As the cost of living in the U.S. continues to rise, housing and health care affordability have also been increasingly impacted. For example, a new resource from the U.S. Census Bureau used 5-year ACS estimates to determine that the median rent across the U.S. increased by $100 a month during 2020–2024, and renters in 20% of U.S. counties paid more during the same time period than in the previous 5 years (2015–2019).
Unaffordable rent is defined by the U.S. Department of Housing and Urban Development (HUD) as “the percentage who spend more than 30% of their households’ monthly income on rent. When people are burdened by rent that is unaffordable—combined with the also rising cost of living and increased spending on health care—they may look to cut costs in other areas. Some individuals may choose to forgo medical care or make changes to medical drugs to save money, while others might forgo other necessities. For example, recent polls on affordability in America found that 20% of respondents reported skipping meals to make housing-related payments while 11% reported driving less to afford health care expenses.
Lack of affordable housing can also lead to housing instability and homelessness, both of which can contribute to higher health care costs and poor health outcomes. High housing costs can also contribute to a number of other financial challenges, including food insecurity, relying on credit card debt to finance necessities, problems affording transportation, and more, all of which can impact employment and mental and physical health.
In this blog, SHADAC researchers explore and analyze the impact of unaffordable rent in the United States by state, disability status, income level, and more using SHADAC’s data tool, State Health Compare. We also examine national trends from the last five years and take a look at some differences by state.
Where Do These Data Come From? American Community Survey Data on State Health Compare
SHADAC’s State Health Compare is a data tool that allows users to download and explore data on a variety of public health measures, including the ‘Unaffordable Rents’ measure.
Specifically, this measure provides data on the ‘percentage of cost-burdened rental households’ (i.e., the percentage of households with unaffordable rent), which is defined by the U.S. Department of Housing and Urban Development (HUD) as “the percentage who spend more than 30% of their households’ monthly income on rent.” Data for this measure come from SHADAC analysis of the U.S. Census Bureau’s American Community Survey (ACS).
State Health Compare makes accessing and visualizing this data easy, allowing users to view these unaffordable rent estimates as charts, maps, and tables at both the national and state levels with breakdowns by disability status, household income, Medicaid enrollment, metropolitan status, and race/ethnicity also available.
Unaffordable Rent in the U.S. from 2019–2024
To give a better overall picture of U.S. housing affordability, let’s start by looking at trends of the percentage of renters with unaffordable rent at the national level over the past five years.
Note: Data for 2020 were not officially released by the U.S. Census Bureau due to pandemic-related disruptions to data collection and resulting issues with data quality. Therefore, data references for “the last five years” goes back to 2019.
In 2019, 45.9% of renters across the nation reported having unaffordable rent. This increased significantly in 2021, jumping almost 2 percentage points (PP) up to 47.5%. After staying relatively steady from 2021 to 2022, another significant increase occurred from 2022 to 2023, rising from a rate of 47.3% in 2022 to 48.5% in 2023. Data from the latest release shows 48.6% households with unaffordable rent in 2024, which is not a statistically significant change from the prior year.
Figure 1. Percentage of Rental Households with Unaffordable Rent in the U.S., 2019–2024
Unaffordable Rent: Breakdowns by Subpopulation
Let’s look at this measure’s available breakdowns from State Health Compare to understand how the burden of unaffordable rent was experienced amongst different communities in the U.S. in 2024.
Disability Status
Households with at least one person with a disability had a significantly higher rate of rental burden, with 54.9% spending more than 30% of their monthly income on rent compared to 46.3% of households with no individuals having a disability.
Figure 2. Percentage of Rental Households with Unaffordable Rent by Disability Status, 2024
Income Level
Of renters with an annual household income of less than $25,000, 83.3% experienced unaffordable rent compared with 71.0% among households with annual incomes of $25,000–$49,999, and 24.2% among households with annual incomes of $50,000 or more. Rates for the middle- and higher-income categories increased significantly from 2023 to 2024 and the 2024 rates are the highest they’ve ever been since SHADAC began tracking unaffordable rent data on State Health Compare in 2012.
Figure 3. Percentage of Rental Households with Unaffordable Rent by Income Level, 2024
Medicaid Enrollment
Households that have at least one person enrolled in Medicaid reported a significantly higher rate of unaffordable rent than households without a Medicaid enrollee. For households with a Medicaid enrollee, 59.3% experienced rental burden; for households without a Medicaid enrollee, the rate was 42.7%.
Figure 4. Percentage of Rental Households with Unaffordable Rent by Medicaid Enrollment, 2024
Metropolitan Status
The percentage of those spending more than 30% of their households’ monthly income on rent also varied significantly by metropolitan status. Approximately half (50.2%) of individuals that lived in a metropolitan area experienced unaffordable rent, while only 39.6% of individuals living in a non-metropolitan area did.
Figure 5. Percentage of Rental Households with Unaffordable Rent by Metropolitan Status, 2024
Race/Ethnicity (White vs. Non-White)
Finally, we looked at unaffordable rent by race/ethnicity, specifically households with or without a person of color (White vs. Non-White). Households with only White individuals experienced a significantly lower rate of unaffordable rent compared to households with at least one individual who does not identify as White: While 51.3% of households with at least one non-White individual experienced rental burden, only 45.0% of White households did.
Figure 6. Percentage of Rental Households with Unaffordable Rent by White vs. Non-White, 2024
These breakdowns can help identify which populations are experiencing the highest rates of unaffordable rents, which can help direct efforts in maintaining and securing stable and affordable housing. This can also help in identifying communities and populations that might be more likely to experience the health impacts of unaffordable housing, and may require tailored programs, services, or resources to meet their unique needs.
Check Out Our Accompanying National and State-Level Housing Affordability Infographics
As we can see above, disaggregating the national-level data by subpopulation can help reveal differences and disparities in the experience of unaffordable rent between groups.
State Health Compare also allows users to disaggregate these housing affordability data by state, which can help us to better understand differences in experience of unaffordable rent across the country. Figure 7 below shows that percentage of households with unaffordable rents ranged from 58.5% in Florida to 33.7% in North Dakota in 2024.
Figure 7. Percentage of Rental Households with Unaffordable Rent by State, Ranked, 2024
We can take this another step further by disaggregating the state-level data by subpopulation (such as by disability status, income level, etc.), which can help us understand disparities in the experience of unaffordable rent between communities within the same state. To accompany this blog, we created infographics on unaffordable rents data for the United States and four geographically and rental burden diverse states (Florida, Nevada, North Dakota, and Vermont) to explore some of these state-level differences. You can find these accompanying infographics here.
Housing and Health: Rent and Housing Affordability Impacts Public Health
Access to affordable and stable housing is a key driver of health. If an individual spends more than 30% of their monthly household income on rent, they may have difficulty paying for other needs. They may not be able to pay for prescriptions, provider visits, or other essential health care related costs.
Using State Health Compare, we can see that rental households with an individual (or individuals) with a disability, of lower socioeconomic status (SES), who are enrolled in Medicaid, living in a metropolitan area, or who are non-White experience rental cost burden at higher rates. We also saw just how much unaffordable rent differs by state (delve a bit deeper into state-level differences in unaffordable rents in the accompanying infographics here).
Due to the multiple ways that unaffordable housing costs can impact health and well-being, it is crucial for policymakers, community workers, and other stakeholders to create and implement tailored strategies to increase the availability of affordable rental housing and to help people impacted by unaffordable rent to secure and maintain such housing.
Have you used State Health Compare to explore data on unaffordable rents? What about one of the other 40+ measures? We would love to hear how you’ve used State Health Compare; let us know on LinkedIn or by contacting us here.