Home as Health

9/11 was a life altering event. Like many of us, I can remember exactly where I was when I received word of the attack and saw live footage of the twin towers collapsing. It was a shock to the system. Soon after, pundits speculated how our society would forever change, including how many of us would never again feel comfortable flying. Many of those predictions proved wrong. Within two years, US airline travel rebounded to its pre-9/11 levels.

We’re going through a similar moment with COVID-19. Much has been written about how our society will change from the pandemic, including its impact on aging and retirement. (See Wall Street Journal article: “How Covid-19 will change aging and retirement.”) Predicting how society will change in the midst of a disruptive event can be a fool’s errand. For one, I am confident the attractiveness of urban living won’t disappear, remote working won’t be the norm, and we will shake hands and hug once again.

However, I think that how we think about housing will be different. I was a panelist for the launch of Johns Hopkins University School of Nursing’s Housing and Health Initiative. The discussion covered the link between place and health across the life spectrum, highlighted innovative approaches, and discussed the next frontier for important research. I was part of a similar session recently with the Brookings Institute.

The pandemic has put a spotlight on the intersection of place and health, and it’s something critically important for researchers, policymakers and, perhaps most important, consumers to carefully consider.

The 9/11 terror attacks shook the world, but air travel traffic rebounded sooner than many expected (Source: Business Insider)

Home as Health

Where we call home matters. Research on longevity show us that DNA is a factor, but its significance is far outweighed by other elements. By rough numbers, genetics only account for at most 30% of our longevity. Other lifestyle factors, including the role of place and your living environment, are more influential in healthy aging.

Research has highlighted the impact of place. Raj Chetty, an economics professor at Harvard University and director of Opportunity Insights, has harnessed big data to demonstrate how life expectancy can differ by decades based on zip code. And, Blue Zones: Lessons for Living Longer from the People Who’ve Lived the Longest, a book by Dan Buettner, shows specific regions where people have lived significantly longer and healthier. In each case, place had a key role in nudging people towards greater purpose, social connection, physical activity, overall healthy aging, and more.

How to Think About Home

The first step is to think about home as more than a house. Often, the terms are used interchangeably. A house has a set address and is a physical dwelling, most often a single-family house. A home is much more. Home is a composite of our country, region, metropolitan area, neighborhood, streets and physical dwelling, such as a house.

But home is more than a physical space. It has economic, psychological, and social dimensions. It is also a feeling, a sense of attachment. Home has a time dimension, as well. A connection to home can change without necessarily moving. Friends and neighbors move. Interests shift. The perfect home for one point in time can be a terrible place later on.

The right home can elevate well-being. It can help promote purpose, facilitate human connection, catalyze physical activity, support financial health, inspire community engagement, and ultimately serve as a boon for healthy aging. The wrong home can do just the opposite.

What to do about it?

In some cases, nothing. You or a loved one may be in a great spot. It may be the right region, metropolitan area and neighborhood. The physical dwelling may precisely fit your needs and desires.

More often, a minor modification may be best. It could be a lifestyle change, such as making efforts to strengthen social connections – no doubt harder in a pandemic, but even more important – or exercising more regularly. It could be a change to your physical environment. Since we spend about 90% of our time indoors, mostly in our homes, even small changes to our place can have a big impact. Small ideas include finding ways to include more indoor plants, utilizing natural colors, and rearranging furniture for better aesthetics and safety. More significant changes can be done through remodeling.

In other situations, a more significant change may be required. Maybe it is a move to be closer to family. Maybe it is a relocation to a different neighborhood where it is easier to develop and maintain friendships. Maybe it is a move to a smaller place that is more affordable and more in line with the needs of your current life stage, whether you're in your 20s or if you're focusing on healthy aging through the second half of life.

People who live alone should be particularly cognizant of the impact of place. Older people who live alone are less healthy, and they feel sad or depressed more often than their counterparts who live with a spouse or with others. These correlations stand up even after controlling for demographic factors such as gender, race, age, income and education. Maybe the necessary change is to find a roommate or to move into a congregate setting when it becomes safer after the pandemic.

Big Decisions Take Time

Pundits aren’t the only ones to come to brash conclusions about the long-term impact of the pandemic. Many of us are equally capable of making predictions about the future that don’t last the test of time. The key is not making big decisions that we may regret.

We do know that our environment helps drive our health and well-being. The pandemic has made this link more obvious. With more research, we’ll know more about the factors that matter most when choosing place. Ultimately, it’s our choice as to whether we take advantage of this information and add more quality years, and make healthy aging a priority in our lives.