Examining the role of tenure, household crowding and housing affordability on psychological distress, using longitudinal data

Socioeconomic deprivation modifies green space and mental health associations: A within person study

Living in an area with good availability and accessibility of residential green spaces such as parks, woodlands, and residential gardens can improve mental health and reduce the global disease burden. Unlike for physical health, it is not well understood if mental health and green space associations might be modified by local area deprivation. Existing evidence for this association comes from cross-sectional studies, widely considered vulnerable to confounding and bias. Individual time-invariant mental health status, personality, and other factors may result in positive effect modification on green space and mental health associations in more deprived areas. We use fixed-effects models that remove time-invariant confounding by calculating differences within-persons to eliminate this bias and add to the existing evidence. We modelled changes in mental health status, green space, and deprivation (relative to the within-person mean) within 54,666 individuals with a combined total of 300,710 mental health scores from one of the world's largest panel surveys: "Understanding Society" in the UK. We found a positive effect of increasing residential green space on mental health and this was positively modified and intensified by area deprivation before and after adjusting for confounding. Our results support providing green space to protect against the negative impact of socioeconomic deprivation on health, particularly for those moving from a less deprived to a more deprived area.

Household crowding in childhood and trajectories of depressive symptoms in mid-life and older age

AIMS

We aimed to investigate the association of household crowding in childhood with trajectories of depressive symptoms in middle-aged and older adults.

METHODS

We studied 47,010 participants (56 % women, 63 years at baseline) from SHARE. Using multinomial logistic regression, we estimated odds ratio (OR) with 95 % confidence interval (CI) for the association of household crowding in childhood (number of household members/number of rooms at the age of 10) with trajectories of depressive symptoms (EURO-D scale), which were generated with growth mixture modeling. We adjusted for resources in childhood, sociodemographic and health-related characteristics in mid-life and older age and tested effect modification by sex.

RESULTS

We identified four trajectories of depressive symptoms: constantly low (n = 33,969), decreasing (n = 5595), increasing (n = 5574) and constantly high (n = 1872). When compared to the those with constantly low depressive symptoms and adjusting for all covariates, household crowding in childhood was associated with greater odds of constantly high (OR 1.12; 95 % CI 1.08-1.17), decreasing (OR 1.11; 95 % CI 1.07-1.15) and increasing (OR 1.09; 95 % CI 1.06-1.13) depressive symptoms. The associations were stronger in women than in men.

CONCLUSIONS

Prevention of household crowding in childhood may ameliorate the development of constant as well as transient depressive symptoms during ageing. The effect can be stronger in women than in men.

Emotional Distress in a Marginalized Population as a Function of Household-Level Social Determinants of Health

Low-income, underrepresented communities of color are disproportionally affected by emotional distress. Little is known about malleable, household-level determinants of emotional distress, addressable by feasible, stigma-neutral interventions. The present study addressed this knowledge gap by analyzing secondary data from a cross-sectional community needs assessment survey in a marginalized urban community (N = 677). Relying on dominance analyses, authors found that, on average, the largest household-level contributions to respondents' emotional distress included exposures to fellow household members' alcohol use and anger-driven behaviors. Both determinants are arguably feasible to address via household-level interventions and community-level preventive efforts. Household members' physical and serious mental illness and drug use were moderately associated with respondents' emotional distress; household cohesion and communications, residential overcrowding, and child behavior played a minimal role. Article concludes with a discussion of public health implications of the results.

Geographically varying associations between mentally unhealthy days and social vulnerability in the USA

OBJECTIVES

A growing body of research has incorporated the Social Vulnerability Index (SVI) into an expanded understanding of the social determinants of health. Although each component of SVI and its association with individual-level mental health conditions have been well discussed, variation in mentally unhealthy days (MUDs) at a county level is still unexplored. To systematically examine the geographically varying relationships between SVI and MUDs across the US counties, our study adopted two different methods: 1) aspatial regression modeling (ordinary least square [OLS]); and 2) locally calibrated spatial regression (geographically weighted regression [GWR]).

STUDY DESIGN

This study used a cross-sectional statistical design and geospatial data manipulation/analysis techniques. Analytical unit is each of the 3109 counties in the continental USA.

