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County-level housing affordability in relation to risk factors for cardiovascular disease among middle-aged adults: The National Longitudinal Survey of Youths 1979.

Abstract：

BACKGROUND:Housing is a fundamental social determinant of health yet housing affordability has diminished over much of the twenty-first century. Research on housing affordability as a determinant of health is limited, but studies to date have shown correlations with mental health. However, few studies have examined the relationship between housing affordability and risk factors for cardiovascular disease, the leading cause of morbidity and mortality among Americans. METHODS:Using a nationally-representative sample of middle-aged adults from the National Longitudinal Survey of Youths 1979 (NLSY79) and exploiting quasi-experimental variation before and after the Great Recession, we estimated the associations between the change in median county-level percentage of household income spent on housing (rent/mortgage) between 2000 and 2008 and individual-level risks of incident hypertension, obesity, diabetes, and depression from 2008 to 2014. We employed conditional fixed effects logistic regression models to reduce bias due to time-invariant confounding. RESULTS:Each percentage point increase in county-level median percentage of household income spent on housing was associated with a 22% increase in the odds of incident hypertension (OR = 1.22, 95% CI = 1.06 to 1.42; p = 0.01), a 37% increased odds of obesity (OR = 1.37, 95% CI = 1.00-1.87; p = 0.049), and a 15% increased odds of depression (OR = 1.15, 95% CI = 1.01-1.31; p = 0.03), controlling for individual- and area-level factors. These associations were stronger among renters than homeowners, and among men compared to women. CONCLUSIONS:Our findings suggest that lower levels of housing affordability contribute to worse risk profiles for cardiovascular disease. Policies that make housing more affordable may help to reduce the population burden of cardiovascular disease.

journal_name

Health Place

journal_title

Health & place

authors

Rodgers J,Briesacher BA,Wallace RB,Kawachi I,Baum CF,Kim D

doi

10.1016/j.healthplace.2019.102194

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

102194

eissn

1353-8292

issn

1873-2054

pii

S1353-8292(18)31179-1

journal_volume

pub_type

杂志文章

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County-level housing affordability in relation to risk factors for cardiovascular disease among middle-aged adults: The National Longitudinal Survey of Youths 1979.