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Reyes A, Macaya Munell I, Borrell C, Carmezim Correia JP, Fernández A, Vásquez-Vera C, Pérez K, Carrere J, Daví L, Novoa AM. Cooperative housing under a grant-of-use in Catalonia and health: pre-post analysis. BMC Public Health 2024; 24:1835. [PMID: 38982448 PMCID: PMC11234659 DOI: 10.1186/s12889-024-19214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/20/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Housing is considered a social determinant of health. In Catalonia and Spain, ensuring affordable housing is challenging and cooperative housing under a grant-of-use emerges as an alternative, challenging traditional housing models. This study aims to quantify its impact on health before and after moving to the cooperative house. METHODS A longitudinal study of individuals in cooperative housing projects in Catalonia (July 2018-April 2023) was conducted. Data, including sociodemographic, housing information, and health-related details, were collected through baseline and follow-up surveys. RESULTS Seventy participants (42 women, 28 men) showed positive changes in housing conditions during follow-up. Improved perceptions of health, mental health, and social support were observed. Despite limitations in sample size and short follow-up, initial findings suggest improvements in health. CONCLUSIONS Cooperative housing under a grant-of-use in Catalonia appears promising for improving health and living conditions. Further research is warranted to explore its full potential as an alternative amid housing challenges in the region.
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Affiliation(s)
- Alexia Reyes
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain.
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain.
| | - Irene Macaya Munell
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
- Dinamo Fundació, C. d'en Blanco 73, bx, Barcelona, 08028, Spain
| | - Joao Pedro Carmezim Correia
- Biostatistics Support and Research Unit, Germans Trias i Pujol Research Institute and Hospital (IGTP), Barcelona, Catalonia, Spain
| | - Ana Fernández
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Constanza Vásquez-Vera
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Juli Carrere
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Lali Daví
- Dinamo Fundació, C. d'en Blanco 73, bx, Barcelona, 08028, Spain
- LaCol Arquitectura Cooperativa, C. Riera d'Escuder, 38, nau 2 Planta 1, Barcelona, 08028, Spain
| | - Ana M Novoa
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
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Ocaña-Ortiz A, Gea-Caballero V, Juárez-Vela R, Peiró R, Pérez-Sanz E, Santolalla-Arnedo I, Sufrate-Sorzano T, Garrote-Cámara ME, Paredes-Carbonell JJ. Health equity in urban and rural settings: implementation of the place standard tool in Spain. Front Public Health 2024; 12:1292032. [PMID: 38803816 PMCID: PMC11129683 DOI: 10.3389/fpubh.2024.1292032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
The physical, social, and economic characteristics of neighborhoods and municipalities determine the health of their residents, shaping their behaviors and choices regarding health and well-being. Addressing local environmental inequalities requires an intersectoral, participatory, and equity-focused approach. Community participation plays a vital role by providing deeper insights into local contexts, integrating community knowledge and values into processes, and promoting healthier, fairer, and more equitable actions. In recent years, various tools have been developed to assess places and transform them into health-promoting settings. One such tool, the Place Standard Tool (PST), facilitates discussions on Social Determinants of Health grouped into 14 themes, serving as a starting point for local health interventions. In this study, that took place between August 2019 and February 2020, we described the resident's perceptions of two municipalities in the Valencian Community, Spain, using the validated Spanish version of the PST. A mixed-method convergent-parallel design was used to gain a holistic insight into residents' experiences concerning their physical, economic, and social environment. A total of 356 individuals from both municipalities participated in the study through discussion groups, structured interviews, and online survey. Descriptive analysis of the individual questionnaire answers was conducted, and differences between municipalities were explored. Qualitative thematic analysis was conducted on structured interviews and discussion groups. Quantitative and qualitative data were integrated to facilitate their comparison and identify areas of convergence or divergence in the findings. Overall, rural areas received more favorable evaluations compared to urban ones. Public Transport as well as Work and Local Economy were consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. In the urban area, additional negative ratings were observed for Traffic and Parking, Housing and Community, and Care and Maintenance. Conversely, Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were given to Walking or Cycling, Traffic and Parking, Housing and Community, and Influence and Sense of Control. Significant differences (p < 0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. Our study illustrated the capacity of the PST to identifying aspects within local settings that influence health, revealing both positive and challenging factors. Successful implementation requires appropriate territorial delineation, support from local authorities, and effective management of expectations. Furthermore, the tool facilitated community participation in decision-making about local environments, promoting equity by connecting institutional processes with citizen needs.