METHODS

We tested the model performance of two different methods and suggest using both methods to reduce potential issues (e.g., Simpson's paradox) when researchers apply aspatial analysis to spatially coded data sets. We applied GWR after checking the spatial dependence of residuals and non-stationary issues in OLS. GWR split a single OLS equation into 3109 equations for each county.

RESULTS

Among 15 SVI variables, a combination of eight variables showed the best model performance. Notably, unemployment, person with a disability, and single-parent households with children aged under 18 years especially impacted the variation of MUDs in OLS. GWR showed better model performance than OLS and specified each county's varying relationships between subcomponents of SVI and MUDs. For example, GWR specified that 69.3% (2157 of 3109) of counties showed positive relationships between single-parent households and MUDs across the USA. Higher positive relationships were concentrated in Michigan, Kansas, Texas, and Louisiana.

CONCLUSIONS

Our findings could contribute to the literature regarding social determinants of community mental health by specifying spatially varying relationships between SVI and MUDs across US counties. Regarding policy implementation, in counties containing more social and physical minorities (e.g., single-parent households and disabled population), policymakers should attend to these groups of people and increase intervention programs to reduce potential or current mental health illness. The results of GWR could help policymakers determine the specific counties that need more support to reduce regional mental health disparities.

Overcrowded housing during adolescence and future risk of premature mortality: a 28-year follow-up of 556,191 adolescents from Switzerland

Background

Few large-scale studies have examined the health impacts of overcrowded housing in European countries. The aim of this study was to assess whether household crowding during adolescence increases the risk of all-cause and cause-specific mortality in Switzerland.

Methods

Study participants were 556,191 adolescents aged 10-19 years at the 1990 census from the Swiss National Cohort. Household crowding at baseline was measured as the ratio between the number of persons living in the household and the number of available rooms, categorized as none (ratio ≤ 1), moderate (1 < ratio ≤ 1.5), and severe (ratio > 1.5). Participants were linked to administrative mortality records through 2018 and followed for premature mortality from all causes, cardiometabolic disease and self-harm or substance use. Cumulative risk differences between ages 10 and 45 were standardized by parental occupation, residential area, permit status and household type.

Findings

Of the sample, 19% lived in moderately and 5% lived in severely crowded households. During an average follow-up of 23 years, 9766 participants died. Cumulative risk of death from all causes was 2359 (95% compatibility intervals: 2296-2415) per 100,000 persons when living in non-crowded households. Living in moderately crowded households led to 99 additional deaths (-63 to 256) per 100,000 persons and living in severely crowded households 258 additional deaths (-37 to 607) per 100,000 persons. The effect of crowding on mortality from cardiometabolic diseases, self-harm or substance use was negligible.

Interpretation

Excess risk of premature mortality in adolescents living in overcrowded households appears to be small or negligible in Switzerland.

Funding

University of Fribourg Scholarship Programme for foreign post-doctoral researchers.

Housing as a determinant of Inuit mental health: associations between improved housing measures and decline in psychological distress after rehousing in Nunavut and Nunavik

INTERVENTION

In 2014-2015, more than 400 public housing units were constructed in Nunavut and Nunavik, two of the four Inuit regions in Canada. This provided the opportunity to assess the impact of improved housing conditions from a population health perspective in 12 Inuit communities where housing needs were the most severe. The aim of the research is to examine the associations between changes in housing conditions and changes in psychological distress pre-post rehousing.

METHODS

A pre-post uncontrolled study was conducted in collaboration with Nunavut- and Nunavik-based organizations. Applicants at the top of public housing waitlists were recruited by local housing officers; participants completed questionnaires 1-6 months before rehousing, and 15-18 months after. Change in psychological distress was measured with the Kessler 6-item scale. Changes in three housing measures were examined: number of adults per household, number of children per household, and sense of home score. For each housing measure, a categorical variable stratified participants into three categories. The reference category included participants reporting significant change in the concerned housing measure; the two other categories included participants reporting little or no change. Associations were tested with linear multilevel regression models for change.

RESULTS

A total of 102 Inuit adults completed the study. A reduction in the number of adults per household (living with 2 adults or less after rehousing) and an increase in sense of home were associated with significant decline in psychological distress pre-post rehousing (p < 0.001).

CONCLUSION

Increased investments leading to such improvements in housing circumstances are promising ways to promote mental health in Inuit regions.

