Social Determinant of Health: Housing and Its Impact on Low-Income Families in the US

This essay discusses the impact of housing as a social determinant of health on low-income families in the US. It analyzes the ways in which housing influences health status and how to improve the standards of living among the affected population.

Running head: SOCIAL DETERMINANT OF HEALTH 1
Housing
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Introduction
The social determinants of health (SDH) involve the quality measure which examines the
status and existence of health, health care accessibility and the presence of equity and inequities
in the provision of quality healthcare services. The Department of Human and Health Services
(DHHS) in United State (US) is the one accountable in determining social inequities in disease,
mortality, development strategies and health inequalities for the US population which are likely
to experience health risk such as poor environment based within the minority ethnic groups,
socioeconomic status, urban or rural residents and housing status. In the studies to examine the
inequalities of the social determinant of health, the DHHS focuses on housing condition,
nutrition, pregnancy status in women, the impact of poverty, sanitation and infant mortality rate
in the United State. The social determinants of health can be described as the living conditions or
the social surroundings in which people are live, work, born and the playing grounds especially
during childhood. These factors have significant effects on the quality of an individual’s
lifestyle, health risk, body functioning, and development. The family background gives person
sustainability that is helpful in life such as effective parental skills, the ideal family environment
and social economic status (Bowen, Bowen & Barman-Adhikari, 2016). This essay demonstrates
how housing as a social determinant of health affects the livelihood of the low-income
population in the US. It will address the issue of housing on families living under the poverty
line in America. In addition, the essay will discuss and analyze the ways in which housing
influence health status and how to improve the standards of living among the affected
population.
Population description

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Despite that the United state is known as the richest country in the continent, there is
recognization of millions of population comprising of different races which live under the
poverty line. Around 42.1 million of residents which is around 13.5% of the population in the
United State There are several research that has been conducted which marked the occupational
disparities, the socioeconomic status, ethical and racial groups in the life expectancy and
mortality rate in United State (Beckfield, Bambra, Eikemo, Huijts, McNamara, & Wendt, 2015).
The studies identify the population which has limited access to the Nation’s health
services and longer activities. The most vulnerable population in the US that is likely to be
affected by the housing issues in the US have the following characteristics; the low social class,
population, the minor race and ethnic groups, lowly educated people, low- income individuals,
unemployed, the immigrants, the refugees in US, and the people living with the disabilities in
United State. The social determinant at these populations include, high poverty rate, lack of labor
and market structures, socioeconomic deprivation, income inequalities unaffordable housing,
inaccessibility to shopping centers, poor sanitation environments, inaccessibility , good
nutritional and healthy diet, lack of educational facilities and opportunities, poor transportation
and infrastructure, undeveloped built and physical environment, inadequate space, and
inaccessibility to crucial goods and services. This population experiences a shortage of health
professionals, poor welfare services, insecurity in the environments, and risk of diseases
outbreak (de Andrade et al, 2015).
The families and the populations that mostly operate under the poverty level in United
State are commonly found in very remotes areas of US and in urban caters where people are
densely populated which leads to the creation of slums. These include areas where industry had
been previously developed but it was again removed. The unemployment population which is

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most likely to experience the effects of housing and under poverty level includes races like
Alaska Natives (American Indians which is approximately (26.5%), the African Americans ( the
blacks) which are around (25.4%), the Pacific Islanders and the Hawaiians which make up about
18.9%. Another study carried out to investigate the socioeconomic status of United State,
showed that the population living under poor standards were around 100 million which is almost
one-third of the overall population (Williams, Priest, & Anderson, 2016).
The poverty rate in the year 2017 improved from 12.7% in 2016 to 12,3% indicating that
the poverty level in the United State had decreased by 2.5% since 2015. The housing issue
remained the major problem of facing poor individuals. In the year 2009, it was approximated
that around 643, 00 people in the US were unsheltered and homeless. Among these people, one-
third of them lived in transition houses plan or the emergency rental houses. Other lived the
abandoned buildings in the towns and cities and on the streets whereby these places have an
unfavorable environment for persons. The housing effect in the United stated ameliorated such
that some of the residents chose to reside on their vehicles due to the rise in the house rents
(Neiderud, 2015).
Most of the vulnerable population such as the poor families, homeless population and the
transitional residents migrated and settled to the abandoned areas like where the industries have
been pushed or public spaces and established slum-like villages. These individuals settled in
these regions without any plan or any government authorization, they are clustered anywhere
Leaving no or inadequate space for road construction, good insulation, and it led to poor
ventilation. Such regions in the United state are observed in the southern and on the southwestern
parts of the US. The southwestern regions where the rate of poverty is very high are the Georgia,
Kentucky, West Virginia, Alabama, and Mississippi. The southwestern states that experience a

