Severe Housing Cost Burden*

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Percentage of households that spend 50% or more of their household income on housing. The 2024 Annual Data Release used data from 2018-2022 for this measure.

There is a strong and growing evidence base linking stable and affordable housing to health. As housing costs have outpaced local incomes, households not only struggle to acquire and maintain adequate shelter, but also face difficult trade-offs in meeting other basic needs. When the majority of a paycheck goes toward the rent or mortgage, it makes it hard to afford doctor visits, healthy foods, utility bills, and reliable transportation to work or school.1-4 This can, in turn, lead to increased stress levels and emotional strain.5,6

Find strategies to address Severe Housing Cost Burden*

Data and methods

Data Source

American Community Survey, 5-year estimates

The American Community Survey (ACS) is a nationwide survey designed to provide communities with a fresh look at how they are changing. It is a critical element in the Census Bureau's reengineered decennial census program. The ACS collects and produces population and housing information every year instead of every ten years, and publishes both one-year and five-year estimates. We use American Community Survey data for measures of social and economic factors.

Website to download data
For more detailed methodological information

Key Measure Methods

Severe Housing Cost Burden is a percentage

Severe Housing Cost Burden is the percentage of households that spend 50% or more of their household income on housing.

Severe Housing Cost Burden is not identical to the measure used as part of Severe Housing Problems

Although both measures rely on the same underlying data, the numerator and denominator are defined somewhat differently. Given the difference in measure definitions, and the additional years of data used for this measure, there may be differences in these values of these two measures that seem incompatible. For example, a county can have a higher Severe Housing Cost Burden rate than its Severe Housing Problems rate. In order to provide users with the most recent data, Severe Housing Cost Burden is calculated from the American Community Survey, rather than downloading it from the Comprehensive Housing Affordability Strategy (CHAS) Dataset. 

Caution should be used when comparing these estimates across years

Caution should be used when comparing data across years as data comes from overlapping 5-year spans. Additionally, margins of error for 5-year estimates containing data collected in 2020 increased compared to prior 5-year estimates. For more information about data comparability please visit Comparing 2022 American Community Survey Data.


The numerator is the total number of households in a county that spend 50% or more of their household income on housing.


The denominator is the total occupied housing units for which housing cost burden is computed in a county.

Can This Measure Be Used to Track Progress

This measure can be used to track progress with some caveats. It is important to note that the estimate provided in the Health Snapshots is a five-year average. However, for counties with a population greater than 20,000, single-year estimates can be obtained from the resource below.

Finding More Data

Disaggregation means breaking data down into smaller, meaningful subgroups. Disaggregated data are often broken down by characteristics of people or where they live. Disaggregated data can reveal inequalities that are otherwise hidden. These data can be disaggregated by:

  • Income
  • Subcounty Area

Severe housing cost burden can be calculated for census tracts, census block groups, and income and broken out by owners/renters using tables B25074 and B25095.  


1 Kushel MB, Gupta R, Gee L, Haas JS. Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of General Internal Medicine. 2006;21(1):71-77.

2 Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambulatory Pediatrics. 2008;8(1):50-57.

3 Long SK. Hardship among the uninsured: Choosing among food, housing, and health insurance. The Urban Institute. 2003.

4 Levy H, DeLeire T. What do people buy when they don't buy health insurance and what does that say about why they are uninsured? National Bureau of Economic Research. 2003;w9826.

5 Hiscock R, Kearns A, MacIntyre S, Ellaway A. Ontological security and psycho-social benefits from the home: Qualitative evidence on issues of tenure. Housing, Theory and Society. 2001;18(1-2):50-66.

6 Dunn JR. Housing and health inequalities: Review and prospects for research. Housing studies. 2000;15(3):341-366.