Housing Cost Burden - Children in North Carolina

North Carolina

Safe and stable housing is an essential social determinant of health. According to most guidelines, households should spend no more than 30% of their monthly income on housing. Spending more can be a financial burden, making it difficult to afford other fundamental needs such as adequate health insurance, healthy foods, utility bills, education and reliable transportation. 

Housing has become less and less affordable over the last twenty years, as the cost of renting or owning a home has risen more quickly than incomes. Since 2001, median rent has increased 23.4%, but median renter household income has risen only 5.3%.

Families that struggle to afford housing may face eviction, foreclosure and homelessness. The stress of housing instability can have impacts on physical and mental health, especially for children. Living in a severely cost-burdened household — meaning housing costs exceed 50% of household income — is associated with lower math and reading scores in children. Cognitive achievement declines steeply once housing costs exceed 60% of a family’s income.

The prevalence of cost-burdened households with children is higher among:

• Renters compared with homeowners. Renters also historically have lower incomes than homeowners.
• Black and Hispanic households compared with non-Hispanic white households.

Research shows that public housing is associated with immediate and significant reductions in housing cost burden on households with children. Reducing housing costs allows families to use their income on other valuable items such as food, school and job-related expenses. The Community Preventive Services Task Force recommends tenant-based housing vouchers to help those with low incomes pay rent.

The federal Earned Income Tax Credit (EITC) and Child Tax Credit, designed to benefit low- to moderate-income workers and households with children, respectively, have been shown to improve long-term health outcomes, educational attainment and future earnings for recipients. Expansions for both credits went into effect in 2021 and are expected to lift 4 million children above the poverty line.

Healthy People 2030 has a goal to reduce the proportion of families that spend more than 30% of their income on housing.

Duncan, Greg, and Suzanne Le Menestrel, eds. A Roadmap to Reducing Child Poverty. Washington, D.C.: The National Academies Press, 2019. https://doi.org/10.17226/25246.

Givens, Marjory, Keith Gennuso, Amanda Jovaag, Julie Willems Van Dijk, and Sheri Johnson. 2019 County Health Rankings Key Findings Report. Madison, WI: University of Wisconsin Population Health Institute, 2019. https://www.countyhealthrankings.org/reports/2019-county-health-rankings-key-findings-report.

Gold, Sarah. “Does Public Housing Reduce Housing Cost Burden among Low-Income Families with Children?” Journal of Children and Poverty 26, no. 1 (January 2, 2020): 1–21. https://doi.org/10.1080/10796126.2019.1682754.

Hess, Chris, Gregg Colburn, Ryan Allen, and Kyle Crowder. “Cumulative Housing Cost Burden Exposures and Disadvantages to Children’s Well-Being and Health.” Social Science Research 119 (March 2024). https://doi.org/10.1016/j.ssresearch.2024.102984.

Marr, Chuck, Kris Cox, and Arloc Sherman. Recovery Package Should Permanently Include Families With Low Incomes in Full Child Tax Credit. Washington, D.C.: Center on Budget and Policy Priorities, September 7, 2021. https://www.cbpp.org/research/federal-tax/recovery-package-should-permanently-include-families-with-low-incomes-in-full.

Newman, Sandra, and C. Scott Holupka. “Housing Affordability And Children’s Cognitive Achievement.” Health Affairs 35, no. 11 (November 2016): 2092–99.https://doi.org/10.1377/hlthaff.2016.0718.