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Soc Sci Med. 2014 Oct;118:119-26. doi: 10.1016/j.socscimed.2014.07.063. Epub 2014 Jul 30.

Fragile health and fragile wealth: mortgage strain among African American homeowners.

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Yale University School of Public Health, Social Behavioral Sciences, 60 College Street, P.O. Box 208034, New Haven, CT 06520-8034, USA. Electronic address:
University of Pennsylvania, Department of Political Science, USA. Electronic address:
University of Wyoming, College of Health Sciences, USA. Electronic address:


Several recent studies identify illness and disability as contributors to mortgage strain, suggesting that the disproportionate burden of poor health that African Americans experience may be an important source of housing fragility in this population. In order to understand how poor health plays out in the lived experiences of African-American homeowners and contributes to mortgage strain, we present an analysis of 28 in-depth interviews conducted with middle and working-class African-American homeowners at risk of losing their homes. Our interviews show how racial inequalities in health, which result from an ongoing history of racial discrimination, intersect with other racially stratified sources of housing fragility to put homeowners at risk of foreclosure. Many participants in this study were long-term homeowners who experienced mortgage strain as result of a health-related event that triggered the collapse of a fragile household budget. Like many middle and working-class African Americans, participants experienced poor health and disability at relatively young ages. Additionally, they often lacked access to personal and public safety nets that could buffer the consequences of illness. Understanding how poor health contributes to mortgage strain among African-American homeowners provides important insight into the downstream consequences of health inequalities. Furthermore, understanding the processes through which illness can act as a financial shock has important policy implications.


Health inequalities; Home foreclosure; Housing; Race; United States

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