Multidimensional housing insecurity and psychological health: how do gender and initial psychological health differentiate the association?

OBJECTIVES: Despite compelling evidence for housing-health associations, it is still unclear (1) whether gender differentiates psychological responses to housing insecurity and (2) the extent to which initial psychological health influences the association between housing insecurity and psychological health. The present study aims to reduce these knowledge gaps. STUDY DESIGN: We used data from over 13 waves (155,114 observations) of the Korea Welfare Panel Study. METHODS: This study tests fixed effects models that can take into account measured and unmeasured heterogeneity. Quantile regression with fixed effects was conducted to assess whether the observed association depends on the initial state of psychological health. All analyses are gender stratified. RESULTS: Fixed effects estimates show that housing problems, such as being a renter (b = 0.159), housing cost burden (b = 0.173), and rental/or mortgage arrears (b = 1.194), are significantly associated with depressive symptoms. Similar patterns were observed for poor housing quality (b = 0.598) and a lack of essential facilities (b = 0.286). Although the association between the severity of housing insecurity and depressive symptoms was concentrated among men with initially higher levels of depressive symptoms, the observed association was consistently pronounced for women regardless of initial psychological health. CONCLUSIONS: This study suggests that gender perspectives need to be incorporated into the development of housing intervention for vulnerable groups.

The Effects of Public Open Space on Older People's Well-Being: From Neighborhood Social Cohesion to Place Dependence.

This quantitative study examines the effects of Public Open Space (POS) on older people's well-being and examines the roles of neighborhood social cohesion (NSC) and place dependence (PD) as series buffers. A questionnaire survey of 501 people aged 65 and over was conducted in various communities of Hong Kong. Structural equation modelling (SEM) was used to analyze the pathways connecting POS and well-being. A multigroup analysis examined differences in the POS-well-being associations between the young-old (aged 65 to 75, n = 166) and old-old group (aged 76 to 95, n = 166). Results show that the association between POS and emotional well-being was stronger than social and psychological well-being. POS promotes three facets of well-being through developing NSC and, subsequently, PD. Multigroup analysis results suggest that the pathway from POS to emotional well-being via NSC is stronger for the old-old group; POS is more important for psychological well-being for the young-old group. This study highlights that the quality of POS, including attractive natural elements, various amenities, and sufficient space for social interactions, is essential for making relationship-rich and health-promotive urban environments.

Homeownership, Depression, and Life Satisfaction in China: The Gender and Urban-Rural Disparities.

This study examines how depression and life satisfaction are associated with assets in the form of homeownership in China and whether their relationships differ between men and women, and between urban and rural areas. While the psychological benefits of homeownership are well-documented, how gender makes a difference in this relationship remains unclear. Given the dynamic housing market conditions characterized by the urban-rural divide and the notable gender gap in psychological well-being, China can provide a relevant context to address this knowledge gap. A series of linear regression analyses based on the China Family Panel Studies (CFPS) data show that homeownership is positively associated with life satisfaction and negatively related to depression, and this relationship is driven by men. While the homeownership-life satisfaction relation does not differ between urban and rural areas, the negative association between homeownership and depression is seen only among rural residents. The gender difference could be explained by the salient role of the financial security obtained from homeownership, whereas the regional difference seems to be supported by the social comparison theory. This study contributes to the knowledge of how a biological determinant, i.e., gender, interacts with a social determinant, i.e., homeownership, to affect psychological well-being.

Housing cost burden and material hardship among older adults: How do they influence psychological health?

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.

Housing, Living Arrangements and Mental Health of Young Adults in Independent Living.

Young adults are prone to psychological stress and anxiety induced by major transitions to adulthood. While employment has predominated in previous research on the social determinants of young people's mental health, this study examines the association between young people's housing problems and mental health in the context of an unaffordable housing market. Using the Survey on the Living Conditions and Welfare Needs of Youths (n = 1308) in Korea, the study found that perceived poor housing quality and material hardship are negatively associated with the mental health of young adults living independently. Specifically, while poor housing quality and material hardship induced by housing cost burden were negatively associated with single-person households' mental health, only poor housing quality was associated with non-single-person households' mental health. This study is one of the few studies examining the linkage between housing problems and mental health of young adults and informs the interventions aimed at promoting the psychological well-being of young adults in the transition from parents' homes to independent living.

