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1.
J Health Care Poor Underserved ; 35(2): 532-544, 2024.
Article in English | MEDLINE | ID: mdl-38828580

ABSTRACT

The Department of Veterans Affairs provides a shallow subsidy (i.e., subsidizing 50% of an individual's rent for two years) to Veterans experiencing housing instability. We sought to describe the characteristics of Veterans who received these subsidies. Methods. We conducted a retrospective cohort study of Veterans between 10/2019-9/2021. We identified Veteran-level characteristics associated with receiving a shallow subsidy using a multivariable two-part regression model. We also conducted qualitative interviews to identify how shallow subsidies are allocated. Results Black race, higher income, more education, and older age were positively associated with receiving a shallow subsidy; previous homelessness, prior VA outpatient cost, and participating in permanent supportive housing were negatively associated with receiving a shallow subsidy. Interviews revealed that income was the most influential determinant of whether to give shallow subsidies. Discussion Our mixed methods findings were consistent, indicating that socioeconomic stability is an important driver of shallow subsidy allocation decisions.


Subject(s)
United States Department of Veterans Affairs , Veterans , Humans , Veterans/statistics & numerical data , Veterans/psychology , United States , Male , Middle Aged , Retrospective Studies , Female , Aged , Housing/economics , Adult , Socioeconomic Factors , Ill-Housed Persons
2.
Front Public Health ; 12: 1345775, 2024.
Article in English | MEDLINE | ID: mdl-38832233

ABSTRACT

Background: Currently, China is steadily pursuing high-quality development and promoting common prosperity, for which residents' health is a precondition. However, high housing-price-to-income ratios and rent-to-income ratios have already triggered many social problems and have substantially affected people's work and life. It is of practical significance to examine the relationship between housing burden and residents' health. Methods: Combining city-level housing price-to-income ratio data and residents' health data from the China Family Panel Studies, this study employs a binary logit model to investigate the impact and mechanism of housing burden on residents' physical and psychological health. Results: Overall, a 1% increase in the housing-price-to-income ratio leads to a 1.2% decrease in physical health and a 1.9% decrease in psychological health. In terms of different psychological state indicators, a 1% increase in the housing price-to-income ratio leads to a 1.1% increase in depression, 1.1% increase in nervousness, 1.4% increase in relentlessness, 1.4% increase in hopelessness, 1.0% increase in a sense of incapability, and 1.4% increase in meaninglessness. According to mechanistic analyses, a 1% increase in the housing-price-to-income ratio leads to increases of 0.6 and 0.7% in the smoking rate and late sleep rate, respectively, while it leads to a 0.9% decrease in the noon nap rate. Conclusion: A growing housing burden significantly negatively impacts both the physical and psychological health of residents and increases the possibility of negative emotions. Further investigation revealed that the housing burden damages residents' health by increasing their likelihood of smoking and sleeping late and decreasing their likelihood of taking a nap at noon, while exercise alleviates the negative impacts of the housing burden on residents' physical and psychological health. Finally, we also find that housing burdens' impacts on physical and psychological health differ significantly in terms of gender, age, and educational attainment. From the perspective of improving livelihoods, governments should consider the relationship between housing burdens and residents' health when formulating livelihood policies. Location-specific and targeted policies should be followed. Additionally, efforts should be made to promote exercise among citizens.


Subject(s)
Housing , Humans , China/epidemiology , Housing/statistics & numerical data , Housing/economics , Female , Male , Adult , Middle Aged , Cities , Health Status , Mental Health/statistics & numerical data , Income/statistics & numerical data , Aged
4.
PLoS One ; 19(5): e0303295, 2024.
Article in English | MEDLINE | ID: mdl-38758751

