Moving Force: Housing Costs May Influence Moves to Nursing Homes

Some studies suggest that high rents and a lack of housing are forces that push older adults to move to nursing homes. In a recent study, researchers sought to understand the relationship between housing cost burden (HCB)—spending 30% or more of monthly income on housing or housing expenses—and moves to nursing homes among older adults.

The study sample came from the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries age 65 and older. Participation was limited to 3,537 low- and moderate-income individuals who were homeowners or renters in 2015 (which excluded persons living in Life Plan Communities, assisted living, nursing homes, and other settings). Researchers were interested in examining differences between those who remained in the community, moved to a nursing home, or died within a three-year period (2015 to 2018). They hypothesized that renters would be more likely than homeowners to move to a nursing home, and that renters with HCB would be the most likely to move to a nursing home. They also anticipated that difficulties with functioning and health problems would not fully explain the greater likelihood of moving to a nursing home.

As predicted, renters with HCB proved more likely to move to a nursing home than others, even after accounting for demographic factors, health, and functioning. Renters with HCB were more than four times as likely to move to a nursing home within the three-year period than were homeowners without HCB. Further, renters with HCB were more likely to move to a nursing home in better health compared to homeowners without HCB. In addition, the results showed that older adults of color were overrepresented among the group of renters with HCB, perhaps influencing the overrepresentation of black older adults in nursing homes. The authors highlighted the need for more affordable housing options for older adults, allowing individuals to live in the environment most suited to their needs and preventing costly nursing home admissions.


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Jenkins Morales M, Robert SA. The effects of housing cost burden and housing tenure on moves to a nursing home among low-and moderate-income older adults. The Gerontologist, (2020); Jun 16.


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