There is a direct link between the affordability and quality of housing and physical and mental health. People who experience housing cost burdens (housing costs exceeding 50% of income) make critical decisions about spending on food, health care, and other necessities. These individuals may have few options besides living in low-quality homes in unsafe neighborhoods. These conditions can lead to high levels of stress and decreased use of health care for issues like chronic diseases. Approximately half a million North Carolinians suffer from housing cost burden.¹

Housing cost burden can also contribute to another component of severe housing problems—overcrowding. Overcrowding is defined as having more than one person per room of a residence (not including bathrooms). Health consequences of overcrowding include chronic stress from space-sharing conflicts and exacerbated respiratory conditions, such as asthma. Approximately 14,000 households in North Carolina are overcrowded. ¹

The final component of severe housing problems—lack of kitchen and/or plumbing facilities—can lead to untreated wastewater surfacing outdoors or backing up into homes, risking exposure to pathogens and contaminated drinking water. This wastewater surfacing can also provide breeding areas for mosquitoes and flies. People who lack kitchen facilities are more likely to experience food insecurity or poor nutrition, contributing to poor health outcomes such as diabetes and obesity. Approximately 24,000 households in North Carolina lack sufficient kitchen facilities and 18,000 households lack complete plumbing.[1]

Disparities in experiences of severe housing problems exist along geographic, racial, educational, and income lines. Metropolitan residents and racial and ethnic minorities are more likely than their rural and white counterparts, respectively, to face all components of severe housing problems. Figure 1 shows the distribution of North Carolinians facing severe housing problems by county.