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Hawaii Value:
Percentage of occupied housing units with more than one person per room
Hawaii Rank:
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Percentage of occupied housing units with more than one person per room
US Value: 3.4%
Top State(s): West Virginia: 1.2%
Bottom State(s): Hawaii: 8.5%
Definition: Percentage of occupied housing units with more than one person per room
Data Source and Years(s): U.S. Census Bureau, American Community Survey, 2022
Suggested Citation: America's Health Rankings analysis of U.S. Census Bureau, American Community Survey, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Overcrowding (defined as housing with multiple occupants per room) has a number of negative effects on physical health and overall well-being. Residential crowding makes it easier for diseases like tuberculosis and other respiratory infections to spread. Further, overcrowding and lack of ventilation can promote a moist environment perfect for mites, roaches and molds, all of which contribute to respiratory problems. Many studies have established links between asthma and environmental triggers such as air pollution, urban density, ventilation and crowding. Living in crowded conditions can also give rise to psychological distress and is associated with behavioral issues and poor academic performance in children.
The number of households living in crowded housing conditions spiked in the U.S. during the Great Recession. Rates of crowded housing have not returned to pre-recession levels, although there has been an overall decline since 2010. Between 2007 and 2017, the number of households living in rental units with more than one occupant per room increased from less than 37 million to an estimated 43.4 million.
Those at greater risk of experiencing housing-related health conditions include:
Evidence supports various interventions to prevent and minimize the impact of housing problems on health. Healthy Homes programs at state and local levels have been found to improve health by remedying hazardous housing conditions. The Centers for Disease Control and Prevention offers more information and guidelines in their Healthy Housing Reference Manual, a comprehensive resource for public health and housing professionals.
Increasing affordable housing options through local and national housing development policies, rental vouchers, subsidized housing and utility assistance programs can help reduce overcrowding. More collaboration between the housing and public health sectors is needed to promote healthy home environments and better integrate health care into the housing system, particularly for those with chronic health needs. The National Low Income Housing Coalition offers additional resources and policy recommendations related to housing challenges.
Healthy People 2030 identifies quality of housing as a key issue in the neighborhood and built environment domain.
Acevedo-Garcia, Dolores. “Residential Segregation and the Epidemiology of Infectious Diseases.” Social Science & Medicine 51, no. 8 (October 16, 2000): 1143–61. https://doi.org/10.1016/S0277-9536(00)00016-2.
Braveman, Paula, Mercedes Dekker, Susan Egerter, Tabashir Sadegh-Nobari, and Craig Pollack. “Housing and Health.” Issue Brief #7: Exploring the Social Determinants of Health. Robert Wood Johnson Foundation Commission to Build a Healthier America, May 2011. https://www.rwjf.org/en/library/research/2011/05/housing-and-health.html.
Centers for Disease Control and Prevention, and U.S. Department of Housing and Urban Development. Healthy Housing Reference Manual. Atlanta, GA: U.S. Department of Health and Human Services, 2006. https://www.cdc.gov/nceh/publications/books/housing/housing.htm.
Howard, Amber, Adelle Mansour, Georgia Warren-Myers, Christopher Jensen, and Rebecca Bentley. “Housing Typologies and Asthma: A Scoping Review.” BMC Public Health 23, no. 1 (September 11, 2023): 1766. https://doi.org/10.1186/s12889-023-16594-8.
Pevalin, David J., Aaron Reeves, Emma Baker, and Rebecca Bentley. “The Impact of Persistent Poor Housing Conditions on Mental Health: A Longitudinal Population-Based Study.” Preventive Medicine 105 (December 2017): 304–10. https://doi.org/10.1016/j.ypmed.2017.09.020.
Pollack, Craig, Susan Egerter, Tabashir Sadegh-Nobari, Mercedes Dekker, and Paula Braveman. “Where We Live Matters for Our Health: The Links Between Housing and Health.” Issue Brief 2: Housing and Health. Robert Wood Johnson Foundation Commission to Build a Healthier America, September 2008. http://www.commissiononhealth.org/PDF/e6244e9e-f630-4285-9ad7-16016dd7e493/Issue Brief 2 Sept 08 - Housing and Health.pdf.
Pollack, Craig Evan, Beth Ann Griffin, and Julia Lynch. “Housing Affordability and Health Among Homeowners and Renters.” American Journal of Preventive Medicine 39, no. 6 (December 2010): 515–21. https://linkinghub.elsevier.com/retrieve/pii/S0749379710004551.
Sandel, Megan, and Matthew Desmond. “Investing in Housing for Health Improves Both Mission and Margin.” JAMA 318, no. 23 (December 19, 2017): 2291–92. https://doi.org/10.1001/jama.2017.15771.
Solari, Claudia D., and Robert D. Mare. “Housing Crowding Effects on Children’s Wellbeing.” Social Science Research 41, no. 2 (March 2012): 464–76. https://doi.org/10.1016/j.ssresearch.2011.09.012.
“The State of the Nation’s Housing 2022.” Cambridge, MA: Joint Center for Housing Studies of Harvard University, 2022. https://www.jchs.harvard.edu/sites/default/files/reports/files/Harvard_JCHS_State_Nations_Housing_2022.pdf.
U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Promote Healthy Homes. The Surgeon General’s Call to Action to Promote Healthy Homes. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2009. https://www.ncbi.nlm.nih.gov/books/NBK44199/.
Weitzman, Michael, Ahmareen Baten, David G. Rosenthal, Risa Hoshino, Ellen Tohn, and David E. Jacobs. “Housing and Child Health.” Current Problems in Pediatric and Adolescent Health Care, Housing and Child Health, 43, no. 8 (September 1, 2013): 187–224. https://doi.org/10.1016/j.cppeds.2013.06.001.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.