ABSTRACT

This study addresses the satisfaction of housing-related needs in single-person households across European countries. The primary objective is to assess the housing satisfaction of single-person households in European countries, specifically within the Visegrad Group. The study seeks to identify trends in housing conditions, create a ranking of countries based on these conditions, and categorize countries with similar levels of unmet housing needs. The study employs statistical measures and methods to achieve its objectives. Time series are constructed for European countries, and linear trends are analyzed to identify statistically significant changes in selected housing aspects from 2005 to 2022. Various research tasks, including ranking countries and grouping them based on housing conditions, are accomplished using established methods like linear ranking and Ward's cluster analysis. Key findings include significant variations in financial burdens related to housing costs, thermal comfort, environmental pollution, and safety issues across European countries. The study reveals both improvements and challenges in housing conditions from 2005 to 2022 in one-person households. For instance, financial stress due to housing costs decreased in some countries, while thermal comfort issues improved in several nations. The results also highlight the heterogeneity within the Visegrad Group. The study concludes that there is a need for targeted actions to address housing-related issues in single-person households. The findings underscore the importance of investments in building energy efficiency, initiatives for affordable housing construction, and environmental policies. The research emphasizes the impact of housing conditions on health, well-being, and overall community life, urging policymakers to consider these factors for holistic improvement in the housing sector.


Subject(s)
Family Characteristics , Housing , Housing/economics , Europe , Humans , Personal Satisfaction
5.
BMC Public Health ; 24(1): 931, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38561729

ABSTRACT

BACKGROUND: Rising housing prices are becoming a top public health priority and are an emerging concern for policy makers and community leaders. This report reviews and synthesizes evidence examining the association between changes in housing price and health outcomes. METHODS: We conducted a systematic literature review by searching the SCOPUS and PubMed databases for keywords related to housing price and health. Articles were screened by two reviewers for eligibility, which restricted inclusion to original research articles measuring changes in housing prices and health outcomes, published prior to June 31st, 2022. RESULTS: Among 23 eligible studies, we found that changes in housing prices were heterogeneously associated with physical and mental health outcomes, with multiple mechanisms contributing to both positive and negative health outcomes. Income-level and home-ownership status were identified as key moderators, with lower-income individuals and renters experience negative health consequences from rising housing prices. This may have resulted from increased stress and financial strain among these groups. Meanwhile, the economic benefits of rising housing prices were seen to support health for higher-income individuals and homeowners - potentially due to increased wealth or perception of wealth. CONCLUSIONS: Based on the associations identified in this review, it appears that potential gains to health associated with rising housing prices are inequitably distributed. Housing policies should consider the health inequities born by renters and low-income individuals. Further research should explore mechanisms and interventions to reduce uneven economic impacts on health.


Subject(s)
Housing , Humans , Housing/economics
7.
PLoS One ; 19(4): e0302631, 2024.
Article in English | MEDLINE | ID: mdl-38687821

ABSTRACT

With the rapid progress of urbanization in China, the real estate industry, characterized by a long industrial chain, has become a pillar industry for economic development. Therefore, we inspect the nexus between land finance, housing prices, and economic growth. For this purpose, we use the panel data of 277 cities at the prefecture level or above in China from 2011 to 2019, and empirically examine it by using the Panel Vector Auto Regression (PVAR) model. The results show that there is a causal relationship between housing prices and economic growth. Housing prices promote economic growth in the short term and inhibit it in the long term. Both economic growth and housing prices have a significant impact on land finance. The economic growth show a significantly positive impact, while housing prices promote land finance in the short term with a long-term trend from positive to negative. This is the first study that tries to probe the relationship between urban housing prices, land finance, and economic growth by considering 277 prefecture-level and above cities in China. To promote the stable development of the regional economy, local governments need to overcome their dependence on the housing market and land finance and promote the healthy development of the housing market.


Subject(s)
Cities , Economic Development , Housing , China , Housing/economics , Urbanization/trends , Humans , Commerce/economics , East Asian People
8.
JNCI Cancer Spectr ; 8(3)2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38372706

ABSTRACT

Unaffordable housing has been associated with poor health. We investigated the relationship between severe housing cost burden and premature cancer mortality (death before 65 years of age) overall and by Medicaid expansion status. County-level severe housing cost burden was measured by the percentage of households that spend 50% or more of their income on housing. States were classified on the basis of Medicaid expansion status (expanded, late-expanded, nonexpanded). Mortality-adjusted rate ratios were estimated by cancer type across severe housing cost burden quintiles. Compared with the lowest quintile of severe housing cost burden, counties in the highest quintile had a 5% greater cancer mortality rate (mortality-adjusted rate ratio = 1.05, 95% confidence interval = 1.01 to 1.08). Within each severe housing cost burden quintile, cancer mortality rates were greater in states that did not expand Medicaid, though this association was significant only in the fourth quintile (mortality-adjusted rate ratio = 1.08, 95% confidence interval = 1.03 to 1.13). Our findings demonstrate that counties with greater severe housing cost burden had higher premature cancer death rates, and rates are potentially greater in non-Medicaid-expanded states than Medicaid-expanded states.


