Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods. We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between 2005 and 2008. There was a marked spike in bipolar and depressive disorders in 2007 in all zip codes. Conclusions. The sharp rise for bipolar and depressive disorders in 2007 coincides with the doubling of foreclosure filings nationally. There are many confounding factors affecting hospital discharge data, which limit its specificity for assessing the health effects of foreclosure. 1. Introduction Home loan foreclosures have impacted most parts of the USA, with the most recent yearly statistics revealing that one in every 45 housing units received a foreclosure filing in 2010 [1], exceeding by over four times the number of homes receiving a foreclosure in 2005 (Figure 1). (Foreclosure filings include default notices, scheduled foreclosure auctions, and bank repossessions.) It seems probable that loss of such housing would have negative health effects. Figure 1: Number of Foreclosure Filings in the US, 2005–2010. Data compiled from Realty Trac statistics. A barrier to assessing the health effects of foreclosure over time is lack of publicly available data on the incidence and prevalence of the conditions most likely to be associated with this stressor. Due to the protracted length of the foreclosure process [2], “home foreclosure can be viewed as a stressful life event of prolonged duration” [3], with the physical and psychological disorders associated with chronic stress. When a body is subjected to chronic stress, there are disturbances in the physiological systems that regulate homeostasis (stability), which may lead to chronic diseases [4]. One study conducted during the marked increase in foreclosures in 2008 found significantly more hypertension and psychiatric disorders (particularly depression) in Philadelphia residents undergoing mortgage foreclosure as compared to community norms [5]. However, cause and effect cannot be inferred due to the cross-sectional design of the study. A related case-control study of
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