.71, 0.77) and routine checkups (AOR = 0.76; 95% CI = 0.74, 0.79). <b>Conclusions.</b> Housing tenure stratifies health. Addressing housing in prevention frameworks is essential to improving US public health. (<i>Am J Public Health</i>. 2026;116(1):137-147. https://doi.org/10.2105/AJPH.2025.308278).