Abstract

Background: This study examined whether living in rented housing is associated with increased all-cause and cause-specific mortality, and whether the association between home ownership and mortality can be explained by household income, occupational class, and educational level.

Methods: A random sample including every seventh Finn aged 40–80 years at the end of 1997 (N  =  308 291) was derived from the population register of Finland. The sample was followed up for mortality until the end of 2003 during which time there were 22 721 deaths.

Results: The hazard ratio for all-cause mortality among renters compared with owner-occupiers was 2.06 (95% CI 1.98 to 2.14) in men and 1.73 (1.65 to 1.81) in women. Adjusting for household income, occupational class, and educational level attenuated the excess mortality among renters by 30% in men and 19% in women. The effect of income was larger among the under 65 year olds than those aged 65 years or over. Excess mortality among renters was particularly high for alcohol-related diseases, respiratory diseases, lung cancer, as well as endocrine, metabolic and nutritional diseases, and infections.

Conclusions: Renters had higher mortality than owner-occupiers even after adjusting for household income, occupational class, and educational level. Home ownership may indicate material living standards and cumulative wealth that cannot sufficiently be captured by conventional socioeconomic indicators. Analysing home ownership may thus increase understanding of the factors producing inequalities in health.