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Affiliation(s)
- Ana Ocaña-Ortiz
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Gandia Health Department, Gandia, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, VIU Valencia International University, Valencia, Spain
- Research Group SALCOM Community Health and Care, Valencia International University, Valencia, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Rosana Peiró
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Publica Health General Directorate, Health Department, Generalitat Valenciana, Valencia, Spain
- CIBERESP ISCIII, Madrid, Spain
| | - Elena Pérez-Sanz
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Publica Health General Directorate, Health Department, Generalitat Valenciana, Valencia, Spain
| | - Iván Santolalla-Arnedo
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Teresa Sufrate-Sorzano
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - María Elena Garrote-Cámara
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Joan Josep Paredes-Carbonell
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Public Health Center of Alzira, Valencia, Spain
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Perafita X, Saez M. Housing Supply and How It Is Related to Social Inequalities-Air Pollution, Green Spaces, Crime Levels, and Poor Areas-In Catalonia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085578. [PMID: 37107859 PMCID: PMC10138561 DOI: 10.3390/ijerph20085578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
We carried out a search of over 12,000 houses offered on the rental market in Catalonia and assessed the possibility of families below the poverty threshold being able to rent these homes. In this regard, we wanted to evaluate whether the economic situation of families is able to influence their social environment, surroundings, and safety. We observed how their economic situation can allow families the possibility of developing a life without exposure to health risks, and how economic constraints result in disadvantages in several areas of life. The results show how families at risk of poverty live in less favourable conditions and experience a widening of different gaps, with current prices leading to a possible poverty trap for the most disadvantaged groups. The higher the percentage of the population below the threshold, the lower the possibility of not being able to rent a house compared to areas with a lower prevalence of population below the threshold. This association was observed both when considering the risk linearly and non-linearly. Linearly, the probability of not renting a house was reduced by 8.36% for each 1% increase in the prevalence of population at risk of extreme poverty. In the second, third and fourth percentage quartiles, the probability of not being able to rent a house decreased by 21.13%, 48.61%, and 57.79%, respectively. In addition, the effect was different inside and outside of metropolitan areas, with the former showing a decrease of 19.05% in the probability of renting a house, whereas outside metropolitan areas the probability increased by 5.70%.
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Affiliation(s)
- Xavier Perafita
- Observatori—Organisme Autònom de Salut Pública de la Diputació de Girona (Dipsalut), 17003 Girona, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003 Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence:
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4
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Borrell C. [Health inequalities in Gaceta Sanitaria, from 1988 to 2022]. GACETA SANITARIA 2023; 37:102291. [PMID: 36806941 DOI: 10.1016/j.gaceta.2023.102291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 02/19/2023]
Affiliation(s)
- Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut de Recerca Biomèdica Sant Pau, Barcelona, España; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España.
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5
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Fan Q, Nogueira L, Yabroff KR, Hussaini SMQ, Pollack CE. Housing and Cancer Care and Outcomes: A Systematic Review. J Natl Cancer Inst 2022; 114:1601-1618. [PMID: 36073953 PMCID: PMC9745435 DOI: 10.1093/jnci/djac173] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Access to stable and affordable housing is an important social determinant of health in the United States. However, research addressing housing and cancer care, diagnosis, and outcomes has not been synthesized. METHODS We conducted a systematic review of studies examining associations of housing and cancer care and outcomes using PubMed, Embase, Scopus, and CINAHL. Included studies were conducted in the United States and published in English between 1980 and 2021. Study characteristics and key findings were abstracted and qualitatively synthesized. RESULTS A total of 31 studies were identified. Housing-related measures were reported at the individual level in 20 studies (65%) and area level in 11 studies (35%). Study populations and housing measures were heterogeneous. The most common housing measures were area-level housing discrimination (8 studies, 26%), individual-level housing status (8 studies, 26%), and individual-level housing concerns (7 studies, 23%). The most common cancer outcomes were screening (12 studies, 39%) and mortality (9 studies, 29%). Few studies assessed multiple dimensions of housing. Most studies found that exposure to housing insecurity was statistically significantly associated with worse cancer care (11 studies) or outcomes (10 studies). CONCLUSIONS Housing insecurity is adversely associated with cancer care and outcomes, underscoring the importance of screening for housing needs and supporting systemic changes to advance equitable access to care. Additional research is needed to develop and test provider- and policy-level housing interventions that can effectively address the needs of individuals throughout the cancer care continuum.
