Housing instability, health, and substance use among adults over age 50 living in New York City.

Introduction: As cities become increasingly expensive, it is unclear how rising housing costs impact older adults' health and the ability to age-in-place. Methods: We examined key indicators of housing instability - concerns about paying rent/mortgage on time and number of moves in the past 5 years - in relation to health and substance use among a sample of adults over age 50 with a history of cannabis use living in naturally occurring retirement communities (NORCs) in New York City. Results: Bivariate analyses and logistic regression models indicate a significant relationship between housing instability and health, such that concerns about paying rent or mortgage were associated with worse self-reported health, and higher tobacco and other substance use. Frequent moves were associated with poorer health and simultaneous alcohol and cannabis co-use in bivariate analyses. Overall, housing instability was consistently associated with worse health and higher rates of substance use, particularly tobacco and other substances, among those who also use cannabis. Discussion: Findings suggest that NORC-dwelling does not fully alleviate housing costs or concerns in densely populated, high-cost cities. Specifically for older adults with a history of cannabis use, housing concerns may be an important correlate of substance use. As NORCs continue to integrate a range of health and social services offerings to achieve aging-in-place goals, substance use and financial literacy programs could be useful additions. Broadly, correlations between substance use and housing stress among older adults warrants additional attention.