Subject(s)
Housing , Medicaid , Mortality, Premature , Neoplasms , Humans , Neoplasms/mortality , Neoplasms/economics , United States , Housing/economics , Medicaid/economics , Middle Aged , Male , Female , Cost of Illness , Income , Adult , Aged
9.
PLoS One ; 18(10): e0292657, 2023.
Article in English | MEDLINE | ID: mdl-37819918

ABSTRACT

People's preferences regarding their neighborhood environment can vary depending on their socioeconomic status and the cities where they live. This study aims to discern the relationship between neighborhood environment factors and single-family detached house sales by sale price and by central and noncentral cities. We analyzed sale prices in the Tokyo Metropolitan Area from 2015 to 2020. The neighborhood environment was assessed using flood/sediment risk and neighborhood walkability measured by net residential density, intersection density, and facility density (walking opportunity). Flood and sediment risk is a major concern that restricts the available land and is included as a negative aspect of the neighborhood environment, taking the topographic features into consideration. A comparison of the results showed that the preference for neighborhood walkability varies by socioeconomic status as well as by target cities. For most facility types, the number of walking opportunities within walking distance from houses was found to be positively related to the sale price of single-family detached houses in all quantiles. The relationship of house price with population and intersection density was found to vary depending on the price level, with a negative relationship with the sale price of relatively more expensive houses being exhibited. People who considered buying houses with relatively higher sale prices were found to devalue houses located in flood/sediment-hazardous areas more. However, it was also found that the negative relationship was slightly mitigated in the highest quantile of sale prices for houses in areas with a moderate flood risk (maximum flooding depth: 3-5 m). Plains near rivers with amenities offer high walkability but pose a flood risk, resulting in a trade-off between flood risk and neighborhood walkability. The findings suggest the use of indices representing diverse preferences in accordance with the target socioeconomic status when policymakers assess the neighborhood environment.


Subject(s)
Disasters , Environment Design , Housing , Neighborhood Characteristics , Humans , Cities , Residence Characteristics , Social Class , Walking , Housing/economics , Neighborhood Characteristics/statistics & numerical data
10.
Int J Drug Policy ; 118: 104084, 2023 08.
Article in English | MEDLINE | ID: mdl-37300920

ABSTRACT

BACKGROUND: People using opioids alone in private settings are at elevated risk of dying in the event of an overdose. In San Francisco, single room occupancy (SRO) tenants are 19 times more likely to die of overdose than non-SRO residents. The "SRO Project" pilot aimed to reduce fatal overdoses in SROs by recruiting and training tenants to distribute naloxone and provide overdose education in their buildings. We explore the implementation and program impacts of the SRO Project pilot in two permanent supportive housing SROs. METHODS: We conducted eight months of ethnographic fieldwork (May 2021 - Feb 2022), including 35 days observing SRO Project pilot activities, and semi-structured interviews with 11 housing staff and 8 tenant overdose prevention specialists ('specialists'). Data were analyzed using a grounded theory approach to characterize program impacts, implementation strengths, and implementation challenges from the perspective of specialists and housing staff. FINDINGS: We found that the SRO project increased awareness, access to, and understanding of naloxone; facilitated other mutual-aid practices; supported privacy and autonomy of tenants regarding their drug use; and improved rapport, communication and trust between tenants and housing staff. Strengths of the implementation process included involvement of tenants with diverse social locations and skill sets and, at one site, a team-based approach that fostered program innovation, tenant solidarity and a sense of collective ownership over the project. Program implementation was challenged by frequent turnover and capacity constraints of housing staff, particularly during overnight shifts when overdose risks were greatest. Additional challenges arose due to the psychosocial burden of overdose response work, gendered violence, issues with compensation methods, and scope creep in specialists' roles. CONCLUSION: This evaluation contributes further evidence regarding the effectiveness of tenant-led naloxone distribution and overdose education in permanent supportive and SRO housing environments. Findings indicate program implementation and sustainability can be improved by expanding tenant specialist training, compensating specialists in cash, and building stronger psychosocial support for tenants responding to overdoses in their homes.