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Affiliation(s)
- Qinjin Fan
- Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, GA, USA
| | - Leticia Nogueira
- Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, GA, USA
| | - K Robin Yabroff
- Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, GA, USA
| | - S M Qasim Hussaini
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Craig E Pollack
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Nursing, Baltimore, MD, USA
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Perez FP, Perez CA, Chumbiauca MN. Insights into the Social Determinants of Health in Older Adults. JOURNAL OF BIOMEDICAL SCIENCE AND ENGINEERING 2022; 15:261-268. [PMID: 36419938 PMCID: PMC9681180 DOI: 10.4236/jbise.2022.1511023] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In this paper, we review the social determinants of health in older adults and their complex interrelationship with medical diseases. Also, we provide recommendations to address these determinants in the integrated healthcare plan. The social determinants in older adults and its influence in health outcomes have been studied for decades. There is solid evidence for the interrelationship between social factors and the health of individuals and populations; however, these studies are unable to define their complex interrelatedness. Health is quite variable and depends on multiple biological and social factors such as genetics, country of origin, migrant status, etc. On the other hand, health status can affect social factors such as job or education. Addressing social determinants of health in the integrated healthcare plan is important for improving health outcomes and decreasing existing disparities in older adult health. We recommend a person-centered approach in which individualized interventions should be adopted by organizations to improve the health status of older adults at the national and global level. Some of our practical recommendations to better address the social determinants of health in clinical practice are EHR documentation strategies, screening tools, and the development of linkages to the world outside of the clinic and health system, including social services, community activities, collaborative work, and roles for insurance companies.
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Affiliation(s)
- Felipe P. Perez
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Carmen A. Perez
- School of Social Work, Indiana University, Indianapolis, IN, USA
| | - Magali N. Chumbiauca
- Richard L. Roudebush Veterans Affairs Medical Center, Home Based Primary Care, Indianapolis, IN, USA
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Vásquez-Vera C, Fernández A, Borrell C. Gender-based inequalities in the effects of housing on health: A critical review. SSM Popul Health 2022; 17:101068. [PMID: 35360438 PMCID: PMC8961216 DOI: 10.1016/j.ssmph.2022.101068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/09/2022] Open
Abstract
Gender and its power relations are produced and reproduced in the housing sphere, leading to inequalities in living conditions and, therefore, in gender inequalities in health outcomes. The aim of the study is to review the published literature on gender, housing and health, to critically evaluate the incorporation of the gender perspective, and to incorporate this perspective into the conceptual framework of housing and health. Using the critical review method, we conducted a literature review in MEDLINE, Scopus, WOS and Redalyc, without restriction of publication date, including studies published up to October 2020. We analyzed the gender perspective in health research using the Gender Perspective in Health Research Questionnaire and described the results according to main housing dimensions. Of the 20,988 articles identified, we selected 90 for full-text analysis, of which 18 were included in the feminist research category, 27 in gender-sensitive, 31 in sex difference and 14 did not include any gender perspective. Regarding the association between housing and health, most studies analyzed affordability (36%) and physical conditions (32%), and trends in health outcomes by gender varied according to each exposure analyzed, although overall the effects were worse for women and non-binary or trans people. To date, very few studies consider the gender perspective. It is urgent to address gender relations in housing and health studies, and to open an interdisciplinary and intersectoral agenda to address this complex relationship.
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Health Effects of Housing Insecurity and Unaffordability in the General Population in Barcelona, Spain. J Urban Health 2021; 98:496-504. [PMID: 34231119 PMCID: PMC8382804 DOI: 10.1007/s11524-021-00546-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 10/20/2022]
Abstract
While the negative effects of housing insecurity and unaffordability on health are well known, most of the studies in Spain have focused on very specific social groups so their findings cannot be extrapolated to the general population. The aim of this study is to assess the effects of housing stress and risk of displacement due to economic reasons, and their combined effect, on the mental and physical health of the general population from a middle-income neighborhood of Barcelona. We conducted a cross-sectional study using a household health survey which included respondents from a representative sample of 1202 non-institutionalized residents (> 18 years old) of the Horta neighborhood. We carried out a descriptive analysis, estimated the prevalence of poor mental and self-rated health (stratifying by the independent variables) and fitted robust Poisson regression models to estimate the effects of housing stress (HS) and the risk of forced displacement (RD) on self-rated health and mental health (GHQ-12). All analyses were stratified by sex. We found a higher likelihood of poor general and mental health among people affected by HS and/or RD compared to those not affected by HS and/or RD. A graded effect of HS and RD emerged mainly on mental health, even after adjusting by socioeconomic variables and housing tenure. The serious problem of housing insecurity and unaffordability in Spain is a widespread public health issue. Evidence-based public policies to improve well-being and health of people under this threat are urgently needed.
