What Comes First – Stable Housing or Mental Health? A Study of the Reciprocal Relationship Between Housing Stability and Mental Health Trajectories among Hurricane Katrina Survivors

Problem: Hurricane Katrina was one of the most deadly and costly storms in US history, leading to the displacement of over 600,000 individuals from their homes for three months or more. Displacement from one’s home and housing instability is often associated with mental health distress, but the relationship is complex, and not always clear which precedes the other. 

Methods: This analysis examines the reciprocal relationship between housing instability following Hurricane Katrina and mental health distress, as measured by the SF-12, using  longitudinal data collected at four time points from 2006-2010.  The Gulf Coast Child and Family Health (G-CAFH) Study drew a representative sample of 1079 displaced or greatly affected households using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005.

Findings: Using survival analysis, time to permanent and stable housing is shown to directly correlate and increase significantly with worse mental health distress. Regression analyses distinguished the paths to housing stability among those with and without mental health distress, and conversely the paths to mental health distress among those stably and unstably housed.

Implications: Initial findings suggest that ongoing and enduring mental health distress is associated with future housing instability, whereas among those who are not initially distressed, housing stability is associated with future mental health distress, relationships are independent of race or income. The variation in these two trajectories is reflective of the differential needs and services for individuals following a disaster.