HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

Wong, Michelle S.; Roberts, Eric T.; Arnold, Carolyn M.; Pollack, Craig Evan

doi:10.5888/pcd15.170517

Cited by 11 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After screening 2294 titles, 243 abstracts, and 81 full texts, 26 articles met criteria for inclusion ( Figure 2 ), comprising 3 RCTs described in 6 articles 32 , 33 , 34 , 35 , 36 , 37 and 20 observational studies (16 longitudinal designs 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 and 4 cross-sectional quasi–waiting list control designs comparing current vs future recipients of an intervention 54 , 55 , 56 , 57 ) ( Figure 3 ; eTable 1 in the Supplement ). Most studies selected participants based on medical or social vulnerability.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

et al. 2022

View full text Add to dashboard Cite

ImportanceHousing insecurity—that is, difficulty with housing affordability and stability—is prevalent and results in increased risk for both homelessness and poor health. However, whether interventions that prevent housing insecurity upstream of homelessness improve health remains uncertain.ObjectiveTo review evidence characterizing associations of primary prevention strategies for housing insecurity with adult physical health, mental health, health-related behaviors, health care use, and health care access.Evidence ReviewPairs of independent reviewers systematically searched PubMed, Web of Science, EconLit, and the Social Interventions Research and Evaluation Network for quantitative studies published from 2005 to 2021 that evaluated interventions intended to directly improve housing affordability and/or stability either by supporting at-risk households (targeted primary prevention) or by enhancing community-level housing supply and affordability in partnership with the health sector (structural primary prevention). Risk of bias was appraised using validated tools, and the evidence was synthesized using modified Grading of Recommendations Assessment, Development, and Evaluation criteria.FindingsA total of 26 articles describing 3 randomized trials and 20 observational studies (16 longitudinal designs and 4 cross-sectional quasi–waiting list control designs) were included. Existing interventions have focused primarily on mitigating housing insecurity for the most vulnerable individuals rather than preventing housing insecurity outright. Moderate-certainty evidence was found that eviction moratoriums were associated with reduced COVID-19 cases and deaths. Certainty of evidence was low or very low for health associations of other targeted primary prevention interventions, including emergency rent assistance, legal assistance with waiting list priority for public housing, long-term rent subsidies, and homeownership assistance. No studies evaluated health system–partnered structural primary prevention strategies.Conclusions and RelevanceThis systematic review found mixed and mostly low-certainty evidence that interventions that promote housing affordability and stability were associated with improved adult health outcomes. Existing interventions may need to be paired with other efforts to address the structural determinants of health. As health care systems and insurers respond to increasing opportunities to invest in housing as a determinant of health, further research is needed to clarify where along the housing insecurity pathway interventions should focus for the most effective and equitable health impact.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Nineteen articles 32 , 33 , 34 , 35 , 36 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 evaluated long-term, targeted primary prevention strategies. Besides 1 study assessing homeownership assistance, all focused on long-term rent subsidies.…”

Section: Resultsmentioning

confidence: 99%

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

et al. 2022

View full text Add to dashboard Cite

show abstract

“…3 Food insecurity may lead to dietary supplementation with less expensive, unhealthy foods. [31][32][33] Exercise may not be feasible or safe in low-income neighborhoods, [34][35][36] and cigarette consumption has been associated with poverty level. [37][38][39][40] We found no statistically significant association between housing insecurity and rapid kidney function decline or incident reduced eGFR.…”

Section: Discussionmentioning

confidence: 99%

Housing Insecurity and Risk of Adverse Kidney Outcomes

Novick

Omenyi²,

Han

et al. 2020

Kidney360

View full text Add to dashboard Cite

BackgroundHousing insecurity is characterized by high housing costs or unsafe living conditions that prevent self-care and threaten independence. We examined the relationship of housing insecurity and risk of kidney disease.MethodsWe used longitudinal data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD). We used multivariable regression to quantify associations between housing insecurity and rapid kidney function decline (loss of >5 ml/min per 1.73 m2 of eGFR per year) and, among those without kidney disease at baseline, incident reduced kidney function (eGFR <60 ml/min per 1.73 m2) and incident albuminuria (urine albumin-creatinine ratio [ACR] ≥30 mg/g).ResultsAmong 1262 participants, mean age was 52 years, 40% were male and 57% were black. A total of 405 (32%) reported housing insecurity. After a median of 3.5 years of follow-up, rapid kidney function decline, incident reduced kidney function, and incident albuminuria occurred in 199 (16%), 64 (5%), and 74 (7%) participants, respectively. Housing insecurity was associated with increased odds of incident albuminuria (unadjusted OR, 2.04; 95% CI, 1.29 to 3.29; adjusted OR, 3.23; 95% CI, 1.90 to 5.50) but not rapid kidney function decline or incident reduced kidney function.ConclusionsIn this urban population, housing insecurity was associated with increased risk of subsequent albuminuria. Increased recognition of housing insecurity as a social determinant of kidney disease is needed, and risk-reduction efforts that specifically target populations experiencing housing insecurity should be considered.

