‘Home is where the health is’: Housing quality and adult health outcomes in the Survey of Income and Program Participation

• Published in: Preventive medicine Vol. 132; p. 105990
• Main Authors: Boch, Samantha J., Taylor, Danielle M., Danielson, Melissa L., Chisolm, Deena J., Kelleher, Kelly J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2020
• Subjects: Adult; Aged; Family Characteristics; Female; Health Status; Home; Hospitalization - statistics & numerical data; House quality; Housing - standards; Housing - statistics & numerical data; Humans; Male; Middle Aged; Neighborhood; Outcome Assessment, Health Care - statistics & numerical data; Patient Acceptance of Health Care - statistics & numerical data; Residence Characteristics - statistics & numerical data; Socioeconomic Factors; Surveys and Questionnaires; United States; Utilization; United States; Utilization; Health status; House quality; Home; Neighborhood
• DOI: 10.1016/j.ypmed.2020.105990
• ISSN: 0091-7435; 1096-0260

Nearly a quarter of the homes in the United States were considered unhealthy or inadequate, but whether these housing characteristics have direct effects on health or whether they are driven by other contextual housing and neighborhood characteristics remains unclear. The purpose of this study was to quantify the independent associations between poor housing quality and adult health outcomes, adjusting for socioeconomic factors (e.g. income to poverty ratio, food insecurity) and other contextual housing characteristics (e.g. rental status, number of people per household, unsafe neighborhood). Using in-person household interview data from wave 1 of the 2014 Survey of Income and Program Participation (SIPP), a secondary analysis was performed using a series of logistic regression models. The 2014 SIPP sample is a multistage stratified sample of 53,070 housing units designed to represent the civilian, noninstitutionalized population of the United States (N = 55,281 adults ages 18 and older). Our results indicate that each additional poor housing characteristic was associated with poorer health status (OR: 1.17, CI [1.11, 1.23]), higher medical utilization (OR: 1.11 CI: [1.06, 1.16]), and a higher likelihood of hospitalization (OR: 1.07, CI [1.02, 1.12]). Non-housing-related government assistance, food security, and safe neighborhoods only partially explained associations between housing quality and health outcomes. Evaluating current local, state, and federal policy on housing quality standards may help determine if these standards decrease the number of Americans residing in inadequate homes or result in improvements in health and reductions in healthcare costs. Simply put, the home is where [we suggest] the health is. •Poor housing quality is linked to poorer health and more healthcare use in adults.•Evaluation of current housing standards is needed.•Home is where [we suggest] the health is.