Research Discovery: The Impact of Housing and Basic Needs on Health in Rural and Urban Communities

Where we live and the resources we have access to—like stable housing, food, transportation, and financial support—can play a big role in our health. This study explores how a housing-based tool can help healthcare teams better understand and respond to these everyday challenges for people living in both rural and urban communities.

What It Is

This study looks at how people’s everyday living conditions—such as housing stability, access to food, transportation, and financial resources—affect their health. Researchers examined whether a housing-based measure called the HOUSES Index can help identify people who may be experiencing social challenges that impact their health, especially when those challenges are not directly reported by patients. The study compared patients living in rural and urban communities across a large Midwest healthcare system.

 How It Works

The HOUSES Index uses publicly available housing information (such as home size, number of bedrooms and bathrooms, and estimated home value) to estimate a person’s socioeconomic status. Researchers linked this housing data to patients’ health records and compared it with patient-reported surveys about social needs like food insecurity, housing concerns, transportation challenges, financial stress, and safety at home. They then looked at how these factors differed between rural and urban residents.

Key Findings

• Social challenges were common among patients, especially those living in rural areas.

• Patients with lower socioeconomic status, as measured by the HOUSES Index, were much more likely to report social risks like food insecurity or financial strain—no matter where they lived.

• Once socioeconomic status was taken into account, living in a rural area alone did not explain higher social risk.

• Many people with the greatest needs were less likely to complete social risk surveys, meaning their challenges may be missed.

• The HOUSES Index helped identify individuals who may need extra support even when survey information was missing.

 Community Impact

This research shows that understanding a person’s living conditions is critical to understanding their health needs. Tools like the HOUSES Index can help healthcare systems, community organizations, and policymakers better identify people who may need support, especially in rural communities where social needs are often underreported. By improving how social challenges are recognized, communities can better connect individuals to resources, reduce health disparities, and support healthier outcomes for everyone.

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About the Study

Researcher: Jessica L. Sosso, M.D.

Sosso JL, Fischer KM, Wi C-I, et al. The Association Between Patient-Reported Social Risks and the HOUSES Index: A Rural-Urban Comparison. Journal of Primary Care & Community Health. 2025;16. doi:10.1177/21501319251369673