Infrastructure, Instability, and Health: Local Determinants of Community Well-Being

Session Submission Type: Panel

Abstract

Population health is shaped not only by individual characteristics and healthcare access, but also by the stability and performance of local systems such as housing, energy infrastructure, community institutions, and public transportation. As environmental stressors and socioeconomic inequalities intensify, understanding how these systems influence health outcomes has become a central concern for policymakers. This panel brings together four complementary studies that examine how disruptions and capacities within local systems affect mental and physical health across different populations and contexts in the United States.
The first paper investigates the longitudinal effects of housing instability and economic well-being on maternal health using data from the Future of Families and Child Wellbeing Study. By tracking mothers over more than a decade, the study shows that frequent residential mobility is strongly associated with increased odds of depression and poorer self-rated health, particularly among economically disadvantaged groups. These findings highlight housing stability as a critical determinant of long-term health outcomes.
The second paper examines the health impacts of infrastructure reliability by focusing on power outages and mental health hospitalizations in Maryland. Using high-frequency outage data linked with administrative health records, the study finds that increased exposure to severe outages leads to measurable rises in mental health hospitalizations. Instrumental variable estimates suggest that conventional models may underestimate the true causal effects. This underscores the importance of resilient energy systems for public health.
The third paper explores the role of public libraries as resilience infrastructure in mitigating heat-related mortality across U.S. counties. Using panel data from 2000 to 2023, the analysis shows that greater access to libraries, measured through the proportion of the population within a 15-minute walking distance, is associated with significantly lower heat-related deaths. The findings suggest that widely accessible, climate-controlled public spaces can function as life-saving infrastructure during extreme heat events.
The fourth paper uses panel data on transit stop changes across 138 U.S. metropolitan areas combined with satellite-derived thermal imagery at the census block group level to find that expanding public transportation infrastructure is associated with lower localized urban heat intensity. These results suggest a novel mechanism through which urban infrastructure investment may reduce heat exposure for vulnerable populations, contributing to the literature on environmental health and health equity.
Together, these papers advance a unifying perspective: local systems, whether housing markets, energy grids, community institutions, or public transit networks, play a fundamental role in shaping population health, particularly under conditions of environmental and social stress. By integrating insights across these domains, the panel highlights the need for cross-sector policy approaches that prioritize stability, accessibility, and resilience in the design of public systems. This work contributes to health policy by demonstrating how investments in infrastructure and social systems can yield significant public health benefits and reduce disparities among vulnerable populations.

Policy Area

• Health Policy

Chair

• Ali Khaleghinia, University of Kansas

Discussants

• Dasom Lee, Korea Advanced Institute of Science and Technology (KAIST)

• Nicole S Ngo, University of Oregon

Organizer

• Ali Khaleghinia, University of Kansas

Individual Presentations

• Longitudinal impacts of housing instability and economic well-being on mental and physical health of mothers - Presenting Author: Olumayowa Adeleke Idowu, Clemson University

• Do Power Outages Impact Mental Health? Evidence from Maryland - Presenting Author: Yueming (Lucy) Lucy Qiu, University of Maryland, College Park

• Uneven Access? Resiliency Infrastructure Locations and Heat Deaths in U.S. Counties - Presenting Author: Rachel M. Krause, University of Kansas

• Public Transportation Networks and Urban Heat - Presenting Author: Sierra Arnold, Xavier University