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November 18, 2015

Understanding The Negative Effects Of Home Foreclosures On Mental And Physical Health

automotive, life sciences,

Dr. Owusu Kizito

Dr. Owusu Kizito
CEO & President/Investigroup

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ABSTRACT

The rising rate of home foreclosures which stands at approximately 1 in 92 households in the United States has raised a national alarm. Medical issues account for approximately half of all home foreclosure filings and it appears that approximately 1.5 million American homeowners could lose their homes to foreclosure every year. The qualitative phenomenological study involved investigating the lived experiences of the consequences of home foreclosures on the physical and mental illness of northern New Jersey homeowners. The research questions asked included what were the lived experiences of physical and mental health decline following home foreclosure and how did the participant’s perceive their physical and mental health decline affected their family members? Four core themes were revealed from the study. The four themes included foreclosure process resulting in hospitalization of family and foreclosure associated with the lack of family’s health insurance, family health and the foreclosure process, and foreclosure and the negligence of doctor’s prescription, foreclosure as perceived loss of money and finally homeownership, displacement and housing instability as a reason for depression. The current phenomenological research study of the lived experiences of home foreclosures on 25 homeowners in the process of foreclosure has added to the body of knowledge because it highlighted the stressors, reasons, and causes. The study provides a framework for local practitioners and decision makers in identifying the consequences on the physical and mental health of the participants and their families and providing a workable foreclosure response system.

INTRODUCTION

A critical national concern has developed because of the growing number of home foreclosures in recent years, which currently stands about one in 92 households in the United States (Realty Trac, 2007). This situation has wide social implications, including unknown health-related consequences to the individuals involved. According to Robertson, Egelhof, and Hoke (2008), medical crises are among the major causes of home foreclosures, along with other factors such as rising interest rates, loose lending, a flat real estate market, and irresponsible borrowers. Approximately half of all home foreclosure filings result from family medical crises, and approximately 1.5 million American homeowners could undergo foreclosure each year.

It appears the threat of losing a home can be stressful enough to make a homeowner sick, and researchers have shown a correlation exists between foreclosure rates and people’s health using the states of Arizona, New Jersey, Florida, and California as examples (Kalita, 2011). Kalita (2011) explained that researchers at Princeton University and Georgia State University found that a 7.2% and 8.1% rise in emergency visitations and hospitalizations occurs for hypertension and diabetes, respectively, among people aged 20 to 49 years, and 12% more anxiety-related hospital visits occur for every increase of 100 foreclosures in the same age category. Thirty-nine percent more hospital visits occur for suicide attempts for the same rise in foreclosures among the same age group.

The consequences of home foreclosures on affected families include eliminating the entire savings of the homeowners and causing unknown health-related concerns (Robertson et al., 2008). Other repercussions involve leaving significant debt on the homes they no longer own and having harmful consequences on neighborhoods and local communities. Home foreclosures reduce the return on investment for investors and lenders and upset the national goal of homeownership that influences social policy. As explained by Robertson et al. (2008), medical crises account for about half of all home foreclosure filings, which was previously unknown to policy makers and scholars; equally unknown are the health ramifications to persons undergoing foreclosure. The study involved investigating the lived experiences of the potentially negative consequences home foreclosures have on the physical and mental health of northern New Jersey homeowners. The study focused on the physical and mental health consequences and involved sampling 25 individuals in the process of foreclosure to explore their health consequences and analyze the findings to provide recommendations. The results may be particularly useful for local legal practitioners, state and local officials, and other decision makers in suggesting solutions for a workable local foreclosure response system.

PROBLEM STATEMENT AND RESEARCH OBJECTIVES

The general problem is that even though “stress is a normal part of everyday life, . . . the high levels of anxiety, shame, uncertainty, and fear likely associated with home foreclosure may contribute to a host of physical and mental illness” (Kingsley et al., 2009, p. 3). The health-related concerns of home foreclosures on families are mostly unexplored (Housing Program of Jefferson Parish, 2007). The specific problem is that the potential deleterious consequences of home foreclosures on physical and mental health remain generally unknown. Families in foreclosure may have more health problems than do their unaffected counterparts (Childs, 2008). Kalita (2011) found a rise of 100 foreclosures accounted for 12% more emergency and hospital visits for the individuals involved, and for an increase of 100 foreclosures, 39% more suicide-attempt patients went to emergency rooms and were hospitalized.

The purpose of this qualitative phenomenological study was to examine the participant’s lived experiences of the possible negative consequences of home foreclosures on physical and mental health in northern New Jersey. To fulfill the objectives of the study, 25 homeowners in the process of foreclosure participated in interviews to investigate the as-yet undetected health-related concerns brought about by home foreclosures. Older adults might especially feel the consequences of foreclosure because of the chronic health conditions that make relocation and adjustment to new neighborhoods stressful. The most intense demonstration of the possible impairment to mental health is the suicide rate of individuals before, during, or after foreclosure with its related financial problems (Kingsley et al., 2009).

LITERATURE REVIEW

The focus of this chapter is on the literature concerning those events or issues such as illness, divorce, or job loss that can cause personal and family stress as well as poor outcomes for families facing foreclosure. Fischerand Kittleson (2000) defined stress as resulting from a person’s perception that an event in life, a situation, or a particular circumstance is overwhelming and is greater than his or her ability to cope. Fischer and Kittleson (2000) noted further that situations, events, negative family dynamics, and interactions that occurred during childhood make an individual singularly susceptible to stress.

Armatrading (1999), Gwynne (1992), and Larsen, Wilson, and Beley (1994) asserted the precipitating factors that cause health issues and adverse family relationships include job insecurity, foreclosure, or savings and loans collapse, with their devastating effects including the dislocation of families. Job insecurity and work intensification appear to affect the general health and family relationships of the individuals involved (Armatrading, 1999). Armatrading further indicated employees who enjoy supportive relationships from their managers tend to experience less work-related stress, but the job insecurity remains. Gwynne noted economic hardship causes people to experience emotional problems such as fear when financial insecurities exist.

