Rental price shocks and mental health in Spain’s Autonomous Communities, 2011–2023

Background

Housing affordability pressure is increasingly recognised as a structural driver of health inequalities, yet its territorial impacts may be uneven. In segmented rental markets, rent shocks can concentrate in specific dwelling types, generating unequal exposure to affordability stress and widening regional mental health gaps. This paper examines whether rental price dynamics are associated with changes in mental health prevalence across Spanish regions, and whether these associations differ by segment and territory.

Methods

We assemble a panel for Spain’s Autonomous Communities covering 2011–2023, combining rental price indices from the Spanish National Statistics Institute with region-level mental health prevalence from Spanish National Health System records. Annual changes in rental price indices are modelled contemporaneously and with lags. To proxy unequal exposure, rent changes are analysed by dwelling size: small, medium and large units. Models include socioeconomic and demographic controls, region and year effects, and specifications accounting for regional heterogeneity and interregional dependence.

Results

Rental price increases are associated with modest but statistically significant rises in mental health prevalence, with effects emerging after a delay. The association is stronger for small and medium-sized dwellings, whereas rent changes for larger dwellings show no robust relationship. Estimated effects vary across regions, pointing to territorial heterogeneity in vulnerability to rental price shocks.

Conclusions

The findings suggest that regional mental health is shaped by overall rental trends and the segment-specific incidence of rent inflation, reinforcing housing affordability as a determinant of territorial health inequalities. Results support regional strategies coordinating housing affordability instruments with mental health prevention and service planning, with attention to territories and segments most exposed to rent shocks.

Key messages

• Rental price shocks may act as an upstream determinant of regional mental health, with effects emerging after a delay.

• Housing affordability policies should account for market segmentation, as rent increases in small and medium-sized dwellings appear most strongly linked to mental health inequalities.