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high rate of poverty include; the New Mexico, Arizona, and Oklahoma. The cities involved are
San Francisco City, Portland, and Oregon. In the areas, there is overcrowding which leads to
suffocation, disease outbreak, and high cost of living (Giles-Corti et al, 2016).
Housing Impact on the Poor Families in the US
The person’s social development and health are highly influenced by the availability,
accessibility of healthcare services and the condition of living standards. The families in the
United State living under the poverty line are negatively influenced by the issue of housing.
These populations live under very poor housing conditions. The is the prevalence of asthmatic
condition to the families under the poverty line making up to 56% of the children with the
asthmatic condition in the US. Compromised sheltering and improper housing conditions may
result to severe health problems which result from the likely of the outbreak of disease due to the
ill- environment including where a person stays, working areas or where a person was brought up
(Woo, Joh, & Van Zandt, 2016).
The investigation carried out by the Urban Institute of the United State in the year 2016,
indicated that many teenagers and youths operate under low- income and this leads them to
involvement into unethical behaviors in the society (Gubits et al, 2016). These unethical
behaviors include; crime gangs, unethical and unprotected sexual activities and selling of drugs
so that to afford rents and foods. The engagement in the sexual activities leads to the contraction
and high rate of spread of HIV/AIDs and sexually transmitted diseases (STDs). The families
under the low poverty line are prone to inadequate healthcare services, limited community
resources such as recreation centers, and deadly diseases. The paces with poor housing do
experience mold, dampness of the area, asthmatic and overcrowded which may increase the rate
of spread of communicable diseases. The mold and the microbial growth are the factors with

SOCIAL DETERMINANT OF HEALTH 6
facilitating to wheezing conditions in infants and adult. The dumpy and cold area is a good
environment for bacterial growth and they encourage the growth of mold protozoan, dust mites
and other dangerous microbial which causes different illnesses to human beings. The children
living in these areas are prone to acute respiratory diseases like common cold and bronchitis
(Jocson, & McLoyd, 2015).
The poor housing conditions and the vulnerability to many diseases suppress the immune
systems leading to the high increase of medical demands and these people are the ones mostly
admitted to the public hospital in the emergency department and a long stay in the hospitals.
These marginalized population in the United state living in poor housing conditions are more
exposed to dangerous domestic issues such as frequent domestic violence, insufficient parental
skills, violent neighborhoods, substance abuse especially in youths, and inadequate security.
Some of the researchers in the healthcare department said that the quality of housing and
surroundings affect the health statuses of an individual. The substandard housing facilities where
there are unfavorable ventilation and insulation predisposes one to suppressed health conditions.
The infants, the old people, and the children mostly stay indoors; therefore poor housing
conditions make them develop weak immune systems and psychological stress disorders
(Yilmazer, Babiarz, & Liu, 2015).
How Families Living under the Poverty line is Susceptible to Health Issues due to
Housing Problems
The housing issue in the US, is experienced in the major cities and in remote areas which
are densely populated. The densely populated areas are overcrowded due to unplanned
settlements and this lead to lack of privacy and draught. The areas which are highly populated
have inadequate latrines and the environment is filthy with stool scattered all over and litter

SOCIAL DETERMINANT OF HEALTH 7
everywhere this makes the people living there to become more susceptible to diseases (Ezeh et
al, 2017).
There is poor insulation, hygiene, and insulation. Generally, there is poor sanitation in the
densely populated regions in the united state. The cold which a very severe condition in the
children and infants is experienced in this part of the cities due to the presence of good shelters
the factor that makes them be more susceptible to respiratory illnesses and communicable
diseases. Lack of capital makes the poor families living in the disadvantaged environment to
experience inadequate cooking facilities, an unsafe electrical installation which could support
cooking and poor diet (Lewis, 2017).
There filthy or no proper food storage facilities such refrigerator or cupboards in those
areas. These place in the town has a lot of noise both from the local industries or due to the
traffic in the town. There is total environmental pollution both air and water as these areas in
town are where most of the sewerage and damping sites are directed. Their area is also
inaccessible due to poor infrastructure by the department of health of United State. The nearby
hospital is private hospital are unaffordable by most of the people, and there is unavailability of
developed shopping centers, clinics hospitals and recreation facilities (Pascoe et al, 2016).
Other Problems related to Housing in the US
In the region where many people have problems with housing, they experience a lot of
psychosocial disorders which worsens their health. Health issues associated with inadequate
housing are inadequate sleep, food poisoning, unbalanced diet, hypothermia, and substance
abuse. The psychological issues related to poor housing conditions include anxiety, excess stress,
low self-esteem, social isolation, fewer opportunities in life, poor marriages and relationships,

