Low-Income Housing Rental Assistance, Perceptions of Neighborhood Food Environment, and Dietary Patterns among Latino Adults: the AHOME Study.

INTRODUCTION: Federal rental assistance programs, in the form of the traditional public housing program and the Housing Choice Voucher Program (HCVP-formerly known as Section 8), are designed to reduce the economic rental burden for low-income residents. While residents using federal housing vouchers, which allow low-income residents in public housing to move out of public housing to rent-subsidized homes, have been found to be have better cardiovascular outcomes compared to the cardiovascular outcomes of low-income public housing residents, the mechanisms explaining these associations remains an understudied area. PURPOSE: The aim of this study is to assess whether residents participating in HCVP or unassisted residents had greater access to healthy foods such as fruits and vegetables, and less access to unhealthy foods such as fast food and sugar sweetened beverages, when compared to residents living in public housing (referent group). METHODS: The Affordable Housing as an Obesity Mediating Environment (AHOME) study is a cross-sectional study of Latinos residing in low-income housing in the Bronx, NY (n = 362). Participants were interviewed to assess food patterns and perceptions of neighborhood environment. RESULTS: The analytic sample was primarily female (74.5 %) with a mean age of 46.4 years (SD = 14.68). Residents participating in HCVP had similar availability of fruits and vegetables in the home compared to residents receiving no assistance or public housing residents. HCVP participants consumed more fast food (ß = 0.34; CI = 0.10-0.58) but had similar sugar sweetened beverage consumption compared to public housing residents. Unassisted residents had more fast food consumption (ß = 0.25; CI = 0.01-0.49) but less sugar sweetened beverage consumption (ß = -0.52; CI = -0.76--0.28) than public housing residents. Perceptions of neighborhood food environment were not significantly associated with dietary patterns. CONCLUSION: This study shows variability in consumption of sugar sweetened beverage consumption and fast food consumption, but not in availability of fruits and vegetables, across residents participating in HCVP, public housing residents, and unassisted residents. Evaluating the health benefits associated with low-income housing mobility programs, such as HCVP, requires examining how housing may influence dietary patterns above and beyond an individual's socioeconomic position.

Sleep and the Housing and Neighborhood Environment of Urban Latino Adults Living in Low-Income Housing: The AHOME Study.

Sleep is implicated in the risk of many chronic diseases; however, little is known about the living conditions that influence sleep. In this study of 371 low-income Latino residents, household crowding was associated with reduced odds of long sleep duration relative to average and short sleep duration. Neighborhood disorder and perceived building problems were associated with more sleep disturbances and poor sleep quality. Building problems were associated with prolonged sleep latency. There was a significant cumulative effect of adverse housing and neighborhood conditions on sleep outcomes. These results show that adverse conditions of both the housing and neighborhood environments are associated with poor sleep outcomes.

Depressive Symptomology and Hostile Affect among Latinos Using Housing Rental Assistance: the AHOME Study.

Studies show that those residing in households subsidized with federal housing vouchers exhibit fewer mental health problems than residents of public housing. The role of housing conditions and neighborhood quality in this relationship is unclear. This study investigated the relationship between rental assistance, housing and neighborhood conditions, and the risk of depressive symptomology and hostile affect among low-income Latino adults living in the Bronx, NY. Latino adults participating in the Affordable Housing as an Obesity Mediating Environment (AHOME) study were used for analysis. All AHOME participants were eligible for federal low-income housing rental assistance (n = 385) and living in the Bronx, New York (2010-2012). Housing (crowding and structural deficiencies) and neighborhood (physical disorder and social cohesion) were measured by questionnaire during in-home interview. Depressive symptomology was measured using the Center for Epidemiologic Studies Depression Scale Short Form, CES-D 10 (score ≥10). Hostile affect was measured using items from the Cook-Medley Hostility Scale (score ≥ 4). Results suggest residents of Section 8 housing have similar levels of depressive symptomology and hostility compared to residents in public housing or those receiving no federal housing assistance. However, depressive symptomology was significantly associated with maintenance deficiencies [OR = 1.17; CI 1.02, 1.35] and social cohesion [OR = 0.71; CI 0.55, 0.93]. Hostility was significantly associated with perceived crowding [OR = 1.18; CI 1.16, 2.85], neighborhood physical disorder [OR = 1.94; CI 1.12, 3.40], and social cohesion [OR = 0.70; CI 0.50, 0.98]. Low-income housing assistance did not have an independent effect on mental health outcomes. However, characteristics of the housing and neighborhood environments were associated with depressive symptomology and hostility.