Subject(s)
Community Support , Drug Overdose , Drug Users , Housing , Opioid-Related Disorders , Program Evaluation , Qualitative Research , Housing/classification , Housing/economics , Drug Overdose/therapy , Community Support/economics , Community Support/methods , Pilot Projects , Naloxone/administration & dosage , Naloxone/supply & distribution , Naloxone/therapeutic use , Group Processes , Opioid-Related Disorders/therapy , San Francisco , Health Education , Privacy , Trust , Communication , Aptitude , Violence
11.
JAMA ; 329(19): 1671-1681, 2023 05 16.
Article in English | MEDLINE | ID: mdl-37191703

ABSTRACT

Importance: Structural racism has been implicated in the disproportionally high asthma morbidity experienced by children living in disadvantaged, urban neighborhoods. Current approaches designed to reduce asthma triggers have modest impact. Objective: To examine whether participation in a housing mobility program that provided housing vouchers and assistance moving to low-poverty neighborhoods was associated with reduced asthma morbidity among children and to explore potential mediating factors. Design, Setting, and Participants: Cohort study of 123 children aged 5 to 17 years with persistent asthma whose families participated in the Baltimore Regional Housing Partnership housing mobility program from 2016 to 2020. Children were matched to 115 children enrolled in the Urban Environment and Childhood Asthma (URECA) birth cohort using propensity scores. Exposure: Moving to a low-poverty neighborhood. Main Outcomes: Caregiver-reported asthma exacerbations and symptoms. Results: Among 123 children enrolled in the program, median age was 8.4 years, 58 (47.2%) were female, and 120 (97.6%) were Black. Prior to moving, 89 of 110 children (81%) lived in a high-poverty census tract (>20% of families below the poverty line); after moving, only 1 of 106 children with after-move data (0.9%) lived in a high-poverty tract. Among this cohort, 15.1% (SD, 35.8) had at least 1 exacerbation per 3-month period prior to moving vs 8.5% (SD, 28.0) after moving, an adjusted difference of -6.8 percentage points (95% CI, -11.9% to -1.7%; P = .009). Maximum symptom days in the past 2 weeks were 5.1 (SD, 5.0) before moving and 2.7 (SD, 3.8) after moving, an adjusted difference of -2.37 days (95% CI, -3.14 to -1.59; P < .001). Results remained significant in propensity score-matched analyses with URECA data. Measures of stress, including social cohesion, neighborhood safety, and urban stress, all improved with moving and were estimated to mediate between 29% and 35% of the association between moving and asthma exacerbations. Conclusions and Relevance: Children with asthma whose families participated in a program that helped them move into low-poverty neighborhoods experienced significant improvements in asthma symptom days and exacerbations. This study adds to the limited evidence suggesting that programs to counter housing discrimination can reduce childhood asthma morbidity.


Subject(s)
Asthma , Housing , Residence Characteristics , Social Determinants of Health , Symptom Flare Up , Systemic Racism , Child , Female , Humans , Male , Asthma/diagnosis , Asthma/economics , Asthma/epidemiology , Asthma/psychology , Cohort Studies , Housing/economics , Poverty/economics , Poverty/ethnology , Poverty/psychology , Child, Preschool , Adolescent , Vulnerable Populations/psychology , Urban Population , Systemic Racism/economics , Systemic Racism/ethnology , Systemic Racism/psychology , Social Determinants of Health/economics , Social Determinants of Health/ethnology
13.
Chronic Illn ; 19(2): 327-338, 2023 06.
Article in English | MEDLINE | ID: mdl-34812655