NB housing study protocol: investigating the relationship between subsidized housing, mental health, physical health and healthcare use in New Brunswick, Canada

BACKGROUND

Income and housing are pervasive social determinants of health. Subsidized housing is a prominent affordability mechanism in Canada; however, waitlists are lengthy. Subsidized rents should provide greater access to residual income, which may theoretically improve health outcomes. However, little is known about the health of tenants who wait for and receive subsidized housing. This is especially problematic for New Brunswick, a Canadian province with low population density, whose inhabitants experience income inequality, social exclusion, and challenges with healthcare access.  METHODS: This study will use a longitudinal, prospective matched cohort design. All 4,750 households on New Brunswick's subsidized housing wait list will be approached to participate. The survey measures various demographic, social and health indicators at six-month intervals for up to 18 months as they wait for subsidized housing. Those who receive housing will join an intervention group and receive surveys for an additional 18 months post-move date. With consent, participants will have their data linked to a provincial administrative database of medical records.  DISCUSSION: Knowledge of housing and health is sparse in Canada. This study will provide stakeholders with a wealth of health information on a population that is historically under-researched and underserved.

Family environment characteristics and sleep duration in children: Maternal mental health as a mediator

BACKGROUND

Family environment is a key factor affecting children's health. However, little is known about whether and how the family environment affects sleep duration in children. This study investigated the effects of both physical and social characteristics of the family environment on sleep duration in children and determined whether these associations were mediated by maternal mental health.

METHODS

Data were obtained from the Taiwan Birth Cohort Study. A total of 19,400 children who completed 6-month, 18-month, 3-year, 5.5-year, and 8-year surveys were analyzed. The physical family environment characteristics were household crowding and housing quality. Family functioning was used as an indicator of family social environment. Multiple linear regression and path analysis were performed to test the hypotheses.

RESULTS

The children living in crowded households had shorter sleep durations (β = -0.03, p < .001). Superior housing quality and family functioning were associated with longer sleep durations (β = 0.04 and 0.02, respectively, ps < .01). The effects of housing quality and family functioning on sleep duration were mediated by maternal mental health.

CONCLUSIONS

Both physical and social characteristics of the family environment are critical to sleep duration in children. The effects of family environment characteristics on sleep duration in children are in part mediated by maternal mental health. Interventions to improve sleep during childhood by targeting the family environment may be more effective when maternal mental health is considered.

Can Homes Affect Well-Being? A Scoping Review among Housing Conditions, Indoor Environmental Quality, and Mental Health Outcomes

The purpose of the scoping review is to explore the relationship between housing conditions, indoor environmental quality (IEQ), and mental health implications on human well-being. In fact, time spent at home increased due to the recent COVID-19 lockdown period, and social-sanitary emergencies are expected to grow due to the urbanization phenomenon. Thus, the role of the physical environment in which we live, study, and work, has become of crucial importance, as the literature has recently highlighted. This scoping review, conducted on the electronic database Scopus, led to the identification of 366 articles. This, after the screening processes based on the inclusion criteria, led to the final inclusion of 31 papers related specifically to the OECD area. The review allowed the identification of five housing conditions [house type, age, and floor level; housing qualities; household composition; neighborhood; green spaces] that, by influencing the IEQ parameters, had impacts on the mental health outcomes addressed. By synthesizing the contributions of the review, a list of design recommendations has been provided. These will serve as a basis for future researchers, from which to develop measures to reduce inequalities in housing by making them healthier, more resilient, and salutogenic.

Neighborhood social capital and self-rated mental health: Disparities between migrants and native residents in Beijing

Introduction

Although the impact of neighborhood social capital on mental health has long been recognized, the extent to which the impact differs between immigrants and local residents remains a puzzle. This study aims to bridge the gap by comparing internal migrants who are restricted by their household registration (hukou) status, and urban natives in China.

Methods

Using self-rated mental health and social capital survey data collected in 26 neighborhoods in Beijing, this study examines the mental health outcomes of three types of neighborhood social capital, including social networks, shared norms and mutual trust, and social support.

Results

The study finds that the hukou status of immigrants moderates the effect of neighborhood social capital on mental health, and that the internal migrants in China experience less mental health benefit of neighborhood social capital than urban natives. Compared with urban natives, neighborhood social networks have less positive effect on migrants' mental health than that of urban natives.

Conclusion

The findings suggest that policy makers can improve the mental health of migrants through social capital building on the premise of eliminating the restrictions of hukou system on the migrants' right to participate in neighborhood activities and to access neighborhood services.