Cardiovascular health outcomes of Latinos in the Affordable Housing as an Obesity Mediating Environment (AHOME) study: a study of rental assistance use.

Studies have shown that households subsidized with vouchers live in higher quality units and exhibit fewer physical, mental, and social problems than do their peers living in public housing. However, none of these studies have included cardiovascular outcomes. The objective of this study was to assess if use/type of rental assistance is independently associated with poor cardiovascular health among Latino adults (ages ≥ 18) who are eligible for federal low-income rental assistance and living in the Bronx, NY. Data from the cross-sectional, Affordable Housing as an Obesity Mediating Environment study, collected over 18 months (January 2011 to August 2012) were used. The prevalence of cardiovascular disease (CVD) outcomes was determined by measured high blood pressure and self-reported heart attack and/or stroke. Type of housing status was defined as: public housing units, units subsidized by section 8 vouchers, and units unassisted by either federal program. Statistical techniques used were analysis of variance and multivariate logistic regression. The prevalence of CVD was significantly higher among public housing residents than unassisted participants even in the presence of all individual level covariates. Public housing residents also have higher levels of CVD than do section 8 participants. The prevalence of CVD was similar for unassisted and section 8 participants. These findings point to the potential for health benefits arising from housing voucher use even within a fairly delimited geographic area.

The effect of parents' joint work schedules on infants' behavior over the first two years of life: evidence from the ECLSB.

We test whether infants living with employed, co-resident parents where at least one parent works a non-standard work shift exhibit significantly more behavior problems than children whose parents both work traditional day shifts. We use a sample of infants living with employed, co-resident parents and two waves of data from the Early Childhood Longitudinal Survey, Birth Cohort (ECLSB) to test whether infants' scores on the Infant-Toddler Symptom Checklist (ITSC) at the second wave (average age of 24.3 months) is affected by parents' shift work at the baseline (average age 10.3 months). Infants with at least one parent who works nonstandard hours have significantly more behavior problems than do infants with parents who both work regular day shifts. This relationship is partly accounted for by shift work's negative association with father-child interaction, marital quality, the frequency of shared family dinners, and parental health, including paternal depression. The results also indicate that shift work has larger effects on children's behavior when mothers, rather than fathers, work nonstandard shifts, and when mothers' day shifts regularly oppose fathers' evenings/night shifts. Policy should focus on giving individuals more choice in their work shift as well as more flexibility in when they start and stop working for the day. Given the importance of mediating factors, we should also focus on ameliorating the negative impacts of shift work when they do arise. This includes addressing issues of employee health and stress, and relationship conflict within couples where one or both partners work a non-standard shift.

Racial/ethnic differences in asthma prevalence: the role of housing and neighborhood environments.

This article examines the prevalence of asthma among New York City households from 10 racial/ethnic groups, and it explores whether differential exposure to potentially adverse housing and neighborhood conditions helps to mediate observed disparities. After adjusting for household size, Puerto Rican households exhibit the highest levels of asthma, followed by other Hispanic and black households. Mexican, Chinese, and Asian Indian households exhibit the lowest levels of asthma. Results from multilevel logistic regression models indicate that exposure to deteriorated housing conditions and perceptions of low social cohesion in the neighborhood significantly elevate the odds of asthma. Controlling for these conditions along with household characteristics reduces the disproportionately high levels of asthma among Puerto Rican and black households, although they remain significantly higher than the level among white households.