show abstract

“…12 Public and multifamily housing are associated with better self-reported health, 13 fewer mental health symptoms, 14,15 reduced risk of emergency department visits for asthma, 16 and reduced alcohol and drug dependence. 14 Other studies reported that both projectbased housing and housing vouchers were associated with increased health care access, 17 increased physical activity, 18 and fewer missed school days owed to illness. 19 To our knowledge, no quantitative JAMA Network Open | Health Policy studies have examined whether rental assistance is associated with improved glycemia and related diabetes outcomes, although qualitative evidence suggests that rental assistance may facilitate diabetes management.…”

Section: Introductionmentioning

confidence: 99%

Association Between Rental Assistance Programs and Hemoglobin A_1c Levels Among US Adults

et al. 2022

View full text Add to dashboard Cite

IMPORTANCE Programs that provide affordable and stable housing, such as federal rental assistance, may be associated with improved mean blood glucose levels and related diabetes outcomes.OBJECTIVE To assess whether 2 different types of federal rental assistance programs are associated with glycated hemoglobin A 1c (HbA 1c ) levels among middle-aged and older US adults. DESIGN, SETTING, AND PARTICIPANTSThis cohort study used data from the National Health and Nutrition Examination Survey (NHANES) linked with US Department of Housing and Urban Development records of rental assistance participation. Adults aged 45 years or older who were receiving 2 types of rental assistance (project-based housing or housing vouchers) at the time of the NHANES interview and those who would receive rental assistance within the subsequent 2 years (waitlist group) were included. Data were collected from January 1999 to December 2016 and analyzed in October 2021. EXPOSURES Rental assistance participation, including project-based housing (subsidized housing developments including public housing) and housing vouchers (tenant-based subsidies for private market housing). MAIN OUTCOMES AND MEASURESThe primary outcome was continuous HbA 1c level, a common measure of blood glucose reflecting diabetes control. Linear regression was used to estimate the association between the 2 rental assistance programs and HbA 1c level. Logistic regression was used to assess the association between rental assistance programs and HbA 1c cut points (prediabetes: 5.7% to Յ6.5%; diabetes: >6.5%; uncontrolled diabetes: Ն9% [to convert to proportion of total Hb, multiply by 0.01]). Analyses used weights created by the National Center for Health Statistics that adjust for linkage eligibility. RESULTS Among 1050 adults in the study (41.6% aged Ն65 years; 70.1% female), 795 were receiving rental assistance at time of the NHANES interview (450 lived in project-based housing, and 345 had housing vouchers), and 255 received rental assistance within 2 years after the interview.Participants in project-based housing had lower HbA 1c levels compared with individuals in the waitlist group (β, −0.290; 95% CI, −0.599 to 0.020), but the difference was not significant. No significant differences in HbA 1c levels were found between those receiving housing vouchers and those in the waitlist group (β, 0.051; 95% CI, −0.182 to 0.284). Receiving project-based housing was associated with a reduced likelihood of uncontrolled diabetes (−3.7 percentage points; 95% CI, −7.0 to −0.0 percentage points) compared with being in the waitlist group. CONCLUSIONS AND RELEVANCEIn this cohort study of a nationally representative sample of US adults, living in project-based, federally subsidized housing was associated with a reduced likelihood (continued) Key Points Question Is receiving housing rental assistance associated with glycated hemoglobin A 1c (HbA 1c ) levels among middle-aged and older US adults? Findings In this cohort study of 1050 US adults aged 45 years or older, participants who were ...

show abstract

HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

Cited by 11 publications

References 19 publications

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

Housing Insecurity and Risk of Adverse Kidney Outcomes

Association Between Rental Assistance Programs and Hemoglobin A_1c Levels Among US Adults

Contact Info

Product

Resources

About

HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

Cited by 11 publications

References 19 publications

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

Association of Promoting Housing Affordability and Stability With Improved Health Outcomes

Housing Insecurity and Risk of Adverse Kidney Outcomes

Association Between Rental Assistance Programs and Hemoglobin A1c Levels Among US Adults

Contact Info

Product

Resources

About

Association Between Rental Assistance Programs and Hemoglobin A_1c Levels Among US Adults