‘It changed everything’: How Idaho’s housing crisis negatively impacts mental health

Improving residents’ mental health ranked second in a recent report that surveys the community and determines its top five highest priority health needs, writes guest columnist Rory Cole.

September 20, 2021 4:35 am
Big Wood River in Blaine County

The Big Wood River in Blaine County, Idaho. (Courtesy of Blaine County)

Before COVID-19 hit the United States, Blaine County had the second-highest rate of extreme housing cost burden in Idaho, meaning that the percentage of residents that pay more than 50% of their monthly income toward housing was 17%, according to the Robert Wood Johnson County Health Rankings.

The state average is 11%. On top of this, 18% of Blaine County residents experience severe housing problems, such as overcrowding, high housing costs, lack of kitchen facilities or lack of plumbing facilities. The housing crisis has only worsened since March 2020. 

What happens when a person experiences housing instability impacts far more than where they shower and sleep each night? Housing instability creates public health problems because it contributes to individuals’ risk of developing obesity, experiencing complications during obstetrical care and it contributes to poor mental health.


If you or someone you know is experiencing housing insecurity, reach out for help. Friends, family, your doctor, or any of the community organizations listed here can help you manage changes and seek help.


  • St. Luke’s Family Medicine: (208) 788-3434
  • St. Luke’s Center Mental Health Services: (208) 727-8970
  • The Hunger Coalition: (208) 788-0121
  • NAMI Wood River: (208) 481-0686
  • Center for Community Health: (208) 727-8733
  • Blaine County Housing Foundation: (208) 788-6102

Jeff Emerick is a long-time resident who returned to the Wood River Valley in 2014 after receiving a job with Sun Valley Company and the Ketchum Fire Department. After suffering from a back injury and incurring enough medical debt to knock him off his feet, he spent the next three years homeless, camping during the summers and sleeping in whatever housing he could find during the winters.

Soon after, he began to experience depression. He would frequently be the last of his friends to leave his host’s house just to be able to spend a little extra time in a home. He struggled with loneliness and shame. He had no idea that the stress of housing instability was contributing to these feelings and changes in his mental health. 

Blaine County is privileged, socioeconomically and in terms of the health care resources available to our community. For example, the average patient-to-provider ratio in Blaine County is 980:1, almost two-thirds lower than the state average, 1580:1. Examining the average ratio of patients to mental health care providers tells a different story.

Blaine County falls behind an already steep curve with a ratio of 510 patients to 1 provider. In Idaho, the average is 460:1. Improving residents’ mental health ranked second in St. Luke’s Community Health Needs Assessment, a report published every four years that surveys the community and determines its top five highest priority health needs. 

As mentioned in the Lancet Commission report, homelessness is a cause and consequence of poor mental health. Housing affordability and instability constitute one of nine most influential social determinants of mental health. When people worry whether or not they can afford to stay in their home, or if they are spending too much on food each week, or if they don’t have a home to come home to — this triggers a stress response. Chronic stress leads to many downstream physiological changes within our bodies. 

In 2017, Emerick secured housing in Woodside, an opportunity that pivoted his life to a healthier path. From there, he was able to find work through The Hunger Coalition, a nonprofit that works to end food insecurity. Soon, his mental health began to improve. 

“When I was finally able to secure housing, it changed everything,” Emerick said. “It gave me the foundation to address my mental and physical health. That stability allowed me to put those struggles behind me and actually paved the way for all the work I’ve done in the community.” Through his work at the coalition, Emerick is able to give back to the community and work to find ways to end the cycle he found himself in in 2014. 

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Rory Cole
Rory Cole

Rory Cole is a second-year medical student at the University of Washington School of Medicine and a WWAMI participant doing her rotations in rural Idaho. She completed her bachelor of science degree in materials science and engineering with a minor in Spanish from Johns Hopkins University, graduating in 2019 with university honors. Rory grew up in Hailey, Idaho, and in her spare time, enjoys fly fishing and exploring Idaho’s outdoors.