IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v103y2025ics0167629625000542.html

The effect of housing wealth on health care spending

Author

Listed:
  • Lovenheim, Michael F.
  • Yun, Jun Hyun

Abstract

The U.S. healthcare system requires substantial out-of-pocket payments by most consumers, which can prevent some from receiving needed medical services. At the same time, housing wealth comprises a significant proportion of household wealth that could be used to pay for medical care. We analyze the effects of housing wealth on out-of-pocket medical expenditures among older homeowners. Using data from the Health and Retirement Study and various measures of home price changes, we find no evidence that housing wealth impacts out-of-pocket medical spending. The estimates are universally small and precise, allowing us to rule out even modest-sized effects. Effects are zero across the expenditure distribution, for specific categories of expenditure, and for different types of homeowners split by health insurance status and SES. We present suggestive evidence that our results represent a mix of homeowners not needing to access their housing wealth for additional medical care and being unwilling or unable to access their home equity.

Suggested Citation

  • Lovenheim, Michael F. & Yun, Jun Hyun, 2025. "The effect of housing wealth on health care spending," Journal of Health Economics, Elsevier, vol. 103(C).
    • Handle: RePEc:eee:jhecon:v:103:y:2025:i:c:s0167629625000542
    DOI: 10.1016/j.jhealeco.2025.103019
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629625000542
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2025.103019?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Keith Marzilli Ericson & Justin R. Sydnor, 2018. "Liquidity Constraints and the Value of Insurance," NBER Working Papers 24993, National Bureau of Economic Research, Inc.
    2. Aditya Aladangady, 2017. "Housing Wealth and Consumption: Evidence from Geographically-Linked Microdata," American Economic Review, American Economic Association, vol. 107(11), pages 3415-3446, November.
    3. Meer, Jonathan & Miller, Douglas L. & Rosen, Harvey S., 2003. "Exploring the health-wealth nexus," Journal of Health Economics, Elsevier, vol. 22(5), pages 713-730, September.
    4. Michael F. Lovenheim & C. Lockwood Reynolds, 2013. "The Effect of Housing Wealth on College Choice: Evidence from the Housing Boom," Journal of Human Resources, University of Wisconsin Press, vol. 48(1), pages 1-35.
    5. David Cesarini & Erik Lindqvist & Robert Östling & Björn Wallace, 2016. "Wealth, Health, and Child Development: Evidence from Administrative Data on Swedish Lottery Players," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(2), pages 687-738.
    6. Michael F. Lovenheim, 2011. "The Effect of Liquid Housing Wealth on College Enrollment," Journal of Labor Economics, University of Chicago Press, vol. 29(4), pages 741-771.
    7. Dettling, Lisa J. & Kearney, Melissa S., 2014. "House prices and birth rates: The impact of the real estate market on the decision to have a baby," Journal of Public Economics, Elsevier, vol. 110(C), pages 82-100.
    8. Michael F. Lovenheim & Kevin J. Mumford, 2013. "Do Family Wealth Shocks Affect Fertility Choices? Evidence from the Housing Market," The Review of Economics and Statistics, MIT Press, vol. 95(2), pages 464-475, May.
    9. John Mullahy & Edward C. Norton, 2024. "Why Transform Y? The Pitfalls of Transformed Regressions with a Mass at Zero," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 86(2), pages 417-447, April.
    10. Hannes Schwandt, 2018. "Wealth Shocks and Health Outcomes: Evidence from Stock Market Fluctuations," American Economic Journal: Applied Economics, American Economic Association, vol. 10(4), pages 349-377, October.
    11. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    12. Kerwin Kofi Charles & Erik Hurst & Matthew J. Notowidigdo, 2018. "Housing Booms and Busts, Labor Market Opportunities, and College Attendance," American Economic Review, American Economic Association, vol. 108(10), pages 2947-2994, October.
    13. Hurst, Erik & Stafford, Frank, 2004. "Home Is Where the Equity Is: Mortgage Refinancing and Household Consumption," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 36(6), pages 985-1014, December.
    14. Benedicte Apouey & Andrew E. Clark, 2015. "Winning Big but Feeling no Better? The Effect of Lottery Prizes on Physical and Mental Health," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 516-538, May.
    15. Campbell, John Y. & Cocco, Joao F., 2007. "How do house prices affect consumption? Evidence from micro data," Journal of Monetary Economics, Elsevier, vol. 54(3), pages 591-621, April.
    16. repec:wly:hlthec:v:25:y:2016:i::p:57-69 is not listed on IDEAS
    17. Atif Mian & Kamalesh Rao & Amir Sufi, 2013. "Household Balance Sheets, Consumption, and the Economic Slump," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 128(4), pages 1687-1726.
