While foreclosure activity has declined since the peak of the mortgage crisis, millions of families are still at risk of losing their homes. Over 10 million families were still delinquent in their mortgage payments, underwater on their mortgages or otherwise vulnerable to losing their homes in 2013, according to a report from Harvard University’s Joint Center for Housing Studies. And RealtyTrac recently reported that foreclosure filings increased slightly in the third quarter of 2014.

Meanwhile, economic inequality is on the rise. Researchers with the Century Foundation and Rutgers University found that areas of concentrated poverty — census tracts in which the poverty rate is 20% or greater — have increased by over 40% since 2000. And the Federal Reserve reported in September that the income of the wealthiest 10% of Americans grew by 2% between 2010 and 2013, while the income of the bottom 60% actually declined.

These statistics clearly show that seven years after the housing bust began, millions of Americans are still suffering. And suffering is the operative word — because both foreclosures and economic inequality impact people’s health.

In 2011, the National Bureau of Economic Research reported that people living in areas with high levels of foreclosures are far more likely to experience physical and mental health problems than those in stronger housing markets. Our own research, forthcoming in the Journal of Urban Affairs, has found new connections between foreclosures and health, with economic inequality playing a critical role.

Our study, conducted with Cynthia Ronzio of The Health Initiatives Group, examined the connections between foreclosures, health and inequality in 69 of the nation’s 100 largest metropolitan areas. We found that between 2006 and 2008, the percentage of people with high blood pressure was significantly higher in areas exhibiting higher levels of concentrated poverty. In the five metro areas with the highest frequency of high blood pressure, 28% of census tracts were areas with concentrated poverty. In the five metro areas with the lowest frequency of high blood pressure, just 13% of census tracts exhibited concentrated poverty.

Most importantly, the impact of foreclosures on high blood pressure was greatest in metro areas in which concentrated poverty was most extreme. In 2007, for example, the correlation between foreclosures and high blood pressure was a significant 0.15 in metropolitan areas where more than three-fourths of the census tracts were poor. By contrast, in metro areas with low levels of concentrated poverty, there was virtually no relationship between foreclosures and high blood pressure.

It is not just the poor who suffer. Those who have lost homes endure the greatest costs. But neighbors who have witnessed their property values decline may also be affected. And even those who live in what are currently healthy neighborhoods but in a city with some high-poverty, high-foreclosure zones may be impacted. Simply reading local news reports about foreclosures and subsequent declines in property tax revenue threatening city services may lead people to experience anxiety, high blood pressure and other ailments.

These findings reinforce the wisdom of President Obama’s recent urban policy initiatives that attempt to break through traditional silos and provide comprehensive cradle-to-career services to those in need. Initiatives like Choice Neighborhoods, Strong Cities/Strong Communities, and Promise Zones bring several federal agencies together in programs designed to confront the wide-ranging yet intersecting issues faced by the nation’s metropolitan areas. This is a big improvement over addressing housing, health, education, employment and other challenges through separate funding mechanisms.

One key lesson is that targeting both health care and credit counseling services to metro areas with high levels of concentrated poverty and economic inequality may enhance the benefits of both programs. Another option would be for fair lending enforcement efforts to focus on leveraging more financial services directly to concentrated poverty areas. Health and financial service providers in these neighborhoods could collaborate by sharing office space, marketing efforts and other kinds of outreach aimed at area residents. And lenders could receive enhanced ratings in Community Reinvestment Act exams for collaborating with health care and other service providers, thereby encouraging more comprehensive aid to communities that are underserved on several fronts.

Our study also points to the need for researchers to examine the cumulative effect of multiple causal social and economic factors on those in need. Studying social problems in a silo fashion risks missing out on opportunities to develop potentially effective policies.

There is nothing inevitable about the foreclosure crisis, surging inequality and the impact that these issues have on Americans’ health. Policy choices helped get us here. Different choices — ones that recognize how social problems are interconnected — could help get us out. 

Antwan Jones and Gregory D. Squires are faculty members in the sociology department at George Washington University.