Larsen et al. (1994) noted the slow recovery from the recession is a major stressor for a number of American families. An untold number of Americans will feel their security slipping away as many government agencies and businesses restructure and downsize their operations in response to the current economic realities. These insecurities may result from the threat of job loss; increase in job responsibilities due to layoffs of their coworkers, which results in changes to their job descriptions; and reduced potential for promotion, cutbacks or salary freezes, and forced relocation.

Historical Overview of Poor Outcome From Foreclosures

Poor outcomes will occur for families who suffer foreclosure on their properties. “Households [enter] foreclosure primarily when a precipitating event such as divorce, job loss, illness, or accident dramatically [changes] the family’s financial situation” (Kingsley et al., 2009, p. 6). Further, heightened personal and family stress intensifies marital troubles, health problems, and negative actions such as child abuse, substance abuse, and other addictions (Kingsley et al., 2009). These effects may be difficult to document, but they have long-term consequences.

According to Wagner, Wolfe, Rotnitsky, Proctor, and Erickson (2000), stress causes damage to bodily systems, including the mental well-being of those caught in the midst of the crisis. Some distressed homeowners developing mental health issues from the foreclosure process might even attempt suicide. Childs (2008) mentioned the feelings of depression that occur when people lose their home to foreclosure because home ownership represents stability for an individual or family and its loss causes feelings of failure. Lashley et al. (2009) and Nebehay (2008) noted World Health Organization researchers warned appropriately that the financial and economic crisis would likely escalate and result in increased mental health issues, including suicide, among individuals struggling to come to terms with poverty and unemployment. Older Americans may particularly be vulnerable to the stressful effects of foreclosures because of chronic health problems (Smith & Ferryman, 2006). Indeed, relocation and adjusting to new neighborhoods are particularly difficult for the elderly and individuals with qualified health. Along these lines, Ross and Huber (1985) surveyed a certain population and discovered that retired seniors might experience fatigue, insomnia, and feelings of hopelessness because of high taxes and changes in the economic order.

According to Kingsley et al. (2009), financial stress might be a major contributor to domestic violence, and cases of spousal or child abuse could increase in homes experiencing the burden of foreclosure. Caner and Wolff (2004) explained approximately 46% of American families have as little as $5,000 in liquid assets, including IRAs, which indicated some families are at the brink of financial disaster. In a survey of 60,000 homeowners, researchers for the Homeownership Preservation Foundation (Ackerman, 2010) found the following circumstances might put individuals at risk of foreclosure: 25% resulted from a health crisis; 32% resulted from a job loss; 50% had already missed two mortgage payments and 85% had already missed one; most had first-time home loans; almost all had no savings, no accessible credit, and few assets available in their extended families; most had already refinanced two or three times; and virtually all loans were less than 3 years old. Having valid health insurance is an important consideration in the medical issues surrounding foreclosure. In fact, Duchon et al. (2001) discovered that up to one fourth of families not having health insurance might experience significant changes in their lifestyle to pay medical bills, even with just one member lacking health insurance. Watson, Jorge, Cohen, and Seifert (2007) revealed 53% of St. Louis, Missouri, respondents reported their medical debt resulted in housing problems.

According to Lashley et al. (2009), foreclosures affect both adults and children in households that experience foreclosure. Regardless of their psychological health before the crisis, high degrees of stress affect both grownups and children and last for extended periods. Such a situation can develop into enduring psychiatric ailments (Lashley et al., 2009). These authors noted children in afflicted households face the effects of foreclosures and associated financial problems, indicating that mental health practitioners need to develop workable strategies to empower family members to develop resiliency in managing their current economic reality. The children might exhibit psychiatric symptoms, or the impact might be evident in their emotional growth. Maikranz, Steele, and Forehand (2003) found that some children might develop social functioning difficulties or demonstrate subclinical levels of depression. Maikranz et al. (2003) also discovered urban Black youths are particularly susceptible to symptoms of depression and later psychosocial functioning because they experience frequent exposure to high-risk environments, including violence, drug use, and poor housing conditions in their communities. Such extremes may place the children at a greater risk of behavioral and emotional problems.

The foreclosure crises have resulted in an increase of severe mental and neurological disorders, making it necessary for society to pay a greater degree of attention to addressing the psychological and social effects of the damaged parties.

As discovered in one study (“Mental Health: Keeping Your Emotional Health,” 2002), stress and family problems might trigger mental illness; when a family experiences a tragedy, its members often develop some form of mental or emotional impairment. Lashley et al. (2009) posited economic loss or job stress might result in heart diseases, depression, and anxiety and these may be serious enough to warrant hospitalization. The foreclosure catastrophe in the United States has contributed to an increase in incapacitating mental and neurological disorders.

Lashley et al. (2009) described several possible outcomes of stress associated with foreclosure. The first possible outcome is the feeling of powerlessness and victimization in the adults experiencing foreclosures. The debilitating effects include affecting the subsystems of both parents and adults and making them feel hopeless, even persecuted. Gray, Maguen, and Litz (2004) compared this to the grief experienced by individuals and families who lost relatives and close friends in the September 11, 2001, terrorist strike on the buildings of the World Trade Center. Their struggle to adjust to their bereavement after the event caused irritability, anger, and bitterness and influenced their relationship with family and peers. Parents and parent-figures undergoing foreclosure might blame themselves, and these feelings of guilt might result in cognitive imbalance with the possibility of depressive symptoms. Gray et al. observed that when some people experience adversities in their lives, they find it difficult to adjust to their new reality, which might result in sustained difficulties.

