Home foreclosure and health: A case-control study in Philadelphia

Background: Over 2.3 million properties underwent foreclosure in 2008. Despite the magnitude of the crisis, little is known about the health of people undergoing foreclosure. We perform a case-control study to examine to what extent poor health and high health care utilization are risk factors for foreclosure.

Methods: Cases were identified from public records of people who have undergone mortgage foreclosures from January 2005 to April 2008 in the city of Philadelphia (N= 20496). We excluded homes that were owned by banks (N=3741). This list was linked to medical records at the University of Pennsylvania Hospital System (UPHS) by name and address (N=2260) and then limited to individuals who received primary care in the 15 months prior to the foreclosure date. Controls were chosen based on age, gender, zip code of residence, and date of primary care visit.

Results: 1038 individuals who underwent foreclosure were seen in the UPHS primary care clinics. Of these, 702 (68%) were females and 336 (32%) males with an age range from 18-99. Claims data will be used to examine whether people who underwent foreclosure are more likely to be uninsured, have had a hospitalization or ED visit, and been diagnosed with specific medical conditions (i.e. hypertension, diabetes) in the 15 months prior to foreclosure compared to individuals who have not experienced foreclosure.

Conclusion: Better understanding the association between health and foreclosure is critical for public health practitioners in order to effectively respond to the foreclosure crisis.