Access to ICT at Argentine elementary school children's homes and its impact on school achievements

This article analyzes the relationship between access to Information and Communication Technology (ICT) and school performance. It contributes to the empirical literature in the area since there is no consensus yet. Moreover, the context associated with COVID-19 pandemic also considers the analysis as the most relevant. The goal of this article is to study the impact of ICT on school performance at elementary level. The hypothesis set forth is that having both a computer and connection to Internet at the students' homes, improves their school related achievements. To contrast it, we propose an econometric model using the Propensity Matching Score (PSM) methodology with data from the Learning 2018 (Aprender 2018) campaign of students at the last year of elementary school in Argentina and in each of the regions that conform it. Finally, there is evidence in favor of the hypothesis.

Impact of COVID-19 shocks, precarity and mediating resources on the mental health of residents of share housing in Victoria, Australia: an analysis of data from a two-wave survey

OBJECTIVES

COVID-19 lockdown measures have challenged people's mental health, especially among economically vulnerable households. The objective of this study was to investigate the impact of exposure to COVID-19 shocks (defined as job loss, living cost pressures and changing housing conditions throughout the lockdown period) and double precarity (defined as precarity in housing and employment) on mental health outcomes for members of share households as well as the mediating effects of a range of resources.

DESIGN

We conducted a two-wave survey of occupants of share housing in June and October 2020 during a prolonged period of population lockdown. Research design involved fixed effects ordered logit regression models to assess the mental health consequences of baseline precarity and COVID-related shocks.

SETTING

Victoria, Australia.

PARTICIPANTS

We surveyed 293 occupants of share houses (mean age 34 SD 11.5, 56% female). Members of share houses (where individuals are unrelated adults and not in a romantic relationship) are more likely to be young, casually employed, visa-holders and low-income.

OUTCOME MEASURES

We measured household composition, housing and employment precarity, access to government support, household crowding, social networks and COVID-19 shocks. We used a self-reported measure of mental health.

RESULTS

Those exposed to COVID-19 shocks reported a 2.7 times higher odds of mental health deterioration (OR 2.7, 95% CI 1.53 to 4.85). People exposed to double precarity (precarity in both housing and employment) reported 2.4 times higher odds of mental health deterioration (OR 2.4, 95% CI 0.99 to 5.69). Housing inadequacy and lack of access to sufficient government payments explained 14.7% and 7% of the total effect of double precarity on mental health, respectively.

CONCLUSIONS

Results indicate that residents of group households characterised by pre-existing precarity were vulnerable to negative mental health effects during lockdown. Access to sufficient government payments and adequate housing buffered this negative effect.

Do the Determinants of Mental Wellbeing Vary by Housing Tenure Status? Secondary Analysis of a 2017 Cross-Sectional Residents Survey in Cornwall, South West England

Housing is a social determinant of health, comprising multiple interrelated attributes; the current study was developed to examine whether differences in mental wellbeing across housing tenure types might relate to individual, living, or neighbourhood circumstances. To achieve this aim, an exploratory cross-sectional analysis was conducted using secondary data from a county-wide resident survey undertaken by Cornwall Council in 2017. The survey included questions about individual, living, or neighbourhood circumstances, as well as mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). A random sample of 30,152 households in Cornwall were sent the survey, from whom 11,247 valid responses were received (38% response), but only 4085 (13.5%) provided complete data for this study. Stratified stepwise models were estimated to generate hypotheses about inequalities in mental wellbeing related to housing tenure. Health, life satisfaction, and social connectedness were found to be universal determinants of mental wellbeing, whereas issues related to living circumstances (quality of housing, fuel poverty) were only found to be related to wellbeing among residents of privately owned and rented properties. Sense of safety and belonging (neighbourhood circumstances) were also found to be related to wellbeing, which together suggests that whole system place-based home and people/community-centred approaches are needed to reduce inequalities.