The second possible outcome of stress associated with foreclosure is that homelessness will affect the academic performance of school children. The children will feel the impact of relocation or homelessness on their scholastic achievement because of the displacement from their homes and neighborhoods, as well as the financial and economic stresses (Moen, 1979); these children will inevitably encounter traumatic and distressing conditions by having to change schools at such times and by losing their friends. Further, they might have to share a room with other family members after having their own rooms or even have to move to a shelter. These emotional and physical events might cause nightmares, enuresis, or intrusive thoughts, depending on the age of the child. Adolescents in the family might move out of the house to go and fend for themselves. Lashley et al. (2009) posited that The Mortgage Bankers Association indicated one child in every American classroom is at risk of losing his or her home because the parents are unable to pay their mortgage. Galuszka (2008) further explained that minority students would have a particularly difficult time gaining access to colleges because those institutions are cutting their budgets and minority students might have problems obtaining student loans. At historically Black schools, 70-80% of prospective students are eligible for Pell Grants because of their low income. These individuals will have to take on extra jobs to catch up. According to Galuszka, families confronted with foreclosures who have children attending private schools might have to decide between paying the mortgage or the tuition. Another direct impact of foreclosures on schoolchildren is the decline in their academic performance. Several researchers and publications (Butler, 2008; “Educating the Homeless,” 2008), noted schoolchildren who frequently change locations are more likely to perform poorly academically and lose academic progress.

The third possible outcome of stress associated with foreclosure is widespread foreclosures also have an indirect impact on schoolchildren. Reduction of school funding results directly from less property tax revenue collected when homeowners do not pay the tax because of foreclosures. Because of less funding from the state, school leaders rethink their budgets to reflect current realities, and these cutbacks often involve personnel recruitment, staffing, and professional development.

The fourth possible outcome of stress associated with foreclosure is the primary breadwinner in the family might feel a reduction in his or her status in the community. A foreclosure can limit economic resources and disrupt the family system. Affected families might need to move from well-maintained communities to less affluent neighborhoods, leading to feelings of fear, disbelief, anxiety, hopelessness, and distress. Furthermore, Riley and Eckenrode (1986) noted stress might also affect extended family members and friends of families directly involved in the foreclosure and undergoing fiscal stress. A survey conducted by researchers at Freddie Mac/Roper of over 2,000 U.S. homeowner households in 2005 indicated approximately 60% of individuals delinquent on their mortgages are unaware of the assistance mortgage lenders can offer to distressed homeowners. The impact of foreclosures on the community’s health could be significant because it affects the individual’s and the family’s health (Phillips, Clark, Lee, & Desautels, 2010). The effects on the local population include crime, loss of city revenue, disruption of social networks, and increases in blight.

Impact on Individual or Household Health

Individuals and families who experience high levels of stress resulting from foreclosures might have a host of physical and mental illnesses, causing damage to bodily systems, generating chronic health problems, and undermining their mental and emotional well-being (Pollack & Lynch, 2009). According to Renzetti and Edleson (2008), people currently experiencing impaired health who are undergoing the tension of foreclosure might find their preexisting conditions exacerbated, and the situation might trigger other harmful habits such as alcoholism and smoking. Financial stress might also contribute significantly to domestic violence (Renzetti & Edleson, 2008). Foreclosure might affect a person’s credit and ability to maintain stable housing, thereby necessitating a decline into substandard living conditions that could affect health (Phillips et al., 2010).

Individuals in foreclosure must make sacrifices by choosing between taking care of their own health issues or finances. These decisions might include skipping or delaying meals, ignoring preventative health care measures, foregoing health insurance, or neglecting to maintain prescriptions and utility payments. Other family misfortunes include economic hardship and financial insecurity, displacement and housing instability, personal and family strain, broken relationships, compromised health, and adversity for children, the older adults, and renters. Pettit et al. (2009) noted a family’s removal from home and the residential instability that follows might initiate a downward spiral that could prompt the family to seek assistance from a homeless shelter. Many families troubled by foreclosures might become homeless after moving into rental units, sharing space with family and friends, or seeking assistance from homeless shelters. Pettit et al. further noted sharing space with friends or family usually precedes homelessness.

Researchers at the National Coalition for the Homeless (2009) discovered poverty and homelessness are inevitably linked because impoverished families are often unable to pay for health care, education, housing, or food. Needy families often must make very difficult choices about how to use their limited available resources, and they might simply drop housing. In 2007, about 12.5% of the U.S. population (approximately 37,300,000 people) existed in destitution. A person caught in such circumstances is often one paycheck away from abject ruin and a life on the streets, which might occur after an illness or accident. The researchers at the National Coalition for the Homeless explained that two factors account for poverty: declining job opportunities and diminishing availability of public assistance. The limited availability of affordable housing and reduced number of housing assistance programs worsened the housing crisis and increased the incidence of homelessness. The unavailability of housing and its consequent high rent burdens have not only put a number of people at risk of homelessness but have forced many homeowners to become homeless.

Factors that might escalate homelessness include the lack of low-cost housing, poverty, lack of affordable health care, addiction disorders, domestic violence, and mental illness. Workers in the agricultural or service sectors tend to have limited work-based health insurance because health insurance provisions by employers have become more rare in recent years (Families USA, 2009). Tenants may become homeless quickly when they struggle to pay their rent because of serious illness or disability; the same is true for those with addiction problems. Job loss and depletion of savings normally precede eviction. Domestic violence and abusive relationships can also cause homelessness. The U.S. Conference of Mayors (2005) posited that domestic violence was the leading agent of homelessness from 50% of the cities surveyed. Further, many individuals with mental illness who receive appropriate supportive housing options can live successfully in a community (Center for Mental Health Services, 2003); the challenge is that obtaining access to these housing options and treatment services for mentally ill homeless people might be difficult. Without the appropriate treatment options for these differing groups of homeless people, it might be impossible for them to obtain housing as well as health care and recovery supports once on the streets.

Jayasundera, Silver, Anacker, and Mantcheva (2010) raised the issues concerning financial insecurity and economic hardship affecting homeowners struggling with their mortgages. Nonprofit organizations certified by the U.S. Department of Housing and Urban Development help homeowners prevent foreclosures with mitigation strategies. Approved counselors are loan resolution experts who seek equitable solutions on behalf of these families.