ABSTRACT

OBJECTIVES: To examine the association between chronic obstructive pulmonary disease status and indicators of economic instability and stress to better understand the magnitude of these issues in persons with chronic obstructive pulmonary disease. METHODS: Analyzed 2017 Behavioral Risk Factor Surveillance System data from 16 states that administered the 'Social Determinants of Health' module, which included economic instability and stress measures (N = 101,461). Associations between self-reported doctor-diagnosed chronic obstructive pulmonary disease status and each measure were examined using multinomial logistic models. RESULTS: Adults with chronic obstructive pulmonary disease were more likely (p < 0.001) than adults without to report not having enough money at month end (21.0% vs. 7.9%) or just enough money (44.9% vs. 37.2%); being unable to pay mortgage, rent, or utility bills (19.2% vs. 8.8%); and that often or sometimes food did not last or could not afford to eat balanced meals (37.9% vs. 20.6%), as well as stress all or most of the time (27.3% vs. 11.6%). Associations were attenuated although remained significant after adjustments for sociodemographic and health characteristics. DISCUSSION: Financial, housing, and food insecurity and frequent stress were more prevalent in adults with chronic obstructive pulmonary disease than without. Findings highlight the importance of including strategies to address challenges related to economic instability and stress in chronic obstructive pulmonary disease management programs.


Subject(s)
Economic Stability , Pulmonary Disease, Chronic Obstructive , Social Determinants of Health , Stress, Psychological , Adult , Humans , Behavioral Risk Factor Surveillance System , Housing/economics , Housing/statistics & numerical data , Pulmonary Disease, Chronic Obstructive/economics , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/psychology , Self Report , United States/epidemiology , Stress, Psychological/epidemiology , Social Determinants of Health/economics , Social Determinants of Health/statistics & numerical data , Food Insecurity/economics
14.
Article in English | MEDLINE | ID: mdl-35861287

ABSTRACT

OBJECTIVES: Despite a growing body of evidence for the association between housing cost burden and psychological health, few studies have focused on the potential mediators of this association and the extent to which housing cost burden poses a threat to older adults' psychological health. This study aims to assess (a) the link between housing cost burden and psychological health among older adults and (b) how the association is mediated by material hardship. METHODS: Using thirteen waves of a nationally representative longitudinal study in Korea, this study assessed the association between housing cost burden and depressive symptoms among older adults aged 65 or over. Mediation tests were conducted to identify whether material hardship explains the link between housing cost burden and depressive symptoms. We used fixed-effects models to take into account individual-level heterogeneity. RESULTS: Housing cost burden was significantly associated with depressive symptoms among older adults, regardless of their housing tenure status. Different types of material hardship partially mediated the association between housing cost burden and depressive symptoms in older adults. Older adults with severe housing cost burden are more susceptible to all types of material hardship compared to those with a moderate burden. CONCLUSIONS: To contribute further to the social causation discussions, future studies should seek to identify protective factors of depressive symptoms among older adults and other potential mechanisms of the association between older adults' socioeconomic conditions and their psychological health.


Subject(s)
Depression , Housing , Social Determinants of Health , Aged , Depression/epidemiology , Housing/economics , Humans , Longitudinal Studies , Republic of Korea/epidemiology , Socioeconomic Factors
15.
J Epidemiol Community Health ; 76(9): 833-838, 2022 09.
Article in English | MEDLINE | ID: mdl-35760516

ABSTRACT

Recent crises have underscored the importance that housing has in sustaining good health and, equally, its potential to harm health. Considering this and building on Howden-Chapman's early glossary of housing and health and the WHO Housing and Health Guidelines, this paper introduces a range of housing and health-related terms, reflecting almost 20 years of development in the field. It defines key concepts currently used in research, policy and practice to describe housing in relation to health and health inequalities. Definitions are organised by three overarching aspects of housing: affordability (including housing affordability stress (HAS) and fuel poverty), suitability (including condition, accessibility and sustainable housing) and security (including precarious housing and homelessness). Each of these inter-related aspects of housing can be either protective of, or detrimental to, health. This glossary broadens our understanding of the relationship between housing and health to further promote interdisciplinarity and strengthen the nexus between these fields.