Integrating Urban Land Tenure Security in Health Determinants: The Design of Indicators for Measuring Land Tenure Security and Health Relationships in Developing Country Contexts

Both urban land tenure insecurity and poor urban health outcomes are research topics of urban geographers and health experts. However, health outcomes or patterns are hardly measured in relation to land tenure security. There are no clear measures or indicators of if and how these two issues interrelate and which type of land tenure deficiency is likely to lead to which kind of health outcomes or patterns. To address this knowledge quandary, we reviewed literature to identify which characteristics of land tenure could relate to which types of health outcomes. The review found four specific land tenure security pathways which significantly influence health outcomes. For each of these, it is possible to identify a set of indicators which could measure the extent of interrelation between land tenure security and health. The result of this process is the design of a list of 46 land tenure-enabled indicators that can be applied empirically. The indicators demonstrate how to design a transdisciplinary approach that connects land management and global urban health knowledge spaces.

Housing and Child Health in South Africa: The Value of Longitudinal Research

Research investigating the link between housing and health often produces mixed results. It does not always prove that good housing improves health. The results suggest a complex set of factors play a role, and the findings are sometimes contradictory. Two ways of addressing these concerns are longitudinal research, where the relationship between housing and health is measured in the short and medium terms, and a focus on children. We use the children’s housing and health data from the five waves of the National Income and Distribution Survey (NIDS) survey in South Africa, 2008 to 2017. We investigate the effect that continued living in informal housing over the five waves has had on these children’s health. Our results show a statistically significant relationship between prolonged residence in poor housing and poor health outcomes for some health indicators. The results call for a closer understanding of health issues in housing policy in South Africa.

Impact of changes in housing tenure and affordability status on depressive symptoms: Evidence from a longitudinal study

INTRODUCTION

Housing is an important social determinant of health. We investigated effects of changes in housing tenure and affordability on depressive symptoms.

METHODS

Data of 9,956 individuals aged >20 years from the Korea Welfare Panel Study (2015-2020) were analyzed. Housing tenure was categorized as homeowners or tenants. Individuals with housing-related expenditures exceeding 30% of household income were defined as having housing unaffordability. Analyses using generalized estimating equations were conducted to evaluate the relationship between changes in housing tenure and affordability on depressive symptoms measured with the Center for Epidemiologic Studies Depression Scale.

RESULTS

Individuals who became tenants (β = 0.326, p = 0.027) or were persistent tenants (β = 0.542, p<0.001) demonstrated significantly more severe depressive symptoms than persistent homeowners. Individuals with new (β = 0.562, p < 0.001) or consistent housing unaffordability (β = 1.032, p = 0.036) showed increased depressive symptoms compared with those with persistent housing affordability. Depressive symptoms were reduced in new homeowners and those who left housing unaffordability status (β = -0.807, p = 0.031). The interaction between housing tenure and affordability on depressive symptoms differed by age and household composition. Housing tenure at post-retirement age and single-person households were associated with a decrease in depressive symptoms, respectively.

LIMITATIONS

All housing-related factors, especially different domains of housing insecurity including unstable neighborhoods or reasons for moving, have not been identified.

CONCLUSIONS

Changes in housing tenure, affordability, and the two combined were significantly associated with depressive symptoms. Furthermore, the degree of interactive effect varied among age groups and household composition. Housing welfare policies that can stabilize housing tenure and affordability might help prevent depression.

Association between household overcrowding and depressive mood among Chinese residents

BACKGROUND

Recent household overcrowding has strongly affected households' mental health in China. The possible association of household overcrowding and depressive mood is not fully demonstrated in unique Chinese economic context.

OBJECTIVES

The aim of this study was to examine the association of household overcrowding and depressive mood among Chinese adults and to evaluate whether the association varies across socio-demographic characteristics.

METHODS

The relationship between household overcrowding and individual's depressive mood was examined using ordered logistic regression models. Stratified analysis was used to evaluate whether the association varies across socio-demographic characteristics.

RESULTS

Ordered logistic regression models showed that the odds ratio for depressive mood among residents enduring housing overcrowding, as compared with residents without household overcrowding were 1.12 (95% confidence interval [CI]: 1.02-1.22), after controlling for important confounders. We secondarily examined the association across subgroups. Stratified analysis revealed that household overcrowding significantly affected depressive mood for the low household income subgroups, whereas has no significant effect on depressive mood for the high household income.

LIMITATIONS

CFPS does not investigate the depression of people under 16, making it impossible for us to study the impacts of housing crowding on Chinese children's depression. Secondly, we did not adjust for other potential confounders, such as lifetime history of depression or depressive mood, medication use and anxiety disorders/symptoms.

CONCLUSIONS

This finding indicates that household overcrowding is harmful to residents' mental health, and appropriate protective measures should be taken to reduce the adverse effects of household overcrowding on residents' mental health.