Food insecurity and housing affordability among low-income families: does housing assistance reduce food insecurity?

OBJECTIVE: Given the competing needs for food and housing under the limited household income among poor families, there is lack of research on the associations between housing affordability and food insecurity. The current study examines how housing cost burden affects food insecurity of low-income families and whether decreased housing cost enhances food security. DESIGN: Longitudinal data from the Korean Welfare Panel Study, of which the final sample for the analysis consisted of 31 304 household-level observations from 5466 households based on twelve waves (2007-2018). SETTING: South Korea. PARTICIPANTS: Low-income households in the lowest 40 % of household income distribution. RESULTS: 19·3 % had food insecurity, and housing cost burden was associated with food insecurity. While in-kind housing assistance and in-cash assistance from all sources were likely to reduce food insecurity partially through influencing housing cost burden, in-cash housing assistance was associated with higher likelihood of food insecurity. CONCLUSIONS: Housing cost burden potentially limits food access among poor families, and housing assistance, particularly public housing and sufficient in-cash assistance, is conducive to alleviating food insecurity.

Mental Health Among the Korean Older Population: How is it Related to Asset-based Welfare?

Objective: This article aims to investigate how older adults' income and housing tenure are concurrently associated with depression in Korea. Methods: Using the 2017 Survey of Living Conditions and Welfare Needs of Korean Older Persons, logistic regression was implemented to examine the association of housing tenure and income status with depression among 6,624 older adults. Also, the older adults' satisfaction with their economic conditions was added to examine its mediation effects on this association. Results: Homeownership lowered the likelihood of depression, whereas lower income increased the likelihood of depression among older adults. Also, lack of income security was associated with depression even among older homeowners, being partially mediated through their satisfaction with economic conditions. Conclusion: This study contributes to articulating the mechanisms linking housing tenure, income insecurity, and mental health of the older population in Korea. Future studies are needed to investigate the social determinants of health among older adults.

Revisiting the relationship among housing tenure, affordability and mental health: Do dwelling conditions matter?

Despite growing attention to housing as a social determinant of health, few studies have featured the interplay of its diverse impacts on health. Using the Korea Welfare Panel Study, this study used logistic regression analysis for examining how housing tenure and affordability are associated with depressive symptoms under different physical dwelling conditions among low-income households in Korea. In our findings, renters, compared with homeowners, were more likely to report depressive symptoms, and housing unaffordability was associated with a higher likelihood of having depressive symptoms. When dwelling conditions were considered, housing tenancy, compared with ownership, tended to be associated with depressive symptoms among adequate housing dwellers, whereas housing unaffordability was associated with depressive symptoms mainly among those living in substandard housing conditions. The findings suggest that the linkage of multiple housing problems to psychological well-being is dynamic. Public health policies and housing subsidy programs should, therefore, be designed based on a comprehensive account of not only tenure or income status, but also dwelling conditions.

Diagnosis of acute cholecystitis: value of contrast agent in the gallbladder and cystic duct on Gd-EOB-DTPA enhanced MR cholangiography.

To evaluate value of %volume of contrast agent in gallbladder and contrast in cystic duct in diagnosis of acute cholecysititis with Gd-EOB-DTPA MRC obtained 60 min after contrast injection (T1-MRC60min). We included 16 acute cholecystitis (AC), 23 chronic cholecystitis (CC), and 40 healthy volunteers. Receiver operating characteristic analysis showed cutoff value of 30.5% as predictor of AC comparing with healthy volunteers (sensitivity 93.8%, specificity 100%, AUC 0.958) and cutoff of 0% as predictor of AC comparing CC (sensitivity 81.2%, specificity 82.6%, AUC 0.823). In AC absent or obliterated cystic duct on T1-MRC60min showed 81.3%, 100%, sensitivity and specificity, respectively. These can be helpful for diagnosis of AC.