Using 2022 data from 600 adults (≥ 60 years) in Porto, Portugal, we explored the association between housing insecurity and various health outcomes. We examined housing conditions, affordability, and stability in relation to loneliness, quality of life, cognitive function, perception of healthy ageing, and sleep using regression models. Older adults without house heating (β = 2.293
95%CI = 0.753, 3.833), with leaks/dampness/rot (β = 3.741
1.818, 5.664), insufficient daylight (β = 2.787
0.095, 5.479), living in neighborhoods with noise (β = 1.793, 0.280 to 3.305), pollution/grime (β = 2.580
0.746, 4.414), and violence/crime/vandalism (β = 3.940
1.723, 6.157), who faced housing cost overburden (β = 2.001
0.426, 3.577), eviction (β = 12.651
0.852, 24.450), and moved frequently (β = 4.129
1.542, 6.716) exhibited higher levels of loneliness. Similarly, lack of house heating (β = - 1.942
- 3.438, - 0.445), leaks/dampness/rot (β = - 4.157
- 5.999, - 2.316), insufficient daylight (β = - 3.124
- 5.714, - 0.534), noise (β = - 2.143
- 3.600, - 0.686), pollution/grime (β = - 2.093
- 3.860, - 0.325), violence/crime/vandalism (β = - 2.819
- 4.948, - 0.691), and those with housing cost overburden (β = - 2.435
- 3.930, - 0.940) reported lower quality of life. Those with no toilet (β = - 1.891
- 3.760, - 0.021) or shower (β = - 1.891
- 3.760, - 0.021) and who faced forced displacement (β = - 2.179
- 3.516, - 0.842) presented lower cognitive function. Furthermore, those living in neighborhoods with pollution/grime (OR = 0.494
0.322, 0.756) and violence/crime/vandalism (OR = 0.477
0.284, 0.801), those in social housing (OR = 0.728
0.575, 0.922), and those who moved frequently (OR = 0.475
0.257, 0.879) reported lower levels of perceived healthy ageing. Insufficient sleep was more common among residents in social housing (OR = 2.155
1.102, 4.213), while poor sleep quality was least likely both among those living in social housing (OR = 0.445
0.220, 0.900) and affordable housing (OR = 0.381
0.162, 0.896). Good quality, stable, and affordable housing seems crucial for healthy ageing.