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Carrere J, Reyes A, Oliveras L, Fernández A, Peralta A, Novoa AM, Pérez K, Borrell C. The effects of cohousing model on people's health and wellbeing: a scoping review. Public Health Rev 2020; 41:22. [PMID: 33042597 PMCID: PMC7539375 DOI: 10.1186/s40985-020-00138-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background Housing is a social determinant of health. Extensive research has highlighted its adverse effects on health. However, less is known about the effects of cohousing typology on health, which has the potential to create lively social networks and healthy communities and environments. We report the findings of a scoping study designed to gather and synthesise all known evidence on the relationship between cohousing and wellbeing and health. Method Using the scoping review method, we conducted a literature review in PubMed, ProQuest, Scopus, Web of Science, Science Direct and JSTOR in May 2019 and selected articles published from 1960 onwards, with no geographical limit and no design restrictions. Retrieved articles underwent three sequential screening phases. The results were described through a narrative synthesis of the evidence. Results Of the 2560 articles identified, we selected 25 full-text articles analysing 77 experiences. All of them were conducted in high-income countries. Ten studies analysed the impact of cohousing on physical and mental health or quality of life and wellbeing. Eight of the 10 studies found a positive association. In addition, 22 studies analysed one or more psychosocial determinants of health (such as social support, sense of community and physical, emotional and economic security) and most found a positive association. Through these determinants, quality of life, wellbeing and health could be improved. However, the quality of the evidence was low. Discussion The cohousing model could enhance health and wellbeing mediated by psychosocial determinants of health. However, extreme caution should be exercised in drawing any conclusions due to the dearth of data identified and the designs used in the included studies, with most being cross-sectional or qualitative studies, which precluded causal-based interpretations. Because housing is a major social determinant of health, more evidence is needed on the impact of this model on health through both psychosocial and material pathways.
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Affiliation(s)
- Juli Carrere
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Alexia Reyes
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Laura Oliveras
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Anna Fernández
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Andrés Peralta
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain
| | - Ana M Novoa
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
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10
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Risk of suicide in households threatened with eviction: the role of banks and social support. BMC Public Health 2019; 19:1250. [PMID: 31510963 PMCID: PMC6737669 DOI: 10.1186/s12889-019-7548-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/26/2019] [Indexed: 11/10/2022] Open
Abstract
Background One of the greatest effects of the financial crisis in Spain has been the enormous increase in the number of evictions. Several studies have shown the association of evictions with different aspects of the physical and mental health. Furthermore, evictions have been associated with an increased risk of suicide. Our objective was to evaluate the risk of suicide among victims of eviction and investigate whether it is associated with specific characteristics of households and interviewees, the eviction process and social support, and health needs. Methods A total of 205 participants from households threatened with eviction in Granada, Spain, and 673 being the total number of members of these households, were interviewed in one-on-one sessions between April 2013 and May 2014. Through a questionnaire, information was obtained on physical and mental health, characteristics of their eviction process and support networks, and the use of health services. Results Almost half of the sample (46.7%) were at low (11.8%), moderate (16.9%), or high suicide risk (17.9%). Household and interviewee features had a limited association with suicide risk. On the contrary, the risk of suicide is greater with a longer exposure to the eviction process. In addition, threatening phone calls from banks increased significantly the risk of suicide, especially among men. Suicide risk was also associated with low social support, especially among women. Interviewees at risk of suicide received more help from nongovernmental organizations than those who were not at risk. In interviewees at risk, the main unmet needs were emotional and psychological help, especially in men. A high percentage of those at risk of suicide declare having large unmeet health needs. Finally, there was a tendency among the evicted at risk of suicide to visit emergency room and primary care more often than those not at risk, especially among women. Conclusions To our knowledge, this is the first study showing that when banks adopt a threatening attitude, suicide risk increases among the evicted. As hypothesized, when the evicted felt socially supported, suicide risk decreased. Emotional help was the main mediator of suicide risk and the main unmet need, especially among men.
