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Abstract
Housing is a major pathway through which health disparities emerge and are sustained
over time. However, no existing unified conceptual model has comprehensively elucidated
the relationship between housing and health equity with attention to the full range
of harmful exposures, their cumulative burden and their historical production. We
synthesized literature from a diverse array of disciplines to explore the varied aspects
of the relationship between housing and health and developed an original conceptual
model highlighting these complexities. This holistic conceptual model of the impact
of housing on health disparities illustrates how structural inequalities shape unequal
distribution of access to health-promoting housing factors, which span four pillars:
1) cost (housing affordability); 2) conditions (housing quality); 3) consistency
(residential stability); and 4) context (neighborhood opportunity). We further demonstrate
that these four pillars can lead to cumulative burden by interacting with one another
and with other structurally-rooted inequalities to produce and reify health disparities.
We conclude by offering a comprehensive vision for healthy housing that situates housing’s
impact on health through a historical and social justice lens, which can help to better
design policies and interventions that use housing to promote health equity.