A new study has shown that for cancer patients, housing insecurity in particular may make their cancer worse. “Social risks affect how we interact with the healthcare system and other social systems,” says Matthew Banegas, lead author on the study and a researcher at the Kaiser Center for Health Research in Portland, Oregon. “Slowly and surely, we have been able to show that these risks are important.”

This study builds on other work that has shown the negative effects of housing insecurity, from worsening people’s mental health to disrupting treatment for HIV/AIDS. Insecure living is, it seems, a health risk.

The study looked at the social risks experienced by more than 1,200 US cancer patients at the time of their diagnosis to see whether being exposed to risk factors — housing insecurity, food insecurity, financial hardship, and transport difficulties — appeared to raise their risk of dying from their cancer. The researchers found there was a two-fold greater risk of death for patients experiencing unstable housing — which can refer to a range of housing-related challenges, including homelessness, difficulty paying rent, overcrowding, moving frequently, or spending the majority of income on housing — compared to people who were not.

Notably, the study didn’t assess how insecure housing might influence cancer mortality. There are a lot of different ways that social risk can impact cancer care. The stress of insecure living, for instance, raises the risk of cancer developing. Or disruption caused by housing insecurity might impact a person getting screening, or affect someone’s chances of receiving high-quality treatment. Housing acts as a hub for a person to access health care, and so instability can disrupt access to services.