    18. James Graham & Christos A. Makridis, 2023. "House Prices and Consumption: A New Instrumental Variables Approach," American Economic Journal: Macroeconomics, American Economic Association, vol. 15(1), pages 411-443, January.
    19. Dalton, Michael & LaFave, Daniel, 2017. "Mitigating the consequences of a health condition: The role of intra- and interhousehold assistance," Journal of Health Economics, Elsevier, vol. 53(C), pages 38-52.
    20. Tran, My & Gannon, Brenda & Rose, Christiern, 2023. "The effect of housing wealth on older adults’ health care utilization: Evidence from fluctuations in the U.S. housing market," Journal of Health Economics, Elsevier, vol. 88(C).
    21. Lingxiao Zhao & Gregory Burge, 2017. "Housing Wealth, Property Taxes, and Labor Supply among the Elderly," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 227-263.
    22. repec:hal:pseose:halshs-01155641 is not listed on IDEAS
    23. Sonia Jaffe & Anup Malani, 2017. "The Welfare Implications of Health Insurance," Working Papers 2017-045, Human Capital and Economic Opportunity Working Group.
    24. V. Joseph Hotz & Emily E. Wiemers & Joshua Rasmussen & Kate Maxwell Koegel, 2023. "The Role of Parental Wealth and Income in Financing Children’s College Attendance and Its Consequences," Journal of Human Resources, University of Wisconsin Press, vol. 58(6), pages 1850-1880.
    25. Kaplan, Greg & Mitman, Kurt & Violante, Giovanni L., 2020. "Non-durable consumption and housing net worth in the Great Recession: Evidence from easily accessible data," Journal of Public Economics, Elsevier, vol. 189(C).
    26. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters, in: Perspectives on the Economics of Aging, pages 415-526, National Bureau of Economic Research, Inc.
    27. Michael Insler, 2014. "The Health Consequences of Retirement," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 195-233.
    28. Tal Gross & Timothy J. Layton & Daniel Prinz, 2022. "The Liquidity Sensitivity of Healthcare Consumption: Evidence from Social Security Payments," American Economic Review: Insights, American Economic Association, vol. 4(2), pages 175-190, June.
    29. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    30. Costa-Font, Joan & Frank, Richard G. & Swartz, Katherine, 2019. "Access to long term care after a wealth shock: Evidence from the housing bubble and burst," The Journal of the Economics of Ageing, Elsevier, vol. 13(C), pages 103-110.
    31. A. Colin Cameron & Douglas L. Miller, 2015. "A Practitioner’s Guide to Cluster-Robust Inference," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 317-372.
    32. Erik Lindqvist & Robert Östling & David Cesarini, 2020. "Long-Run Effects of Lottery Wealth on Psychological Well-Being," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 87(6), pages 2703-2726.
    33. Daysal, N. Meltem & Lovenheim, Michael & Siersbæk, Nikolaj & Wasser, David N., 2021. "Home prices, fertility, and early-life health outcomes," Journal of Public Economics, Elsevier, vol. 198(C).
    34. Meta Brown & Sarah Stein & Basit Zafar, 2015. "The Impact of Housing Markets on Consumer Debt: Credit Report Evidence from 1999 to 2012," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 47(S1), pages 175-213, March.
    35. Zeldes, Stephen P, 1989. "Consumption and Liquidity Constraints: An Empirical Investigation," Journal of Political Economy, University of Chicago Press, vol. 97(2), pages 305-346, April.
    36. Oscar Erixson, 2017. "Health responses to a wealth shock: evidence from a Swedish tax reform," Journal of Population Economics, Springer;European Society for Population Economics, vol. 30(4), pages 1281-1336, October.
    37. Ben Handel & Igal Hendel & Michael D. Whinston, 2015. "Equilibria in Health Exchanges: Adverse Selection versus Reclassification Risk," Econometrica, Econometric Society, vol. 83(4), pages 1261-1313, July.
    38. Bound, John & Schoenbaum, Michael & Stinebrickner, Todd R. & Waidmann, Timothy, 1999. "The dynamic effects of health on the labor force transitions of older workers," Labour Economics, Elsevier, vol. 6(2), pages 179-202, June.
    39. Adam M Guren & Alisdair McKay & Emi Nakamura & Jón Steinsson, 2021. "Housing Wealth Effects: The Long View," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 88(2), pages 669-707.
    40. Eleonora Fichera & John Gathergood, 2016. "Do Wealth Shocks Affect Health? New Evidence from the Housing Boom," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 57-69, November.
    41. Poterba, James & Venti, Steven & Wise, David A., 2018. "Longitudinal determinants of end-of-life wealth inequality," Journal of Public Economics, Elsevier, vol. 162(C), pages 78-88.