Foreclosures affect personal and family stress levels, disrupt relationships, and escalate ill health (Bennett, Scharoun-Lee, & Tucker-Seeley, 2009). Such potential health dangers, which are often of prolonged duration, have not gained much attention from policy makers worldwide, even though these same leaders have rushed to counter the economic impacts of the foreclosure crisis. Few if any researchers have reported specific disease consequences of home foreclosures or suggested foreclosure might increase the risk of chronic illness because the foreclosures might link to a possible range of health and psychological outcomes (Bennett et al., 2009). Policies intended to manage delinquencies and prevent foreclosures might protect those with the greatest health risk (Bennett et al., 2009).

Bennett et al. (2009) noted home foreclosures could be a stressor because of the aversive procedures and length of the process. U.S. banks usually retain all the home sale proceeds, whereas other nations, such as the United Kingdom, return net profits (once all debts are paid) to the foreclosed homeowner. The stress to families begins when they become delinquent on their mortgage and the bank starts the foreclosure process; the process itself varies substantially among different jurisdictions of the United States, ranging from several months to over a year (Immergluck, 2007; Schuetz, Been, & Ellen, 2008) and may include judicial supervision (Pence, 2006). Home foreclosures have phases of intensity through the process and can be stressful life events (Brown & Harris, 1978).

Indeed, previous studies have already listed foreclosure as one of the 43 most stressful occurrences facing people in their lives. Foreclosure reached number 21 using the Social Readjustment Rating Scale in 1967 (Holmes & Rahe, 1967); by 1997, a study update revealed foreclosure had reached number 11 of such life happenings (Scully, Tosi, & Banning, 2000). It remains unclear how to explain independent effects of foreclosures, but Lazarus and Folkman (1984) suspected anxiety resulting from foreclosure surpassed families’ ability to cope. Schneiderman, Ironson, and Siegel (2005) indicated foreclosure might influence psychological activity and behavior, as well as increase the chance of some chronic ailments such as cardiovascular disease. This implies a negative psychological impact of foreclosures on families.

Some possible psychological reactions to home foreclosures are important. According to Faravelli and Pallanti (1989) and Kendler, Gardner, and Prescott (2003), the etiology of anxiety and depression has implicated stressful life events. Strong evidence indicates disturbing life occurrences causally relate to the process and intensity of a foreclosure and the initial episode of depression (Finlay-Jones & Brown, 1981; Kendler, Karkowski, & Prescott, 1998). Chronic tension-producing agents such as job or financial stress often increase the effect of catastrophic life occurrences on depression, especially if the exposure of both stressors is simultaneous. Home foreclosure usually happens during prolonged financial crises in families and produces damaging health problems because of the tie to chronic stressors (Belkic, Landsbergis, Schnall, & Baker, 2004; Bosma, Peter, Siegrist, & Marmot, 1998; Dooley, Fielding, & Levi, 1996; Gallo, Bradley, Siegel, & Kasl, 2000; Grossi, Perski, Lundberg, & Soares, 2001; Shortt, 1996; Weich & Lewis, 1998). Several studies included examples of this association of depressive symptoms with chronic financial strain in populations from the United States, Britain, and China (Krause, 1987; Krause, Liang, & Gu, 1998).

Individuals become depressed when they feel some responsibility for a stressful life situation, and this might be common among people who experience foreclosures, despite the widely acknowledged notion that deceptive mortgage industry practices are to blame rather than solely the families (Schroeder, 2006). Individuals or families in the foreclosure process have limited control over the events surrounding them, and their sense of helplessness may increase the effect of stress on their depression (Benassi, Sweeney, & Dufour, 1988; Nettleton & Burrows, 2001). People with depression frequently demonstrate negative behaviors that can promote additional unfavorable life events, including job and financial problems and interpersonal conflicts (Hammen, 2006). Home foreclosures might affect health-related behaviors; clearly, unhealthy choices such as smoking, drinking alcohol, developing sleep disorders, and gaining weight are positively related to such stressful life events as foreclosures (Korkeila, Kaprio, Rissanen, Koshenvuo, & Sörensen, 1998).

Home foreclosures might also affect health care use; for example, financially distressed individuals might forgo preventive visits to physicians, reduce compliance to their prescription medication regimens, and switch from prescription drugs to over-the-counter drugs (Cobaugh et al., 2008). Both compositional and contextual dimensions are associated with susceptibility to home foreclosures. Cobaugh et al. (2008) noted individuals from minority ethnic backgrounds and with lower socioeconomic status might be particularly vulnerable and likely to experience stress and depression, as well as have limited opportunities to seek stress-buffering resources.

Many people who experience stressful life events are sufficiently resilient to get through them, but notable exceptions might exist for people with poor psychiatric and health histories, low self-esteem, poor coping mechanisms, inadequate social support systems, and emotional disturbance, as well as for those who highly value economic success, making them particularly vulnerable (Bleich, Gelkopf, & Solomon, 2003; Moos, Brennan, Schutte, & Moos, 2006). Soaring food, energy, and health care costs put financial strain on the average household, and coupled with the macroeconomic climate and detrimental contextual circumstances in times of economic uncertainties, those suffering through foreclosure might undergo increased stress exposure (Joint Center for Housing Studies of Harvard University, 2008). Unemployment seems to be the most troubling problematic macroeconomic indicator, and combined with foreclosure in the present economic climate, the lack of a job appears particularly deleterious (Cahill, 1983; Colledge, 1982; Kasl, 1982).

