Identifying predictors of housing distress in later life: A lagged exposure-wide approach in a national sample of older U.S. adults

Objectives Housing insecurity is increasingly prevalent among older adults in the US, yet the factors that contribute to housing-related distress in this population remain inadequately understood. This study examined how changes in a comprehensive set of physical health, health behaviors, psychosocial, and economic factors are associated with subsequent housing distress, and explored differences by military veteran status. Methods We analyzed three waves of prospective data from a national sample of US adults aged 50+ years (Health and Retirement Study, N = 13,771). Sixty-five candidate predictors spanning physical health, health behaviors, psychological well-being and distress, and social and economic domains were assessed for associations with housing distress four years later. Multivariable analyses were conducted adjusting for a range of potential confounders. Results were further stratified by military veteran status. Results Eleven of the candidate predictors were significantly associated with subsequent housing distress (after Bonferroni correction), with at least one significant predictor observed in the domains of psychological well-being (4/6; e.g., decreased life satisfaction), psychological distress (3/12; e.g., increased perceived constraints), and social (2/23; e.g., increased social strain from children) and economic (2/6; decrease financial mastery) factors. Stratified results by veteran status suggested differences in the strength associations in each subsample. Discussion Results identify a range of modifiable risk and protective factors associated with housing distress among older adults. These findings suggest several promising intervention targets to mitigate housing insecurity in this population, with consideration of potential differences by veteran status.