    42. Amitabh Chandra & Evan Flack & Ziad Obermeyer, 2024. "The Health Costs of Cost Sharing," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 139(4), pages 2037-2082.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. He; Z.;, 2026. "Pension Schemes, Healthcare Use, and Health: Evidence from China," Health, Econometrics and Data Group (HEDG) Working Papers 26/03, HEDG, c/o Department of Economics, University of York.
    2. Zeen He & Luu Duc Toan Huynh, 2026. "Wealth, Medical Spending, and Health: Evidence from a Housing Reform," Working Papers 124, Queen Mary, University of London, School of Business and Management, Centre for Globalisation Research, revised 09 Mar 2026.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daysal, N. Meltem & Lovenheim, Michael & Siersbæk, Nikolaj & Wasser, David N., 2021. "Home prices, fertility, and early-life health outcomes," Journal of Public Economics, Elsevier, vol. 198(C).
    2. Shi, Xuezhu, 2022. "The health-wealth nexus for the elderly: Evidence from the booming housing market in China," Labour Economics, Elsevier, vol. 78(C).
    3. N. Meltem Daysal & Michael F. Lovenheim & David N. Wasser, 2023. "The Intergenerational Transmission of Housing Wealth," CESifo Working Paper Series 10647, CESifo.
    4. Atalay, Kadir & Edwards, Rebecca, 2022. "House prices, housing wealth and financial well-being," Journal of Urban Economics, Elsevier, vol. 129(C).
    5. Rui Zhang, 2024. "Do housing prices affect individual physical health? Evidence from China," PLOS ONE, Public Library of Science, vol. 19(4), pages 1-22, April.
    6. Fan, Qingli & Zhou, Qiyao, 2025. "The Lavish, the wealthy, and the healthy — Effect of housing wealth on health outcomes and behaviors," Journal of Economic Behavior & Organization, Elsevier, vol. 237(C).
    7. Van Doornik, Bernardus & Fazio, Dimas & Ramadorai, Tarun & Skrastiņš, JÄ nis, 2024. "Housing and Fertility," CEPR Discussion Papers 19805, Centre for Economic Policy Research.
    8. Eleonora Fichera & John Gathergood, 2016. "Do Wealth Shocks Affect Health? New Evidence from the Housing Boom," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 57-69, November.
    9. Li, Han & Li, Jiangyi & Lu, Yi & Xie, Huihua, 2020. "Housing wealth and labor supply: Evidence from a regression discontinuity design," Journal of Public Economics, Elsevier, vol. 183(C).
    10. Atalay, Kadir & Li, Ang & Whelan, Stephen, 2021. "Housing wealth, fertility intentions and fertility," Journal of Housing Economics, Elsevier, vol. 54(C).
    11. Zeen He & Luu Duc Toan Huynh, 2026. "Wealth, Medical Spending, and Health: Evidence from a Housing Reform," Working Papers 124, Queen Mary, University of London, School of Business and Management, Centre for Globalisation Research, revised 09 Mar 2026.
    12. John Gathergood & Eleonora Fichera, 2012. "House Prices, Home Equity and Health," Discussion Papers 12/07, University of Nottingham, School of Economics.
    13. Hanming Fang & Long Wang & Yang Yang, 2022. "Housing Wealth and Online Consumer Behavior: Evidence from Xiong'an New Area in China," NBER Working Papers 30465, National Bureau of Economic Research, Inc.
    14. Richard Disney & John Gathergood, 2018. "House Prices, Wealth Effects and Labour Supply," Economica, London School of Economics and Political Science, vol. 85(339), pages 449-478, July.
    15. Anna Pestova & Alexander Popov, 2026. "Housing Bust and Long-Term Human Capital Scarring in the U.S," CERGE-EI Working Papers wp817, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    16. Yunho Cho & James Morley & Aarti Singh, 2024. "Did marginal propensities to consume change with the housing boom and bust?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 39(1), pages 174-199, January.
    17. Belloc, Ignacio & Molina, José Alberto & Velilla, Jorge, 2025. "When wealth hurts: Inheritances and the health of older Europeans," The Journal of the Economics of Ageing, Elsevier, vol. 32(C).
    18. Costa-Font, Joan & Frank, Richard G & Raut, Nilesh, 2026. "The effects of wealth shocks on public and private long-term care insurance," Journal of Health Economics, Elsevier, vol. 106(C).
    19. Xiandeng Jiang & Zheng Pan & Ningru Zhao, 2023. "Relative Value vs Absolute Value: Housing Wealth and Labor Supply," The Journal of Real Estate Finance and Economics, Springer, vol. 66(1), pages 41-76, January.
    20. Nguyen, Cuong Viet & Nguyen, Minh Khanh Hoang & Phung, Tung Duc & Tran, Oanh Ngoc, 2023. "The effect of income shocks on health behaviors: Evidence from a low-income country," Economic Analysis and Policy, Elsevier, vol. 79(C), pages 257-276.

    More about this item

    Keywords

    ;
    ;
    ;

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • R30 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Real Estate Markets, Spatial Production Analysis, and Firm Location - - - General

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:103:y:2025:i:c:s0167629625000542. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.