Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Danya E. Keene


When individuals enter into mortgage delinquency or foreclosure, the benefits of home become threatened. How individuals respond to economic stress, and the strategies they use to recover, provides insight into personal spending priorities, the importance of healthcare for such individuals, and resulting health outcomes and behaviors. This paper aims to explore how foreclosure and mortgage strain act as distal or upstream determinants of health for a small sample of individuals from an urban African-American community. It presents a qualitative analysis of how individuals’ experiences with, attitudes concerning and circumstances surrounding mortgage delinquency, and their recovery from it, impact health. It examines the coping strategies used by citizens to maintain their status as homeowners and the concessions they make towards other essential needs, such as food, education and healthcare. Data in the form of semi-structured interviews was collected by a team of researchers (Danya E. Keene and Amy Castro Baker) in a neighborhood situated in the northeastern United States. Original transcripts were conferred by Keene, and a secondary analysis was completed for this study driven by codes relating to employment, social networks, social services, payments, and spending strategies. Final analysis showed that additional employment, loan modifications, spending reprioritization, government support, and social support were various strategies by which the interviewees attempted to recover from mortgage strain. Each strategy was associated with an increased risk to various negative health outcomes as evidenced in previous literature. The primary health problems experienced by the interviewees were mental health symptoms such as stress, fatigue and depressive symptoms; an increased risk of cardiovascular and respiratory diseases; and decreased use of healthcare services.


This is an Open Access Thesis.

Open Access

This Article is Open Access