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11
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Jiménez-Picón N, García-Reposo A, Romero-Martín M. [Biopsychosocial consequences in Spanish population affected by an eviction process]. GACETA SANITARIA 2019; 34:289-296. [PMID: 31474382 DOI: 10.1016/j.gaceta.2019.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
Abstract
The biopsychosocial consequences in Spanish population affected by an eviction process were described in this paper. A scoping review was conducted, consulting the following databases: PubMed, Scopus, PsycINFO, CINAHL, LILACS, CSIC, MEDES, Scielo, Dialnet, Cuiden Plus and Cochrane. The search strategy was (Eviction OR "Home eviction" OR "Housing eviction" OR "Households at risk of eviction" OR Foreclosure) AND ("Health" OR "Mental Health" OR "Psychosocial impact" OR "Impacts on health" OR "Social impact indicators" OR "Social Determinants of Health" OR "Social Indicators").Eleven articles published between 2008 and September 2018 were selected. They followed a quantitative or qualitative methodology. The research quality was measured, and the results were organized according to the biopsychosocial model. From the physical perspective, results described a poor self-perception of health, as well as an increase of chronic diseases, pain, drug consumptions. From the psychological perspective, it was found negative thoughts, recurrent emotions and increased anxiety, depression, mental disorder and post-traumatic stress. From the social perspective, it was found that family, the offspring and the guarantor were affected, as well as the health system with greater medical visits and emergencies. This review showed worse health indicators among women, such as a headache, smoking habits, worse self-perception of health and more mental health disorders (depression, anxiety and other types of psychological distress). Daughters revealed worse self-perception of health than sons. It is necessary an approach from public health, epidemiological surveillance, action protocols and health programs, to advise, diagnose, prevent, protect and promote the health of the Spanish population affected.
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Affiliation(s)
- Nerea Jiménez-Picón
- Centro Universitario de Enfermería Cruz Roja de Sevilla, Universidad de Sevilla, Sevilla, España.
| | - Alicia García-Reposo
- Centro Universitario de Enfermería Cruz Roja de Sevilla, Universidad de Sevilla, Sevilla, España
| | - Macarena Romero-Martín
- Centro Universitario de Enfermería Cruz Roja de Sevilla, Universidad de Sevilla, Sevilla, España
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12
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Bilal U, Glass TA, Del Cura-Gonzalez I, Sanchez-Perruca L, Celentano DD, Franco M. Neighborhood social and economic change and diabetes incidence: The HeartHealthyHoods study. Health Place 2019; 58:102149. [PMID: 31220800 DOI: 10.1016/j.healthplace.2019.102149] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 05/09/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
We studied the association between neighborhood social and economic change and type 2 diabetes incidence in the city of Madrid (Spain). We followed 199,621 individuals living in 393 census tracts for diabetes incidence for 6 years using electronic health records, starting in 2009. We measured neighborhood social and economic change from 2005 to 2009 using a finite mixture model with 16 indicators that resulted in four types of neighborhood change. Adjusted results showed an association between neighborhood change and diabetes incidence: compared to those living in Aging/Stable areas, people living in Declining SES, New Housing and Improving SES areas have an 8% (HR = 0.92, 95% CI 0.87 to 0.99), 9% (HR = 0.91, 95% CI 0.81 to 1.01) and 11% (HR = 0.89, 95% CI 0.81 to 0.98) decrease in diabetes incidence. This evidence can help guide policies for diabetes prevention by focusing efforts on specific urban areas.
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Affiliation(s)
- Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Social and Cardiovascular Research Group, Universidad de Alcala, Alcala de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Thomas A Glass
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Isabel Del Cura-Gonzalez
- Primary Care Research Unit, Gerencia de Atención Primaria, Madrid, Spain; Department Preventive Medicine and Public Health, University Rey Juan Carlos, Madrid, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC) ISCIII, Madrid, Spain
| | - Luis Sanchez-Perruca
- Primary Care Research Unit, Gerencia de Atención Primaria, Madrid, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC) ISCIII, Madrid, Spain
| | - David D Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manuel Franco
- Social and Cardiovascular Research Group, Universidad de Alcala, Alcala de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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13
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Vásquez-Vera H, Fernández A, Novoa AM, Delgado L, Barcala J, Macías C, Borrell C. Our lives in boxes: perceived community mediators between housing insecurity and health using a PHOTOVOICE approach. Int J Equity Health 2019; 18:52. [PMID: 30917833 PMCID: PMC6438010 DOI: 10.1186/s12939-019-0943-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/25/2019] [Indexed: 11/24/2022] Open
Abstract
Background While the negative effects of housing insecurity on health are well known, the mechanisms and mediators of these effects have been less well studied. The aim of this study is to identify perceived mediators involved in the relationship between housing insecurity and health. Methods We used a participatory action research approach, the Photovoice methodology. It promotes a reflective process where participants critically discuss housing insecurity and human health and make recommendations to find solutions for the issues identified. This study was conducted with 18 members of the Platform for People Affected by Mortgages who were living in a situation of housing insecurity in Barcelona during the first half of 2017. Results Participants took 990 photographs, of which 147 were printed for analysis in discussion sessions. 109 of these photographs were then selected for categorization by the participants. 11 major categories emerged, representing various factors related to housing insecurity and health. Most categories were acknowledged as possible mediators of the housing/health problem, including: psychological changes; housing-related material aspects; health-related behaviors; eviction; harassment by financial institutions; and family, neighbors and social network. Others were considered as modifiers that could alter the effects of housing insecurity on health. Co-existing determinants may interact with housing insecurity, thereby increasing negative effects on health. Conclusions Through this participatory approach, the Photovoice project gives insight into the mechanisms underlying the relationship between housing insecurity and human health, and provides valuable recommendations to combat this serious public health issue. Electronic supplementary material The online version of this article (10.1186/s12939-019-0943-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hugo Vásquez-Vera
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, ES-08023, Barcelona, Spain. .,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain. .,CEES-Departamento de Salud Pública, Universidad de La Frontera, Temuco, Chile. .,Institut d'Investigació Biomèdica (IIB-Sant Pau), Barcelona, Spain.