According to Seifert (2005), more than 27% of those facing medical debt experienced some form of housing problem or insecurity as well, including the inability to make mortgage payments or qualify for a mortgage, difficulties paying rent, and the possibility of facing eviction. Many Americans are encountering rising health care costs and diminishing coverage, and millions have joined the ranks of the underinsured and uninsured, leaving a number of families facing health care costs they cannot manage (Families USA, 2009). This trend may lead more people deeper into debt, bankruptcy, and possible home foreclosure. Foreclosures cause individuals to become depressed and anxious, which are emotional states affecting marriages and relationships. In the face of foreclosure, people feel involved in a catastrophe, which leads to depression. Other effects include outbursts at work; an increase in drinking, abuse, and violence toward children; and suicide rates increasing (Armour, 2008).

Impacts on Children

Kachura (2011) posited that a multitude of factors might affect a city’s housing market; two of the most significant of these problems are foreclosures and abandoned homes, which always cause a decline in the value of the house; then the foreclosures endanger families through loss of household wealth and neighborhood instability. Foreclosures directly affected nearly 3% of Baltimore City’s students, as a representative example; and an additional 21% of the students affected by foreclosures move on to a new address the following year. According to Been, Ellen, Schwartz, Stiefel, and Weinstein (2010), many schools with large numbers of children whose families face foreclosure have the following characteristics: a larger degree of students receiving free or reduced-price lunches, a higher percentage of Black students, and a smaller prevalence of students making adequate scores on standardized math and reading tests.

Been et al. (2010) noted housing instability could affect a child’s academic ability in at least five areas: moving residences and sometimes doubling up with other family members; moving to different neighborhoods; stress for students causing anxiety or depression; moving to unfamiliar schools and falling behind or encountering conflict with classmates; and spillover effects on other children who may not have experienced foreclosures themselves. Disruption is an expectation for students with families undergoing housing instability when they move unexpectedly. Goux and Maurin (2005) and Maxwell (2003) have noted it is common for families experiencing foreclosure to take up residence with friends or end up homeless. Children’s social networks might experience confusion because families must move from their neighborhoods as a result of foreclosure (Gruman, Harachi, Abbott, Catalano, & Fleming, 2008; South, Haynie, & Bose, 2007). Because of instability, students might have to change schools, possibly in the middle of the school year. According to Alexander, Entwisle, and Dauber (1996), as well as Lash and Kirkpatrick (1994), it appears that moving to new schools carries the possibility of causing problems related to achieving satisfactory scholastic performance.

One particularly significant factor is that students and their families might experience stress or trauma as a result of their housing uncertainty. These reactions might cause depression and more absences, as well as impair the students’ ability to focus (Kingsley et al., 2009). The trauma of foreclosure makes relocating abruptly displaced children more difficult than it would have been if other happier circumstances precipitated the move. Children whose families remain unaffected by housing instability might suffer the spillover effects of affected children that slow the pace of their class (Hanushek, Kain, & Rivkin, 2004; Mehana & Reynolds, 2004). Calvó-Armengol, Patacchini, and Zenou (2009), Lavy and Schlosser (2011), and Weinberg (2007) indicated another consequence is exposure to crime and disorder in a high foreclosure community with an effect on the educational performance of children involved in foreclosure as well as their classmates. Equally important is the racial composition of the children whose families go through the foreclosure process. Been et al. (2010) disclosed that even though African American children accounted for 33% of those in the New York public schools in 2006 and 2007, they accounted for 57% of students living under the burden of foreclosure. Lovell and Isaacs (2008) noted the impact of foreclosure on children and described such debilitating effects as disrupting their education; peer relationships; social networks; and most important their physical, emotional, and mental health. These outcomes remain essentially unintended, even unnoticed, until the chaos of the foreclosure crisis brings out behavioral issues in the affected children. Researchers at the Center for Responsible Lending (2007) estimated that in 2006, the number of struggling homeowners who had purchased their houses with subprime loans and would face foreclosure would reach 2.4 million, which would also affect their children. Lovell and Isaacs indicated the estimated number of children affected by race/ethnicity in the various households included 62% of owner-occupied Latino families with unsettled mortgages and an average of 2.08 youngsters with 504,600 children directly affected by the foreclosure crisis. The foreclosure crisis affected more than 281,000 African American children and 1.17 million White/Other children. The foreclosure crisis could have directly affected 1.952 million young people.

A child’s long-term chances of success with his or her education, health, and economic well-being rely on a host of components, including housing stability. The members of Partnership for America’s Economic Success noted the high school graduation rate is far less for children who experience frequent moves in their early years (Partnership for America’s Economic Success, 2008). Pettit (2004) further noted youngsters who move more frequently might seem disadvantaged compared to their unaffected counterparts, and such circumstances lead to reduced levels of employment capacity in early adulthood, a heightened probability of dropping out of high school, and decreased academic achievement.

Turbulence and instability have debilitating effects on children. Moore, Vandivere, and Ehrle (2000) defined experiencing turbulence as being a schoolchild who has moved from one state to another or changed schools during a 12-month period. Turbulence may be short-lived or long-lived with its concurrent short-term or long-term risks to the child’s development. Several indicators indicated turbulence might be higher in poor families than in more affluent families. More often, it appears that turbulence and instability occur with increased behavioral and emotional issues among children.

In the United States, an average of 6% of children experienced some form of turbulence, which doubled to 13% for children with family incomes below the federal poverty level (Moore et al., 2000). Addy, Engelhardt, and Skinner (2013) identified that 45% of children under the age of 18 live in low-income families, and 22% of these youngsters lived in poor families. The percentage increases significantly for families receiving federal or state assistance and food stamps and for children living with an unmarried parent or with parents who have not completed high school. A link might exist between turbulence and poorer outcomes for children, including raised levels of behavioral and emotional distress, reduced degrees of school involvement, more frequent suspension and expulsion, and higher instances of skipping school (Moore et al., 2000).

