Rural Wisconsinites are facing a dangerous choice: housing or health

July 29, 2025

by Erin Gaede, Tessa Conroy and Steven Deller

Increasing housing costs are forcing some rural residents to delay medical care, threatening both individual health outcomes and the long-term well-being of entire communities.

As housing costs continue to rise nationwide, particularly in the post Covid-19 period, the number of people experiencing housing financial stress, referring to financial strain due to a large housing expense, is becoming a cause for concern.

Compared to other forms of stress, housing financial stress imposes a relatively rigid and high-stakes burden on individuals that is related to their experience of our economic, social, and health systems.

Housing financial stress is a distinct and especially impactful form of financial burden because housing is a fundamental human need, essential for physical safety, health, and social stability. Falling behind on housing payments can result in eviction, foreclosure, or homelessness, whereas missing a credit card or utility payment might incur fees but not an immediate loss of shelter.

Financial stress, such as constant worrying about housing costs, can lead to anxiety or depression, feelings of personal failure, as well as impaired cognitive functioning and poorer decision-making over time. Long-term financial pressure can activate the body’s stress response, leading to issues like high blood pressure, weakened immunity, and sleep disruptions.

Under housing stress, families may be more prone to conflict, neglectful parenting, and increased risk of unhealthy coping mechanisms such as smoking, alcohol use, or overeating. People may neglect medical care by delaying or avoiding care, skipping medication, or ignoring symptoms due to cost.

A recent study out of Wisconsin found that housing financial stress, defined as spending more than 30% of income on housing, is affecting both renters and homeowners. These burdens are not evenly distributed. Renters face the highest levels of stress, but homeowners are also struggling. In Wisconsin, 44.1% of renters and 22.9% of owner-occupied households with a mortgage are financially burdened by housing costs. Even among homeowners without a mortgage, nearly 14% still experience housing-related financial stress.

Interviews across Wisconsin reveal that some rural residents are delaying medical care due to housing costs. Older adults reported skipping doctor visits and medications, while younger individuals and families reported untreated mental health issues, indicating that the health impacts of housing financial stress span across different age groups.

Effects on the Community’s Well-Being

Drawing on interview insights, we explored the link between housing stress and health outcomes across Wisconsin’s 72 counties by comparing housing financial stress with the share of residents reporting fair or poor health. County-level data shows a weak positive relationship for homeowners, suggesting that financial strain may contribute to poorer health outcomes, while a slight negative relationship among renters, which likely reflects their younger age profile and generally better health.

The implications of foregoing individual medical care negatively affect the well-being of the broader community. One registered nurse described witnessing community members experiencing financial stress related to housing regularly skipping medical care, and as a result, often end up seeking treatment in emergency rooms (ERs) for conditions that could have been managed or prevented through routine care.

These non-emergency visits are significantly more expensive and further strain limited hospital resources, making it harder for true emergencies to receive timely care. This issue is particularly important as many rural communities continue to face hospital closures. Since forgoing medical care often disproportionately affects low-income and vulnerable residents, it can exacerbate health disparities and increase inequality within the community.

At a time when rural communities are grappling with both housing affordability and overburdened health systems, it is important to understand how housing financial stress and health are related. Communities would do well to ensure that hospitals and clinics are represented on local housing task forces. By integrating health perspectives into local housing initiatives, rural communities can craft housing solutions that also address health needs.

Erin Gaede is a graduate student in the Sociology PhD program at the University of Wisconsin-Madison and a research assistant with the Wisconsin Rural Livability Project.

Tessa Conroy is a Vilas Associate Professor in the Department of Agricultural and Applied Economics and Extension Specialist in the Community Development Institute at the University of Wisconsin-Madison.

Steven Deller is a Vilas Distinguished Achievement Professor in the Department of Agricultural and Applied Economics and Extension Specialist in the Community Development Institute at the University of Wisconsin-Madison.

Related: ‘Some people work their butts off and other people get rich’: Gwen Frisbie-Fulton’s view from rural America