| | - Ana Fernández
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, ES-08023, Barcelona, Spain.,CIBER de Epidemiología y Salud pública (CIBERESP), Madrid, Spain
| | - Ana M Novoa
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, ES-08023, Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB-Sant Pau), Barcelona, Spain
| | - Lucía Delgado
- Plataforma de Afectados por la Hipoteca de Barcelona, Barcelona, Spain
| | - Joaquín Barcala
- Plataforma de Afectados por la Hipoteca de Barcelona, Barcelona, Spain
| | - Carlos Macías
- Plataforma de Afectados por la Hipoteca de Barcelona, Barcelona, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Plaça Lesseps 1, ES-08023, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,CIBER de Epidemiología y Salud pública (CIBERESP), Madrid, Spain.,Institut d'Investigació Biomèdica (IIB-Sant Pau), Barcelona, Spain
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14
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Borges FT, Fernández LAL, Campos GWDS. Políticas de austeridade fiscal: tentativa de desmantelamento do Sistema Nacional de Salud da Espanha e resistência cidadã. SAUDE E SOCIEDADE 2018. [DOI: 10.1590/s0104-12902018180043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este ensaio de natureza teórica analisa os ajustes fiscais colocados em marcha na Espanha como resposta à crise financeira de 2008, suas implicações para o Sistema Nacional de Salud (SNS) e a consequente resistência cidadã. Elaboramos um estudo de caso tendo como fonte primária a narrativa de um ator social que participou da reforma espanhola. Utilizamos também fontes secundárias para coleta de dados socioeconômicos e a análise de 20 artigos publicados pelo Relatório Sespas 2014. O SNS formou-se por aumento progressivo da cobertura populacional, financiamento total por impostos e organização da rede por meio da Atenção Primária em Saúde (APS). As medidas de austeridade fiscal impuseram limitações de ordem orçamentária, reduziram a provisão de serviços, introduziram copagamentos e retrocederam o direito à saúde à meritocracia. A corrente crítica da economia política sinaliza que o propósito dos ajustes econômicos é a transferência regressiva de renda e riqueza. As Mareas Ciudadanas constituíram-se numa resposta cidadã com êxito em muitas lutas sociais contra a austeridade fiscal. A alternativa de resistência e superação pela via política se fez presente com vigor na Espanha e tem resistido ao desmantelamento do SNS.
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Borrell C, Malmusi D, Muntaner C. Introduction to the "Evaluating the Impact of Structural Policies on Health Inequalities and Their Social Determinants and Fostering Change" (SOPHIE) Project. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2017; 47:10-17. [PMID: 27956577 DOI: 10.1177/0020731416681891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The SOPHIE Project (acronym for Structural Policies for Health Inequalities Evaluation) has focused on evaluating the impact of structural policies on health equity, considering as such all those policies that exert a powerful influence on the structural determinants of health (e.g., patterns of social stratification, living and working conditions) and thus on health-related exposures through intermediary determinants. In these sections of the International Journal of Health Services, we present some of the main findings of the SOPHIE Project. We include both articles that summarize all the evidence already published in the project on a thematic area (such as labor market, gender, or housing) and articles that present new, unpublished evidence on a specific health inequality or policy.