Impacts on Older Adults

Apgar (2008) explained the foreclosure crisis has had serious consequences on older adults. A sizable number of homeowners still have mortgages when they retire, which became evident in a study indicating that in 2007 over half of all breadwinner homeowners over age 50 maintained a mortgage, whereas only one third of them were in that situation in 1987. It appears housing wealth continues to be a significant part of a financial buffer for seniors. In 2007, approximately 2.3 million elderly Americans had less than 20% equity in their homes. The significance of these numbers is that a decrease in home equity might hinder retirement and economic plans for these elderly Americans.

The housing market downturn and the stock market plunge adversely affected many retirees in their foremost means of income because their homes and investments were their primary assets (Green, 2008). Many retirees struggled economically and sought jobs. Another problem for retirees as a result of the housing crisis is difficulty selling their houses to move into assisted-living centers or retirement communities (Healy, 2008). Unsold houses or condominiums for these people make it practically impossible to afford the payment to buy into retirement homes because they may have to pay $100,000 to $500,000 to relocate.

Shelton (2008) revealed older African Americans and Hispanics have higher foreclosure rates than their Caucasian counterparts of any age. Older Americans in general have less time and ability to recover from a financial crisis, and resulting losses from home foreclosures jeopardize their finances. The prospect of moving to a different environment is especially difficult for older individuals (Smith & Ferryman, 2006) and might be more difficult when it results from problematic conditions such as foreclosure. Older residents might have lived in their home for much of their lives and might have raised their children there. Rowles (1983, 1993) noted the comfortable old neighborhood provides a connection to social networks and familiarity with neighbors and offers a personal sense of belonging. Even if these seniors must involuntary move from blighted communities to somewhat better ones, they might still experience grim outcomes with respect to health, social support, and personal mobility (Danermark & Ekström, 1990). Relocation of seniors might exacerbate their chronic conditions if their health is poor already and precipitate mental stress over moving from their homes, neighbors, and familiar surroundings. Keith (1993) also studied the vulnerability of older adults when exposed to chronic financial strain and found both older men and older women would lose their sense of control and become distressed when exposed to financial difficulties.

Impacts on Renters

The foreclosure crunch also significantly affected renters, and affected tenants have become the victims of problems they did not create. According to Treves (2011), in 2010, tenants had to endure banks’ policies of evicting all tenants of foreclosed properties, resulting in needless displacement of families and leaving neighborhoods with abandoned homes and blighted conditions. Treves noticed that attempts at persuading mortgage companies to keep renting to their tenants have failed, and the banks persist in the wholesale eviction of all occupants. The potential loss to banks is staggering because the rental income they forfeited was approximately $755 million in 2010. Other costs to banks include paying lawyers to handle eviction cases as well as paying realtors to negotiate their cash-for-keys deals. Vacant buildings cause property values in the community to decrease, led the buildings to become targets for vandalism, and generate legal liability for banks as the owners of blighted abandoned property. Bankers’ insistence on evicting innocent tenants diminished their reputation in the local area.

Treves (2011) observed many tenants find out that they are in foreclosure only when they face imminent displacement. Foreclosure can damage a tenant’s life in a number of ways; for example, preforeclosure tenants might face health hazards because their defaulting landlords ignore their requests for maintenance and allow the structures to deteriorate. Habitability worsens after a foreclosure when a bank assumes ownership of a property; that is, the property becomes real estate owned. At that point, the banks might evict and displace tenants and many might struggle to find alternative housing. Some may not receive their security deposits back. Other problems involve living far from their workplaces and schools for their children and social networks, and still other tenants may become homeless. Some tenants have experienced displacement from multiple houses because more than one landlord defaulted on mortgages, even when the tenants paid rent on time. Such situations undermine housing stability and become damaging to the elderly, individuals with disabilities, and families with children.

Some researchers (“Foreclosures,” 2013) observed that a 61% rise in homelessness occurred in 2008 according to state and local homeless groups. The laws in most areas lack adequate protections for people living in homes caught in the foreclosure process (National Law Center on Homelessness and Poverty [NLCHP], 2010). The only two areas of the country that provide limited protection in terms of lease survival issues are New Jersey and the District of Columbia. Tenants living in foreclosed properties in at least three states could be subject to eviction proceedings to vacate the property after 3 days’ notice.

Treves (2010) noted unscrupulous behavior from private investors and banks that acquire properties at foreclosure continues to plague the nation, despite the adoption and expansion of tenant protection laws. Banks and investors contract with eviction law firms and real estate agents to deceive and harass tenants in foreclosure situations to vacate and sell their foreclosed properties. Realtors see the tenants as obstacles to obtaining their commission checks after selling foreclosed properties, so they employ scare tactics and offer misinformation and cash incentives provided by the banks and investors to induce tenants to move out quickly. However, tenants lose their legal rights when signing such agreements to vacate their homes (Treves, 2010). Eviction law firm professionals violate tenant rights by filing eviction lawsuits against those living in foreclosed homes. The affected tenants might avoid fighting these wrongful lawsuits for fear of risking their strong tenant history and giving the appearance of being a defendant in an eviction case, because of a lack of knowledge of their tenant rights, or due to their inability to afford legal representation (Treves, 2011).

Researchers at Tenants Together (2009) noted the impact of foreclosure on tenants was as follows:

1. Evicted Through No Fault of Their Own
2. Denied Information About What Is Going On With Their Homes
3. Evicted Without Receiving 60-Day Notice
4. Forced to Live Without Water, Gas or Electricity
5. Cannot Reach Owners To Get Repairs Done
6. Losing Their Security Deposits
7. Subject to Rent Skimming
8. Victims of Fraud and Deceptive Practices
9. Credit Damaged
10. Unable to Get Legal Services
11. Forced Into Homelessness

LITERATURE SYNTHESIS AND RESEARCH QUESTIONS

Research offers growing evidence of a connection between foreclosure and physical and mental illness in both individuals and families. According to Rohe and Stegman (1994) and Lubell, Crain, and Cohen (2007), while home ownership often relates to an agreeable sense of well-being, it might produce the reverse when individuals or families lose their homes through foreclosure. The foreclosure process can indeed be traumatic and stressful (Bennett et al., 2009). The study involved empirically linking foreclosures and their potentially negative effects to the health of family members.

