Building the case for housing policy: Understanding public beliefs about housing affordability as a key social determinant of health.

Background: The current housing crisis in the U.S. requires the consideration and promotion of policies that improve the circumstances of severe housing cost burdens. Building public awareness of the health impacts associated with housing affordability may be a key prerequisite for policy change.

Methods: Quantitative and qualitative data from a national survey were used to investigate public understandings about housing affordability as a key driver of health. Quantitative and qualitative findings were integrated to test whether any relationships existed between respondents' considerations and concerns about housing affordability and their perceptions about housing affordability as a social determinant of health.

Findings: These data support four key findings. First, understandings of the relationship between affordable housing and health are partisan and income-based driven, with Republicans and high-income respondents less likely to acknowledge the effects of housing affordability on health. Second, varied frames of communication about the relationship between housing affordability and health may produce significantly different reactions among political and income subgroups.Third, while there is considerable agreement that housing affordability promotes health when using forced-choice measures, connections between affordable housing and health are not readily volunteered. Finally, the themes of personal responsibility and stability and security significantly resonate with Republicans and high-income earners.

Conclusions: Contextualizing the issue of housing affordability within various domains in ways that effectively resonate with the American public and policymakers and across political and income spectra, is highly imperative.