Subject(s)
Health Status , Housing , Costs and Cost Analysis , Ill-Housed Persons , Housing/economics , Humans , Poverty
16.
PLoS One ; 17(1): e0260405, 2022.
Article in English | MEDLINE | ID: mdl-35085260

ABSTRACT

Social Scientists and policy makers need precise data on market rents. Yet, while housing prices are systematically recorded, few accurate data sets on rents are available. In this paper, we present a new data set describing local rental markets in France based on online ads collected through to webscraping. Comparison with alternate sources reveals that online ads provide a non biased picture of rental markets and allow coverage of the whole territory. We then estimate hedonic models for prices and rents and document the spatial variations in rent-price ratios. We show that rents do not increase as much as prices in the tightest housing markets. We use our dataset to estimate the market rent of each transaction and of social dwellings. In the latter case,this allows us to estimate the in-kind benefit received by social tenants which is mainly driven by the level of private rent in their municipality.


Subject(s)
Housing/economics , Housing/statistics & numerical data , Administrative Personnel , Advertising , Big Data , France , Housing/legislation & jurisprudence , Humans , Social Sciences , Urban Population
17.
Educ. med. super ; 35(4)dic. 2021. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1404507

ABSTRACT

Introducción: La nueva Ley Universitaria 30220 permite mejorar las condiciones básicas de calidad universitaria en Perú, y es pertinente conocer las condiciones del estudiante y su procedencia para la mejora continua de su progreso académico. Objetivo: Determinar las características sociodemográficas, económicas y de salud de beneficiarios de los servicios educacionales complementarios básicos de la Universidad Nacional de Frontera, Sullana Perú. Métodos: Se trata de un estudio descriptivo. Se revisaron los cuestionarios socioeconómicos, familiares y de salud de los beneficiarios. La población fue censal y ascendió a 1285 estudiantes. Resultados: Del total de estudiantes, 64 por ciento fueron mujeres y 35 por ciento hombres; asimismo, se determinó un elevado porcentaje de estudiantes con servicio de agua por horas, y se observó que algunos trabajaban en ocupaciones de ventas, en trabajo independiente y como mototaxistas. También se determinó que la mayoría de los estudiantes percibían un sueldo mensual entre 250-500 soles. En cuanto a la vacunación, se determinó que los estudiantes se colocaron la vacuna antitetánica, la vacuna contra el sarampión, la vacuna contra la hepatitis B, y la vacuna contra el virus del papiloma humano. Además, se halló un bajo porcentaje de estudiantes con asma, con algún tipo de alergia, y con padecimiento de alguna discapacidad, depresión y abuso sexual. Conclusiones: El servicio complementario de salud que brinda la universidad es pertinente para reducir riesgos de deserción por motivos de salud durante el pregrado. Aunque se necesita articular esfuerzos con los Gobiernos locales para establecer programas de salud(AU)


Introduction: The new University Law 30220 allows improving the basic conditions of university quality in Peru, insofar it is pertinent to know students' conditions and origins in view of the continuous improvement of their academic progress. Objective: To determine the sociodemographic, economic and health-related characteristics of beneficiaries of basic complementary educational services of the National University of Frontera in Sullana, Peru. Methods: This is a descriptive study. The socioeconomic, family and health questionnaires of the beneficiaries were reviewed. The population was of census type and amounted to 1,285 students. Results: Of the total of students, 64 percent were women and 35 percent were men. Likewise, a high percentage of students with hourly water service was determined, as well as some were observed to work in sales occupations, self-employment and as motorcycle taxi drivers. Most of the students were observed to receive a monthly salary between 250-500 soles. Regarding vaccination, the students were observed to receive vaccines against tetanus, measles, hepatitis B and human papillomavirus vaccines. In addition, a low percentage of students with asthma, with some type of allergy or suffering from some disability, depression and sexual abuse was found. Conclusions: The complementary health service offered by the university is pertinent to reduce the risk of dropping out due to health-related reasons during undergraduate studies. Although it is necessary to coordinate efforts with local governments for establish health programs(AU)