RESEARCH QUESTIONS

The specific problem was that the potential adverse consequences of home foreclosures on physical and mental health are unknown. The two main research questions investigated were as follows:

Research Questions:

1. What were the lived experiences of physical and mental health decline following home foreclosure?
2. How did the participant’s perceive their physical and mental health decline affected their family members?

METHODOLOGY

Twenty-five homeowners in the process of foreclosure participated in interviews to investigate the health-related concerns brought about by home foreclosure. To gain insight into the lived experiences of these participants in foreclosure, the researcher conducted 24 face-to-face interviews and one telephone interview. To guide data collection, the study included a Colaizzi method of analysis of phenomenological data with semistructured, audiotape recorded, and transcribed interviews. Chapter 1 contained an introduction to the study. Chapter 2 contained the review of relevant literature, and the focus of Chapter 3 was on the description of the research method. Chapter 4 contains the results of the study.

Chapter 4 includes the specific analysis of 25 interviews with homeowners in the process of foreclosure in the Union and Essex Counties of New Jersey. A pilot study with five struggling homeowners tested and validated the interview questions. The pilot study was necessary because it served as a basis for the interview protocol. After the pilot study, the main study commenced with 25 struggling homeowners in the process of foreclosure. The researcher then analyzed the data collected for trends and themes of the participants’ lived experiences when going through foreclosure, specifically the consequences on their physical and mental health. Chapter 4 includes an explanation of the data analysis method used to unveil the major themes. The focus was answering the principal research question to understand the possible negative consequences of home foreclosures on physical and mental illness. The primary research question for the qualitative phenomenological study was as follows: What are the possible negative consequences of home foreclosures on physical and mental health? This question necessitated the study and the discovered outcomes.

Data Collection Processes

Collecting information for this research occurred in two stages: Stage 1 comprised the pilot study to solidify the protocol of flow during the interview process and validated the interview questions (see Appendix C) and Stage 2 covered the formal data collection for the analysis. For the survey instrument, open-ended questions helped get to the heart of the issues. Adapting the instrument involved adding the open-ended questions to facilitate the need to investigate and understand the possibly negative consequences of home foreclosures on physical and mental health.

To assist in fully exploring the research questions, 25 homeowners in the process of foreclosure formed the population and participated in interviews with semistructured questions. The modes of the interviews were in person or by telephone, and both formats were advantageous in directly gathering information.

Pilot Study

The goal of the pilot study was to clarify the study questions and interview protocol with struggling homeowners to affirm the efficacy of the interview questions. To achieve the goal of understanding this crisis, a sample of five homeowners in the process of foreclosure participated in interviews. The phenomenological approach made it possible for the participants to tell their own stories. Recruiting the study participants involved obtaining the list of homeowners in the process of foreclosure from the free public websites http://www.realtytrac.com and http://www.corelogic.com for property and ownership information in the Essex and Union Counties of New Jersey. No changes occurred to the interview questions (see Appendix C), but the pilot study uncovered the need to modify protocol as follows: provide participants with a general overview of the study and provide a list of the interview questions to participants during the interview. The pilot study brought invaluable insight into the study. The pilot study took place in accordance with the identified study plan after obtaining Quality Review Methods and Institutional Review Board approvals. The researcher explained the study parameters and intent to the pilot study participants and obtained their signatures on the informed consent (see Appendix B). To assist in gauging the time and flow of the interview, each interview lasted 25-30 minutes.

The pilot study centered on distressed homeowners who had gone through the foreclosure process in northern New Jersey. Five potential participants received introductory letters and a copy of the informed consent form for their review and signatures; at that time, the participants were able to ask any questions. Face-to-face interviews began after collecting the signed forms and addressing the individuals’ concerns. To avoid redundancy, the researcher transcribed major responses of the participants in a sampling format because the answers from the respondents were similar in nature. The sampling format of the responses allowed the participants to provide the most significant answers to the study’s questions.

The purpose of the pilot study was to determine the validity and the correct sequencing of the interview questions. A coding system served to differentiate the pilot study participants from the actual research participants after obtaining their signed consent to be involved in the study. Three males and two females all over the age of age of 50 years participated in the pilot study. The pilot participants answered 28 open-ended and closed-ended questions, which provided the research data. The participants reflected on their lived experiences through the foreclosure process, which included their revelations, emotions, and processes. The pilot participants provided their demographic data as three African Americans and two Hispanics. Even though the basic objective of the pilot study was to validate the interview protocol as well as the validity and correct sequencing of the interview questions, four themes were revealed including foreclosure process resulting in hospitalization of family, foreclosure and lack of health insurance, foreclosure and negligence of doctor’s prescription and displacement and housing instability as a reason for depression. These themes were much evident and fully discussed after interviewing the actual study participants.

Data Collection

Data collection took place over a 2-week period from May 9 to May 24, 2014. The researcher transcribed interview data and categorized the data into themes. Thematic data saturation occurred at 25 participants obtained by purposive and snowball sampling. The interview process involved establishing the interview space, describing the intent of the research, and signing the informed consent. The study participants answered the interview questions in an orderly and sequential manner (see Appendix C). The researcher asked the demographic questions in the beginning of the interview. The participants understood that the researcher was recording their responses on an audiotape and would transcribe them after the interview. For ease of consistency and transition, the interview followed a scripted guide. The participants had an opportunity to express themselves after answering a formal question to provide more information about their lived experiences in the foreclosure process.