Anxiety among Lebanese adolescents: scale validation and correlates

BACKGROUND

The Lebanese population has undergone several conflicts and were the most afflicted by shelling and chaos during the civil war from 1975 to 1990, or even by displacement, bereavement, emigration, family separations, not to mention the economic crises that have hit the country since 2019 under which young adults are still succumbing. Our study aims to validate the Lebanese Anxiety Scale and assess correlates of anxiety among Lebanese adolescents.

METHODS

A cross-sectional study was carried between January and May 2019, using a proportionate random sampling of schools from all five Lebanese governorates, among which 1810 adolescents aged 14 to 17 years.

RESULTS

All LAS items remained in the model and formed one factor solution that explained 61.38% of the total variance (KMO = 0.873; p_{Bartlett test} < 0.001), with an excellent Cronbach's alpha of 0.93. Higher neglect (B = 0.38), insomnia (B = 0.21) and child psychological abuse (B = 0.08) were significantly associated with more anxiety. Those results were considered adjusted overall sociodemographic variables since the latter had no statistically significant association with anxiety.

CONCLUSION

The study confirmed the association between anxiety and some variables such as psychological child abuse, neglect, and insomnia and emphasized the correlation between anxiety and these factors. Further, the LAS appears to be a short, valid and efficient tool for assessing anxiety among Lebanese adolescents. Further studies need to be carried to evaluate whether the LAS-10 gives a similar diagnosis to psychiatrists.

The effect of household crowding and composition on health in an Inuit cohort in Greenland

Aims: This study aims to investigate the association between household crowding and household composition and self-rated health and mental health (GHQ scale) among the Inuit in Greenland. Poor housing conditions are a concern in Greenland, especially in the villages, where socioeconomic standards in general are lower. Methods: A cohort of 1282 adults participated in two population-based surveys in Greenland, the Inuit Health in Transition survey 2005–2010 (baseline) and The Health Survey in Greenland 2014 (follow-up). Associations between household conditions at baseline and health outcomes at follow-up (poor self-rated health and mental health measured by the GHQ scale) were examined using logistic regression models, adjusting for covariates at baseline. Results: Participants living in an overcrowded dwelling (more than one person per room) at baseline were more likely to report poor self-rated health at follow-up (OR 1.47; 95% CI 1.09; 1.99) compared with those not living in an overcrowded dwelling. In addition, participants who lived alone at baseline were more likely (OR 1.98; 95% CI 1.09; 3.58) to experience poor mental health at follow-up compared with those who lived with children. Conclusions: Results indicate that household conditions are related to health in Greenland. Public health authorities should work to ensure affordable housing of good quality in all communities.

Association between housing tenure and self-rated health in Japan: Findings from a nationwide cross-sectional survey

Background

Many studies have reported that housing tenure (HT) is associated with health, but little is known about its association in Japan. We investigated the cross-sectional association between HT and self-rated health (SRH) among Japanese adults, taking demographic characteristics and socioeconomic status (SES) into consideration.

Methods

We used data from a nationally representative survey conducted by the Japanese Ministry of Health, Labour and Welfare (28,641 men and 31,143 women aged ≥20 years). HT was divided into five categories: owner-occupied, privately rented, provided housing, publically subsidized, and rented rooms. SRH was evaluated using a single-item inventory and dichotomized into poor (very poor/poor) and good (very good/good/fair). We calculated adjusted odds ratios (OR) and their 95% confidence intervals (CI) for poor SRH with logistic regression models. Covariates included demographic factors (i.e., age, gender, marital status, family size, smoking status, and chronic medical conditions) and SES factors (i.e., education, equivalent household expenditures, and occupation).

Results

Among analyzed participants, 75.9% were owner-occupiers and 14.6% reported poor SRH. After adjustment for all covariates, compared with owner-occupiers, private renters (OR = 1.36, 95% CI = 1.26–1.47), publically subsidized renters (OR = 1.33, 95% CI = 1.19–1.48), and residents in rented rooms (OR = 1.41, 95% CI = 1.22–1.62) were more likely to report poor SRH. Stratified analyses by SES factors showed that the association between HT and poor SRH was stronger in the socially disadvantaged than in the higher socioeconomic group.

