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Home is Where the Heart Is

Why the Foreclosure Crisis is a Health Crisis

In May, when deputies from the Essex County Sheriff's foreclosure unit arrived to oversee his eviction, Augusto Wong of Newark, N.J., was surprisingly polite and cooperative. His home was something of a stand out in its quiet, working class neighborhood. It featured a substantial satellite dish on the roof and two large rabbit figurines perched atop a second-floor air conditioner like adorable bookends.

The 64-year-old Wong spent much of that May day quietly sitting inside the house he had owned for 21 years, watching a crew of bank-hired movers
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Photo: Google Earth
Augusto Wong's home before the fire.
carry his furnishings into a van. When it was over, a locksmith rekeyed the doors and Wong, the deputies, and the movers went their separate ways.

Hours later, Wong broke into his foreclosed house and, starting from the top floor, splashed flammable liquids all through it and set it ablaze. He then descended into his finished basement and stabbed himself repeatedly. Firefighters found his body when they arrived.

Wong's name never made it into the news. The Associated Press did a short story about an anonymous man killing himself in a burning Newark house. The county prosecutor's office said it initially withheld the man's identity until next of kin were notified and then prepared to release the name to reporters who called. But none called. Home foreclosure is a pervasive but nameless outcome of the economic crisis. That is well known. It is also intimately entwined with physical and mental health. That is not so well known.

Total number affected
Although no government office has ever exactly quantified it, a general sense of the size of the population of household members who have directly experienced foreclosure
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Photo: Sally Ryan/NYTimes
The number of Americans dispossessed by the foreclosure crisis is larger than the population of Greece Click for larger image.
can be had by crossing two industry statistics. The national data company CoreLogic tracks most of the auctions of foreclosed properties across the country. Since 2006, when the subprime disaster first emerged, until April of this year, 4,943,025 foreclosed homes have gone on the auction block. At the same time, Census Bureau figures show that an average of 2.6 people live in each U.S. household. This allows us to estimate that 12,851,865 individuals have been evicted from homes seized by banks during that period.

That number of dispossessed Americans is larger than the population of Greece. And it is only the beginning.

Despite recent headlines about slight improvements in housing value or sales in some regions of the country, the wave of foreclosure actions has yet to crest. The U.S. Department of Housing and Urban Development estimates that eight million more foreclosures may occur by the end of 2012. Eight million houses times 2.6 people per house is over 20 million people.

More than losing a house
Wong's was just the latest in a series of suicides in the wake of home repossessions -- and suicide authorities don't find that surprising. "Foreclosure is not just about losing a house," said Dr. John Draper,
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Photo: NSPL
Dr. John Draper: suicide hotline calls continue to increase by double digits.
Project Director of the National Suicide Prevention Lifeline in New York. "It's about losing your place and status within a community and your connection with others. It can put a person at greater risk."

Draper, whose organization oversees 150 crisis centers across the country, noted that while there are no statistics available for foreclosure-related suicides, the overall number of suicide-related hotline calls have increased by double digits during each year of the current economic crisis.

Suicides like Mr. Wong's are at the extreme end of a broader range of health risks that health service researchers now associate with foreclosure. Clearly, they are the tip of the iceberg. For every person who commits suicide in such financial straits, many more are depressed or suffer other forms of ill health. No one knows that number. Who sees these people and what help is there for them?

Talk of suicide
A national survey of 395 mortgage counselors led by Dr. Craig Pollack of Johns Hopkins School of Medicine found that 37% of those counselors had, in the previous 30 days, worked with clients who spoke about wanting to kill themselves. At the same time, 51% of the counselors' clients had no health insurance, 61% couldn't pay their existing medical bills, and 37% could not afford to visit doctors.

A majority of counselors felt they had a duty to point such clients toward available public health services. But 86% also said their own employers
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Mortgage counselors' clients speak of multiple health issues. Click for full chart.
did not provide training about local health resources. Half the counselors said they personally wanted to learn more about health clinics and related services for their troubled clients, but didn't know where to turn. And even if they did, there are fewer such services available at the federal, state and local levels as a result of budget reductions triggered by the same economic crisis now driving more people to thoughts of suicide. And that worries mental health authorities like Dr. Alan Berman, Executive Director of the American Association of Suicidology.

Mental health service cuts
"In these times, the first things cut are social services and mental health programs and that's a concern to everyone in our association," said Berman. "We're trying to reduce the problem and those sorts of cuts just naturally increase it."

Berman, whose organization trains physicians and other clinicians in suicide risk assessment and management, said if funding could be found, it would take little more than an hour to train a mortgage counselor to respond appropriately and be able to "move an at-risk person toward someone who can help."

Foreclosure touches health in a surprising number of other ways.

A study of 250 people grappling with foreclosure and eviction in the Philadelphia area provides a look inside a world
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Photo: Hoag Levins
Dr. Craig Pollack at Johns Hopkins School of Medicine led teams in multiple studies of foreclosure's impact on health Click for larger image.
that most outsiders never see. The analysis by Pollack and his research team found those homeowners much more likely to suffer hypertension, heart disease, major depression and anxiety than comparative individuals in the same community (See Issue Brief on these studies).

"Over a third in our study met symptoms of major depression -- a very serious form of depression," said Pollack. "Hunger is also an enormous issue. Over half of the individuals we surveyed said they had difficulty affording food and were delaying or skipping some meals. This is a concern because many of these families had young children."

'Foreclosure crisis as health crisis'
"We think it's important to try to understand the foreclosure crisis as a health crisis," Pollack said.

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