Subject(s)
Humans , Male , Female , Salaries and Fringe Benefits/economics , Student Dropouts/education , Diagnosis of Health Situation , Employment/economics , Universities/economics , Family , Epidemiology, Descriptive , Housing/economics
18.
Pediatrics ; 148(5)2021 11.
Article in English | MEDLINE | ID: mdl-34663680

ABSTRACT

BACKGROUND: To determine the association between states' total spending on benefit programs and child maltreatment outcomes. METHODS: This was an ecological study of all US states during federal fiscal years 2010-2017. The primary predictor was states' total annual spending on local, state, and federal benefit programs per person living ≤100% federal poverty limit, which was the sum of (1) cash, housing, and in-kind assistance, (2) housing infrastructure, (3) child care assistance, (4) refundable Earned Income Tax Credit, and (5) Medical Assistance Programs. The main outcomes were rates of maltreatment reporting, substantiations, foster care placements, and fatalities after adjustment for relevant confounders. Generalized estimating equations adjusted for federal spending and estimated adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS: States' total spending was inversely associated with all maltreatment outcomes. For each additional $1000 states spent on benefit programs per person living in poverty, there was an associated -4.3% (adjusted IRR: 0.9573 [95% CI: 0.9486 to 0.9661]) difference in reporting, -4.0% (adjusted IRR: 0.903 [95% CI: 0.9534 to 0.9672]) difference in substantiations, -2.1% (adjusted IRR: 0.9795 [95% CI: 0.9759 to 0.9832]) difference in foster care placements, and -7.7% (adjusted IRR: 0.9229 [95% CI: 0.9128 to 0.9330]) difference in fatalities. In 2017, extrapolating $1000 of additional spending for each person living in poverty ($46.5 billion nationally, or 13.3% increase) might have resulted in 181 850 fewer reports, 28 575 fewer substantiations, 4168 fewer foster care placements, and 130 fewer fatalities. CONCLUSIONS: State spending on benefit programs was associated with reductions in child maltreatment, which might offset some benefit program costs.


Subject(s)
Child Abuse/statistics & numerical data , Public Assistance/economics , Public Expenditures , Adolescent , Child , Child Abuse/mortality , Confidence Intervals , Foster Home Care/economics , Housing/economics , Humans , Incidence , Medical Assistance/economics , Poverty/economics , Time Factors , United States
20.
Aging (Albany NY) ; 13(16): 20029-20049, 2021 08 29.
Article in English | MEDLINE | ID: mdl-34456185

ABSTRACT

INTRODUCTION: Despite associated with multiple geriatric disorders, whether housing type, an indicator of socioeconomic status (SES) and environmental factors, is associated with accelerated biological aging is unknown. Furthermore, although individuals with low-SES have higher body mass index (BMI) and are more likely to smoke, whether BMI and smoking status moderate the association between SES and biological aging is unclear. We examined these questions in urbanized low-SES older community-dwelling adults. METHODS: First, we analyzed complete blood count data using the cox proportional hazards model and derived measures for biological age (BA) and biological age acceleration (BAA, the higher the more accelerated aging) (N = 376). Subsequently, BAA was regressed on housing type, controlling for covariates, including four other SES indicators. Interaction terms between housing type and BMI/smoking status were separately added to examine their moderating effects. Total sample and sex-stratified analyses were performed. RESULTS: There were significant differences between men and women in housing type and BAA. Compared to residents in ≥3 room public or private housing, older adults resided in 1-2 room public housing had a higher BAA. Furthermore, BMI attenuated the association between housing type and BAA. In sex-stratified analyses, the main and interaction effects were only significant in women. In men, smoking status instead aggravated the association between housing type and BAA. CONCLUSION: Controlling for other SES indicators, housing type is an independent socio-environmental determinant of BA and BAA in a low-SES urbanized population. There were also sex differences in the moderating effects of health behaviors on biological aging.


Subject(s)
Aging/psychology , Health Behavior , Housing , Aged , Aged, 80 and over , Aging/blood , Body Mass Index , Female , Housing/economics , Humans , Male , Middle Aged , Sex Factors , Social Class
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