Objectives
To examine whether access to housing assistance is associated with better health among low-income adults.
Methods
We used National Health Interview Survey data (1999–2012) linked to US Department of Housing and Urban Development (HUD) administrative records (1999–2014) to examine differences in reported fair or poor health and psychological distress. We used multivariable models to compare those currently receiving HUD housing assistance (public housing, housing choice vouchers, and multifamily housing) with those who will receive housing assistance within 2 years (the average duration of HUD waitlists) to account for selection into HUD assistance.
Results
We found reduced odds of fair or poor health for current public housing (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.57, 0.97) and multifamily housing (OR = 0.75; 95% CI = 0.60, 0.95) residents compared with future residents. Public housing residents also had reduced odds of psychological distress (OR = 0.59; 95% CI = 0.40, 0.86). These differences were not mediated by neighborhood-level characteristics, and we did not find any health benefits for current housing choice voucher recipients.
Conclusions
Housing assistance is associated with improved health and psychological well-being for individuals entering public housing and multifamily housing programs.
Objective:
To characterize progression of geographic atrophy (GA) associated with age-related macular degeneration in AREDS as measured by digitized fundus photographs.
Methods:
Fundus photographs from 181 of 4757 AREDS participants with a GA area of at least 0.5 disc areas at baseline or from participants who developed bilateral GA during follow-up were scanned, digitized, and evaluated longitudinally. Geographic atrophy area was determined using planimetry. Rates of progression from noncentral to central GA and of vision loss following development of central GA included the entire AREDS cohort.
Results:
Median initial lesion size was 4.3 mm2. Average change in digital area of GA from baseline was 2.03 mm2 (standard error of the mean, 0.24 mm2) at 1 year, 3.78 mm2 (0.24 mm2) at 2 years, 5.93 mm2 (0.34 mm2) at 3 years, and 1.78 mm2 (0.086 mm2) per year overall. Median time to developing central GA after any GA diagnosis was 2.5 years (95% confidence interval, 2.0-3.0). Average visual acuity decreased by 3.7 letters at first documentation of central GA, and by 22 letters at year 5.
Conclusions:
Growth of GA area can be reliably measured using standard fundus photographs that are digitized and subsequently graded at a reading center. Development of GA is associated with subsequent further growth of GA, development of central GA, and loss in central vision.
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