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Affiliation(s)
- Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Carles Muntaner
- Dalla Lana School of Public Health, Bloomberg Faculty of Nursing, Dept. of Psychiatry and Center for Research in Inner City Health, St Mike's Hospital University of Toronto Toronto, Canada
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16
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Post-Traumatic Stress Disorder Symptomatology in People affected by Home Eviction in Spain. SPANISH JOURNAL OF PSYCHOLOGY 2017; 20:E57. [PMID: 29076802 DOI: 10.1017/sjp.2017.56] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Despite the higher proportion of foreclosures and home evictions executed in Spain, compared to other countries, and the known link between social exclusion and mental health problems, studies exploring this association in Spain remain scarce. This study investigated the link between the process of home eviction and the appearance of symptomatology of post-traumatic stress disorder (PTSD), anxiety, depression, and perceived stress. Two hundred and five people affected by the process of home eviction were assessed using a structured interview that included three validated assessment instruments for PTSD, perceived stress, anxiety and depression. Analysis involved comparison with the normative groups that formed the validation studies together with regression analysis to determine the major psychological and socio-demographic predictors of perceived stress. Of the participants, 95.1% reported that they were experiencing the process of home eviction with fear, helplessness, or horror. In PTSD symptomatology, they scored higher than the normative PTSD group in symptoms of avoidance (t = 5.01; p < .05), activation (t = 5.48; p < .01), and total score (t = 4.15; p < .05). Of this subgroup, 72.5% fulfilled the DSM-IV symptom criteria for PTSD. The major predictor of perceived stress was PTSD symptomatology (B = .09; p < .001). The process of home eviction in Spain is having an alarming impact on mental health of affected people calling for effective measures to provide psychological and social support.
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17
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Mehdipanah R, Schulz AJ, Israel BA, Mentz G, Eisenberg A, Stokes C, Rowe Z. Neighborhood Context, Homeownership and Home Value: An Ecological Analysis of Implications for Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1098. [PMID: 28937613 PMCID: PMC5664599 DOI: 10.3390/ijerph14101098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/04/2017] [Accepted: 09/19/2017] [Indexed: 11/16/2022]
Abstract
While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a case study, and data from the American Community Survey (2009-2013; 5-years estimates) and Michigan Department of Community Health, we tested the following questions: (1) Is neighborhood percentage non-Hispanic Black (NHB) associated with homeownership? (2) Is neighborhood percentage NHB associated with health? (3) Is the association between percentage NHB and health mediated by homeownership? (4) Does neighborhood housing value modify associations between percentage NHB and health, or between homeownership and health? Percentage NHB was associated with homeownership and health outcomes; Associations between percentage NHB and mortality, but not disability, were partially mediated by neighborhood homeownership. Neighborhood housing value modified associations between neighborhood homeownership and both disability and mortality, but not between percentage NHB and health outcomes. Findings are consistent with the thesis that health-promoting effects of homeownership may be contingent upon house values. These results add to a limited body of evidence suggesting that variations in homeownership may contribute to persistent racial and socioeconomic health inequities.
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Affiliation(s)
| | - Amy J Schulz
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Barbara A Israel
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Graciela Mentz
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Alexa Eisenberg
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Carmen Stokes
- School of Nursing, University of Detroit Mercy, Detroit, MI 48221, USA.
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18
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Vásquez-Vera H, Palència L, Magna I, Mena C, Neira J, Borrell C. The threat of home eviction and its effects on health through the equity lens: A systematic review. Soc Sci Med 2017; 175:199-208. [DOI: 10.1016/j.socscimed.2017.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/22/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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19
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Marí-Dell'Olmo M, Novoa AM, Camprubí L, Peralta A, Vásquez-Vera H, Bosch J, Amat J, Díaz F, Palència L, Mehdipanah R, Rodríguez-Sanz M, Malmusi D, Borrell C. Housing Policies and Health Inequalities. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 47:207-232. [PMID: 28030990 DOI: 10.1177/0020731416684292] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A large body of literature shows the link between inadequate housing conditions and poor physical and mental health. The aim of this paper is to summarize the research on the impact of local housing policies on health inequalities, focusing on the issues of access to housing and fuel poverty as studied in the SOPHIE project. Our case studies in Spain showed that people facing housing insecurity, experienced intense levels of mental distress. We found that access to secure and adequate housing can improve the health of these populations, therefore, public policies that address housing instability and their consequences are urgently needed. Housing conditions related to fuel poverty are associated with poorer health and are unevenly distributed across Europe. We found possible positive effects of façade insulation interventions on cold-related mortality in women living in social housing; but not in men. Policies on housing energy efficiency can reduce the health consequences of fuel poverty, but need to be free to users, target the most vulnerable groups and be adaptable to their needs.