Data Analysis

Data analysis involved using the recommended Colaizzi method. Using this method allowed the researcher to eliminate anomalies in the data that were not useful to the themes. The researcher obtained a full description of the experience of the phenomenon by the participants. From the verbatim transcripts, the researcher considered each statement with respect to significance in describing the experience, recorded all relevant statements, listed each non-repetitive, non-overlapping statement, related and clustered the invariant meaning units into themes, synthesized the invariant meaning units and themes into a description of the textures of the experience, reflected on own textural description and constructed a textural-structural description of the meanings and essences of the experience. The textural description that resulted enabled the construction of each research focus and the accurate translation of the interview notes. Grouping the data helped to translate the textural structural descriptions of their lived experiences into meaning and essence for the purpose of further analysis. To relate to the participants’ lived experiences, open-ended questions served to elicit responses. The Colaizzi method helped to analyze individual transcripts and create a thematic analysis.

Interview Thematic Analysis

Demographics of the study participants. The researcher explained the study parameters and selection criteria to the volunteer study participants. Tables 1, 2, 3, and 4 contain summaries of the demographics. Table 5 discusses the thematic development of the interviews. Appendix C details the demographic questions. The researcher randomly selected the study participants. The demographic data captured the following information: respondents’ marital status, whether respondents had children, respondents’ age, and respondents’ educational status. The participants provided the demographic data verbally.

After collecting the data, manual analysis proceeded to determine trends, themes, characteristics, and descriptions. The researcher developed themes from the interviews. The themes helped in analyzing words, phrases, expressions of participants, and opinions of the participants.

The study participants answered 28 open-ended and closed-ended questions, which provided the research data. To ensure the qualitative study was phenomenological, the study participants reflected on their lived experiences through the foreclosure process, which included their revelations, emotions, and processes. The semistructured approach ensured the participants shared their experiences without restrictions on their answers. The final question provided the participants the opportunity to reflect on and express anything they wanted to share about their foreclosure experience. The preferred analysis method for the participants’ textural descriptions was the Colaizzi method.

 

Table 1

Gender of Respondents

Gender N %
Male 19 76
Female  6 24

 

Table 2

Age Group of Respondents

Age range N %
21-30  3 12
31-40  6 24
41-50 11 44
50 and above  5 20

 

Table 3

Ethnic and Racial Distribution of Respondents

Ethnicity or race N %
African American or Black 7 28
Asian American 3 12
Hispanic or Latino/a 8 32
White or Caucasian 4 16
Other/None 3 12

 

Table 4

Marital Status of Respondents

Marital status N %
Married 23 92
Unmarried  2  8

 

Table 5

Hospitalization Due to Illness/Diseases Resulting From Foreclosures

Illness/disease %
Mental disease, e.g., PTSD   20
Physical injury   20
Depression 100
Suicide/suicidal behavior   20
Cardiac disease     8
Stress/anxiety 100
Alcohol abuse   20
Emotional trauma 100

 

 

Thematic development of interviews. Four core themes evolved from the interview questions. The participants fully explained their lived experiences of the potential negative consequences of home foreclosures on mental and physical health during the process of their foreclosure. The data were categorized and the correlating themes were derived through the Colaizzi methodology.

Theme 1: Foreclosure and lack of health insurance. The analysis of responses to Interview Question 21 led to another theme. The question was as follows: How did your family’s health insurance or lack of health insurance affect your healthcare during your foreclosure process? The lack of health insurance affects health care received during the foreclosure process. The lack of health insurance or possessing low-quality health insurance policies during the process of foreclosure led to mental or physical illness. Data analysis revealed 80% of participants suffered medical issues due to the absence of or low quality of health insurance programs. Fifty-six percent of the participants who went through the foreclosure process lacked health insurance because they were unable to purchase it directly due to financial troubles. Participant V stated that “Like sickness, my husband is a heart patient. He’s taking many medications. I also have a right arm problem and not going to work right now. And my daughter is sick. And my mother is also sick, older mother.” The participants who experienced foreclosure tended to have lower insurance rates due to their income levels but were still unable to purchase insurance.

The financial problems of the participants’ families were the primary reason they were unable to buy insurance. The analysis also noted that the victims of foreclosure were less educated than unaffected homeowners, unemployed, and had a difficult time finding respectable and dignified jobs. The lack of health care insurance during the process of foreclosure affected many respondents. Some reported they developed chronic diseases because they were unable to visit doctors. Viral diseases affected their children when they were going through the home foreclosure process. Due to the foreclosure process, challenging health conditions, and adverse financial conditions, the family environment became unstable. Distress existed among the family members, who subsequently developed stress and depression.

Many of the participants in the study reported that the lack of health insurance affected most of the elderly people in their family because they were unable to pay the insurance programs. They were unable to afford private medical expenses and suffered great losses. The participants reported children underwent hospitalization for diseases that health-care providers could cure in the early stages. Twenty-four percent of the participants reported their children suffered from asthma. Sixty percent of the participants reportedly faced malnutrition issues while going through the process of foreclosure. Prolonged delays in hospitalization occurred among children suffering from any diseases during the process of foreclosure.

Subtheme: Family health and foreclosure process. Question 24 in the survey that developed this subtheme was “How was your family’s health affected during the foreclosure process when a member got sick or injured and did not seek healthcare because of the cost involved?” Participant Y responded as “Yeah, I couldn’t take them—my parents—to regular visits to their doctor as I was supposed to due to cost issues.” As discussed earlier, financial barriers were challenges for families going through the process of foreclosure. Fifty-six percent of the participants reported they faced financial crisis during an accident or injury to themselves or family. Many governmental programs provide insurance for children but some people are unable to be a part of these programs due to a lack of adequate resources for full coverage. Children’s insurance for accidents could provide children the necessary medical care in case of injury. However, the victims of the foreclosure reported they could not afford this health insurance program due to financial challenges.

All the research participants with children and seniors in their homes explained that children and elderly members in the family were the greater victims of home foreclosures. Children are more likely to experience negative psychological consequences from home foreclosure, as they have to move from their homes and neighborhood to poor living conditions and sometimes become homeless. Three participants in the current study were unable to contact any health care specialist or psychologist due to the lack of health care programs. They continued that anxiety and disturbing behaviors were also observed behaviors in their children. Foreclosure an

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