Data Source

"American Community Survey, 5-year estimates: The American Community Survey (ACS) is a nationwide survey designed to give communities a fresh look at how they are changing. It is critical in the Census Bureau's reengineered decennial census program. The ACS collects and produces population and housing information yearly instead of every ten years and publishes one-year and five-year estimates. The County Health Rankings use American Community Survey data to measure social and economic factors."

Measure Methods

• "Severe Housing Cost Burden is a percentage: Severe Housing Cost Burden is the percentage of households that spend 50% or more of their household income on housing."

• "Severe Housing Cost Burden is not identical to the measure used for Severe Housing Problems: Although both measures rely on the same underlying data, the numerator and denominator are defined somewhat differently. Given the difference in measure definitions and the additional years of data used for this measure, there may be differences in the values of these two measures that seem incompatible. For example, a county can have a higher Severe Housing Cost Burden rate than its Severe Housing Problems rate. The Severe Housing Cost Burden is calculated from the American Community Survey rather than downloaded from the Comprehensive Housing Affordability Strategy (CHAS) Dataset to provide users with the most recent data."

• "Numerator: The numerator is the total number of households in a county that spend 50% or more of their household income on housing."

• "Denominator: The denominator is the total occupied housing units for which a county's housing cost burden is computed."

• "Can This Measure Be Used to Track Progress?: This measure can be used to track progress with some caveats. It is important to note that the estimate provided in the County Health Rankings is a 5-year average. However, for counties with a population greater than 20,000, single-year estimates can be obtained from the resource listed below."

Source: Severe Housing Cost Burden* | County Health Rankings & Roadmaps

References

• Kushel MB, Gupta R, Gee L, Haas JS. Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of general internal medicine. 2006;21(1):71-77.

• Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambulatory Pediatrics. 2008;8(1):50-57.

• Long SK. Hardship among the uninsured: choosing among food, housing, and health insurance. The Urban Institute. 2003. http://webarchive.urban.org/publications/310775.html

• Levy H, DeLeire T. What do people buy when they don't buy health insurance and what does that say about why they are uninsured? National Bureau of Economic Research. 2003;w9826.

• Hiscock R, Kearns A, MacIntyre S, Ellaway A. Ontological security and psycho-social benefits from the home: Qualitative evidence on issues of tenure. Housing, theory and society. 2001;18(1-2):50-66.

• Dunn JR. Housing and health inequalities: review and prospects for research. Housing studies. 2000;15(3):341-366.