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unprotected sexual behaviors lack exercises, and mental health issues and unemployment’s
(Sahoo et al, 2015). People living in substandard housing environments are susceptible to all
kinds of diseases such as cholera, cancerous, typhoid, stomach ulcers, diarrhea and also the
common cold. The people in these conditions have low achievement in the education sector as
many children from these families are the victim of bullying and theft cases in schools. The
student lack places to conduct their supplementary studies or to do their school assignments. The
children who have been risen up from these families pass through intense pressure in life as
compared to those brought up from the able and wealthy families (Shaw & Hagemans, 2015).
How to Improve the housing Issue in the United State for the Poor Families
A well-developed model of approach is required to address such a case of housing issues
so that to improve and fight health inequalities. The problems caused by the lack of housing can
be handled through the development of the right based approach to analyze, discuss and address
the issues and the strategies to improve the health statuses of the influenced populations. The
most appropriate right based approach for the improvement of healthcare in the areas occupied
by the marginalized group is the establishment of Primary Health Care (PHC). The approach is a
multi-leveled model that can be used to promote health through health campaigns which m
involve education to the public and establish healthcare centers to the disadvantaged groups
(Gubits et al, 2015).
The approach aims a putting up of facilities that particularly to areas that have been
inaccessible due to the poor road network and due to examining the vulnerability to contracting
the diseases. The PHC approach, for it to work well as it involves very semiarid and densely
populated area within the towns requires several stakeholders for through implementation. The
approach has to involve, the US government through the ministry of health, Non- Government

SOCIAL DETERMINANT OF HEALTH 9
Organisations (NGOs), heads of all public healthcare centers, health care in the private sectors,
the department of house planning and infrastructure. The approach involves campaign programs
to the public regarding the prevention and cure of the associated disease (Thornton et al, 2016).
The approach aims at improving and maintaining the housing problems and promote the
living standards of all the American citizens. The outcomes of this healthcare approach can be
achieved through the provision of the healthiest housing environments and availing of affordable
healthcare services and offering proper education to the influenced groups concerning the health
risk associated with a poor livelihood. The health service providers involve having to conduct a
door to door movement especially to the densely populated areas while offering services like
treating the patients and providing education about the hygienic ways to prevent the disease. The
approach also involves the tertiary healthcare actions such as the establishment of a basic
rehabilitation center for the people who have been affected psychologically and those addicted to
substance abuse (Doull, O'Connor, Tugwell, Wells & Welch, 2017).
The department and infrastructure play a role in designing and planning the models of
house and regulation of the number of people to occupy a certain space so that to overcome the
cases of environmental pollution and overcrowding. The department also helps creations of
public spaces, installation, and repair of sewerage systems, ventilation, insulation and
encouraging the public the importance of participating in health development programs. The
Disease Prevention and Control Center is another body that promotes the housing conditions and
improves the living standards, especially to the marginalized groups. This department can
improve conditions such as the outbreak of acute diseases and concentrate on research
concerning the cases of diseases in the families under the poverty line. The government has the
authority to make decisions that may bring about change in the health sector with immediate

SOCIAL DETERMINANT OF HEALTH 10
effects. The US government will have to conduct a random engagement to build better houses
with good insulation, spacing, ensure the installation of electricity and ventilation of the
disadvantaged groups in the country (Scally & Tighe 2015).
This approach will enable the US government to focus on the areas that are most affected
as it is strategized by the PHC research report. The PHC will enable the people living under the
poverty level to have better living standards, promote health in the country and reduce the
susceptibility of disease associated with hygiene and respiratory complication (Meyer et al,
2019).
Conclusion
In conclusion, it is clearly demonstrated that the surrounding society and the
surroundings are the main factors that affect the quality of an individual in the future. Most of the
American citizen living under the poverty line face housing problems which are the main cause
of the distribution of the health services inequalities. Since the housing as a determinant of health
in the US affect a large population and has multifaceted inequalities in the urban centers and the
most remote areas a well multi-sectoral approach is the best model to handle the situation. the
housing effect is experienced in almost all the recess in United State and the issue affect the
livelihood of the people in all areas such as education, healthcare facilities, transport and
infrastructure, nutrition, and socioeconomic status. The intervention of the right based approach
can be useful in improving the housing conditions of the population in the United State living
under the poverty level. Since the implementation of the PHC approach is costly, it requires the
coordination of the several stakeholders including the government, NGOs and the heads of both
private and public hospitals. Through this approach to improve the housing conditions and the

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living standards of the vulnerable groups, it can lead to a reduction of the burden ill health status
and disease outbreak in the disadvantaged environments.

SOCIAL DETERMINANT OF HEALTH 12
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