Conclusions

Our results show a significant association between HT and SRH, independent of socio-demographic factors. HT may deserve greater attention as an indicator of socioeconomic position in Japan.

Household overcrowding and psychological distress among Nunavik Inuit adolescents: a longitudinal study

About half of Nunavik Inuit live in overcrowded households compared to very few Canadians from the general population. Living in overcrowded households is associated with greater risks of suffering from mental health problems for Canadian adolescents. The present work aims at studying prospectively the hypothesised relationship between household overcrowding at childhood and psychological distress during adolescence among Nunavik Inuit, as well as the hypothesised relationship between these phenomena when they are both measure at adolescence. Recruited as part of the Nunavik Child Development Study, 220 participants were met at 11 years old in average and then when they were 18 years old in average. Household overcrowding was assessed using the people per room ratio. Psychological distress symptoms were operationalised at adolescence using depressive symptoms and suicidal thoughts. The results did not show that childhood household crowding had a long-term effect on psychological distress. An absence of moderation by sex of the association was also found in the present study. Despite those results, household crowding could be a risk factor only when in interaction with other elements related with poverty or housing or could be experienced as a difficulty for adolescents on other aspects than depressive symptoms and suicidal thoughts.

Making the Case for "Whole System" Approaches: Integrating Public Health and Housing

Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. Today, the traditional public health emphasis on the type and quality of housing merges with other wider determinants of health. These include the neighbourhood, community, and "place" where a house is located, but also the policies which make access to a healthy house possible and affordable for everyone. Encouragingly, these approaches to policy and action on housing have the potential to contribute to the "triple win" of health and well-being, equity, and environmental sustainability. However, more effective housing policies (and in public health in general) that adopt more systemic approaches to addressing the complex interactions between health, housing, and wider environment are needed. This paper illustrates some of the key components of the housing and health challenge in developed countries, and presents a conceptual model to co-ordinate activities that can deliver the "triple win." This is achieved by offering a perspective on how to navigate more effectively, inclusively and across sectors when identifying sustainable housing interventions.

The Mental Health Benefits of Acquiring a Home in Older Age: A Fixed-Effects Analysis of Older US Adults

Homeownership is consistently associated with better mental health, but whether becoming a homeowner in later in life has positive psychological benefits has not, to our knowledge, been examined. We assessed whether acquiring a home after age 50 years was associated with depression in a representative sample of older US adults. We used individual fixed-effects models based on data from 20,524 respondents aged ≥50 years from the Health and Retirement Study, who were interviewed biennially during 1993-2010. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale. Controlling for confounders, becoming a homeowner in later life predicted a decline in depressive symptoms in the same year (β = -0.0768, 95% confidence interval (CI): -0.152, -0.007). The association remained significant after 2 years (β = -0.0556, 95% CI: -0.134, -0.001) but weakened afterward. Buying a home for reasons associated with positive characteristics of the new house or neighborhood drove this association (β = -0.426, 95% CI: -0.786, -0.066), while acquiring a home for reasons associated with characteristics of the previous home or neighborhood, the desire to be closer to relatives, downsizing, or upsizing did not predict mental health improvements. Findings suggest that there are small but significant benefits for mental health associated with acquiring a home in older age.

Loneliness, socio-economic status and quality of life in old age: the moderating role of housing tenure

The study investigated housing tenure as a factor moderating the effects of loneliness and socio-economic status (SES) on quality of life (control and autonomy, pleasure, and self-realisation) over a two-year period for older adults. Data from the 2010 and 2012 waves of the New Zealand Health, Work, and Retirement Study were analysed. Using case-control matching, for each tenant (N = 332) we selected a home-owner (N = 332) of the same age, gender, ethnicity, SES, working status and urban/rural residence. Structural equation modelling was employed to examine the impact of SES, housing tenure and loneliness on quality of life over time. Emotional loneliness exerted a significant negative main effect on control and autonomy and pleasure. Tenure and SES influenced control and autonomy, but not pleasure or self-realisation. Tenure moderated the effect of emotional loneliness on control and autonomy, with the negative effect of emotional loneliness weaker for home-owners compared to renters. Tenure moderated the effect of SES on control and autonomy, with the positive impact of SES stronger for home-owners. Findings suggest that owners capitalise on their material and financial resources more than tenants in terms of their quality of life. In addition, home-ownership can act as a protective factor against the harmful effects of emotional loneliness in old age.