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Cited by 545Health disparities and outcomesEnvironmental Justice and Health DisparitiesHomelessness and Social Issues

Housing as a determinant of health equity: A conceptual model

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Swope, Carolyn B., Hernández, Diana·2019·Social Science & Medicine
DOI 10.1016/j.socscimed.2019.112571PMC PMC7146083
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Abstract

Housing is a major pathway through which health disparities emerge and are sustained over time. However, no existing unified conceptual model has comprehensively elucidated the relationship between housing and health equity with attention to the full range of harmful exposures, their cumulative burden and their historical production. We synthesized literature from a diverse array of disciplines to explore the varied aspects of the relationship between housing and health and developed an original conceptual model highlighting these complexities. This holistic conceptual model of the impact of housing on health disparities illustrates how structural inequalities shape unequal distribution of access to health-promoting housing factors, which span four pillars: 1) cost (housing affordability); 2) conditions (housing quality); 3) consistency (residential stability); and 4) context (neighborhood opportunity). We further demonstrate that these four pillars can lead to cumulative burden by interacting with one another and with other structurally-rooted inequalities to produce and reify health disparities. We conclude by offering a comprehensive vision for healthy housing that situates housing's impact on health through a historical and social justice lens, which can help to better design policies and interventions that use housing to promote health equity.

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Cited by

Sorted by citations

Authors
Swope, C. B., & Hernández, D.
Affiliations
Columbia University (US)
Corresponding author
Swope, Carolyn B.
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2019-12
Volume
243
Pages
112571
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2019.112571
PMC
PMC7146083
OpenAlex
W2974931552
Cited by
545
References
11
Citations by year
2026: 91 · 2025: 133 · 2024: 127 · 2023: 84 · 2022: 59 · 2021: 40 · 2020: 10 · 2019: 1
FWCI
5.85
Type
journal article
Language
en
Open access
Licence
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion, cc-by-nc-nd)
Funders
  • Harvard T.H. Chan School of Public Health
  • National Institute of Environmental Health Sciences (P30ES009089)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Sociology and Political Science › Environmental Justice and Health Disparities
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
Keywords
housing and health, health equity, health disparities, structural inequality, housing affordability, housing quality, residential stability, neighborhood opportunity, cumulative burden, social justice, healthy housing, conceptual model
MeSH terms
Health Equity, Housing, Humans, Models, Theoretical, Residence Characteristics, Socioeconomic Factors, United States

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