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Affiliation(s)
- Marc Marí-Dell'Olmo
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,2 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,3 Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.,4 Universitat Pompeu Fabra, Barcelona, Spain
| | - Ana M Novoa
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,3 Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Lluís Camprubí
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,2 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Andrés Peralta
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,4 Universitat Pompeu Fabra, Barcelona, Spain
| | - Hugo Vásquez-Vera
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,4 Universitat Pompeu Fabra, Barcelona, Spain.,5 Universidad de La Frontera, Temuco, Chile
| | - Jordi Bosch
- 4 Universitat Pompeu Fabra, Barcelona, Spain
| | - Jordi Amat
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Laia Palència
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,2 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,3 Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Roshanak Mehdipanah
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,7 University of Michigan School of Public Health, Michigan, USA
| | - Maica Rodríguez-Sanz
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,2 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,3 Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.,4 Universitat Pompeu Fabra, Barcelona, Spain
| | - Davide Malmusi
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,2 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,3 Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Carme Borrell
- 1 Agència de Salut Pública de Barcelona, Barcelona, Spain.,2 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,3 Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.,4 Universitat Pompeu Fabra, Barcelona, Spain
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20
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Novoa AM, Amat J, Malmusi D, Díaz F, Darnell M, Trilla C, Bosch J, Borrell C. Changes in Health Following Housing Improvement in a Vulnerable Population in Spain. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 47:83-107. [DOI: 10.1177/0020731416676228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study is to compare changes in health among a sample of families living in substandard dwellings or with housing affordability problems assisted by Caritas Diocesana de Barcelona, according to the improvement of their socioeconomic and housing situation during the study period. A quasi-experimental study was performed, including 232 families assisted by Caritas who were interviewed in 2012 and one year later. Participants could have received a set of interventions, including relocation and different types of economic subsidies. Regression models were fitted to identify the association of participants' changes in self-rated general health and mental health between baseline and follow-up with improvements across three dimensions: socioeconomic situation and housing affordability, physical housing characteristics, and neighborhood. An improvement in self-reported health status was associated with having found a job and reporting fewer problems in meeting monthly housing costs. Mental health improved among participants with an increased household income, with a reduction in the perceived risk of losing their house, and with reduced housing-related material deprivations. The study shows that health gains can derive from improvements in housing conditions, especially those related to housing affordability.
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Affiliation(s)
- Ana M. Novoa
- Agència de Salut Pública de Barcelona, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau)
| | - Jordi Amat
- Agència de Salut Pública de Barcelona, Spain
| | - Davide Malmusi
- Agència de Salut Pública de Barcelona, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau)
- CIBER de Epidemiologia y Salud Pública (CIBERESP)
| | | | | | | | | | - Carme Borrell
- Agència de Salut Pública de Barcelona, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau)
- Universitat Pompeu Fabra
- CIBER de Epidemiologia y Salud Pública (CIBERESP)
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21
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How substandard dwellings and housing affordability problems are associated with poor health in a vulnerable population during the economic recession of the late 2000s. Int J Equity Health 2015; 14:120. [PMID: 26530721 PMCID: PMC4632653 DOI: 10.1186/s12939-015-0238-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022] Open
Abstract
Introduction Given the increasing number of people in Spain struggling to pay housing-related costs during the economic recession, it is important to assess the health status of these communities as compared to the general population and to better understand the different housing dimensions that are related with poor mental health. This study aims to describe the housing conditions and health status of a sample of people assisted by Caritas Barcelona (Spain) and living in inadequate housing and/or struggling to pay their rent or mortgage, to compare the health outcomes of this population with those of the overall population of Barcelona, and to analyze the association between housing dimensions and mental health. Methods We used a cross-sectional design. The participating adults (n = 320) and children (n = 177) were those living in the dioceses of Barcelona, Sant Feliu and Terrassa (Spain) in 2012 and assisted by Cáritas. They were asked to answer to three questionnaires on housing and health conditions. Eight health related variables were used to compare participants with Barcelona’s residents and associations between housing conditions and poor mental health were examined with multivariate logistic regression models. Results In Barcelona, people seeking Caritas’s help and facing serious housing problems had a much poorer health status than the general population, even when compared to those belonging to the most deprived social classes. For example, 69.4 % of adult participants had poor mental health compared to 11.5 % male and 15.2 % female Barcelona residents. Moreover, housing conditions were associated with poor mental health. Conclusions This study has shown how, in a country hit by the financial recession, those people facing housing problems have much worse health compared to the general population.
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