Housing Insecurity and Mental Health: the Effect of Housing Tenure and the Coexistence of Life Insecurities.

While the adverse effects of housing insecurity on mental health are known, much less is known about the modifiers underlying these effects. The aim of this study was to analyze the mental health of people with housing insecurity by housing tenure and considering the coexistence of other life insecurities (energy poverty and food insecurity). We conducted a cross-sectional study through a survey performed in all people attending the Platform for People Affected by Mortgages or the Alliance against Energy Poverty of Barcelona for the first time between June 2017 and December 2019 and who reported housing insecurity. The dependent variables were the risk of poor mental health, self-reported anxiety and/or depression, and the use of psychotropic drugs. We fitted age-adjusted robust Poisson regression models for each dependent variable and estimated adjusted prevalence ratios (aPR). The study included 256 women and 104 men. The prevalence of poor mental health was 89% in women and 85.3% in men, which was much higher than that in the general population of Barcelona (19.5% and 14.5%, respectively). Among women, mental health was worse in those living in a squat (aPR 1.16; 95% CI: 1.02-1.31) and in those with food insecurity (aPR 1.11; 95% CI: 1.01-1.21). The number of coexisting insecurities showed a gradient effect (3 insecurities: aPR 1.21; 95% CI: 1.01-1.45). Among men, the results showed no clear pattern. Poor mental health was highly prevalent in people with housing insecurity and was exacerbated by the coexistence of life insecurities. Public policymakers should consider the complexity of persons with housing insecurity.