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Walton L, Skillen E, Mosites E, Bures RM, Amah-Mbah C, Sandoval M, Thigpen Tart K, Berrigan D, Star C, Godette-Greer D, Kowtha B, Vogt E, Liggins C, Lloyd J. The intersection of health and housing: Analysis of the research portfolios of the National Institutes of Health, Centers for Disease Control and Prevention, and U.S. Department of Housing and Urban Development. PLoS One 2024; 19:e0296996. [PMID: 38285706 PMCID: PMC10824422 DOI: 10.1371/journal.pone.0296996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Housing is a major social determinant of health that affects health status and outcomes across the lifespan. OBJECTIVES An interagency portfolio analysis assessed the level of funding invested in "health and housing research" from fiscal years (FY) 2016-2020 across the National Institutes of Health (NIH), the United States Department of Housing and Urban Development (HUD), and the Centers for Disease Control and Prevention (CDC) to characterize the existing health and housing portfolio and identify potential areas for additional research and collaboration. METHODS/RESULTS We identified NIH, HUD, and CDC research projects that were relevant to both health and housing and characterized them by housing theme, health topic, population, and study design. We organized the assessment of the individual housing themes by four overarching housing-to-health pathways. From FY 2016-2020, NIH, HUD, and CDC funded 565 health and housing projects combined. The Neighborhood pathway was most common, followed by studies of the Safety and Quality pathway. Studies of the Affordability and Stability pathways were least common. Health topics such as substance use, mental health, and cardiovascular disease were most often studied. Most studies were observational (66%); only a little over one fourth (27%) were intervention studies. DISCUSSION This review of the research grant portfolios of three major federal funders of health and housing research in the United States describes the diversity and substantial investment in research at the intersection between housing and health. Analysis of the combined portfolio points to gaps in studies on causal pathways linking housing to health outcomes. The findings highlight the need for research to better understand the causal pathways from housing to health and prevention intervention research, including rigorous evaluation of housing interventions and policies to improve health and well-being.
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Affiliation(s)
- Liberty Walton
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Skillen
- Policy Analysis and Engagement Office, Office of Policy, Performance & Evaluation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily Mosites
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Regina M. Bures
- Population Dynamics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States of America
| | - Chino Amah-Mbah
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, United States of America
| | - Maggie Sandoval
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, United States of America
| | - Kimberly Thigpen Tart
- Office of Science Coordination, Planning, and Evaluation, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, United States of America
| | - David Berrigan
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
| | - Carol Star
- Office of Policy Development and Research, Program Evaluation Division, U.S. Department of Housing and Urban Development, Washington, DC, United States of America
| | - Dionne Godette-Greer
- Division of Extramural Science Programs, National Institute of Nursing Research, Rockville, Maryland, United States of America
| | - Bramaramba Kowtha
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Vogt
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Charlene Liggins
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jacqueline Lloyd
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
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Hearld LR, Tafili A, Kelly RJ. Patterns and trends in local health departments' efforts to promote access to care in local communities throughout the United States: The contributions of governance structures. Int J Health Plann Manage 2023; 38:1284-1299. [PMID: 37160718 DOI: 10.1002/hpm.3653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023] Open
Abstract
Public health agencies like local health departments (LHDs) play an important role in addressing healthcare access disparities and service delivery gaps in local communities throughout the United States. Previous research has provided important snapshots into specific access issues confronted by LHDs; however, the literature lacks a more comprehensive view of LHDs' efforts to ensure broad access to care, how these have evolved over time more recently, and whether certain types of LHDs governance structures are more likely to engage in activities to ensure access to care. The purpose of this study was to address these gaps in the literature by exploring the prevalence of different activities to ensure access to care, describing how the prevalence of these activities have evolved over time, and examining whether the prevalence of these activities varied as a function of different governance structures. Using pooled, cross-sectional survey data from four waves of a survey (2009, 2013, 2016, 2019) of LHDs in the United States, the univariate and bivariate analysis revealed that, over time, LHDs have generally increased their efforts to assess gaps in access to healthcare services and across all healthcare categories (i.e., medical, dental, behavioural health) but especially for behavioural health. Poisson regression models showed that LHDs with a more decentralised decision-making structure were associated with more activities to ensure access to care, as compared to more centralised structures. Collectively, our findings indicate that despite growth in the number and percentage of LHDs assessing and addressing gaps in services, opportunities still exist to enhance access to healthcare services in local communities, particularly in the areas of dental and behavioural health. Our findings also suggest that stakeholders interested in improving LHDs' efforts to ensure access to care in local communities may want to pay close attention to governance features of LHDs.
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Affiliation(s)
- Larry R Hearld
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Aurora Tafili
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Reena Joseph Kelly
- Health Administration and Policy Department, School of Health Sciences, University of New Haven, New Haven, Connecticut, USA
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Yang Toh SH, Lee SC, Kosasih FR, Lim JW, Sündermann O. Preliminary effectiveness of an evidence-based mobile application to promote resilience among working adults in Singapore and Hong Kong: Intensive longitudinal study. Digit Health 2023; 9:20552076231178616. [PMID: 37274370 PMCID: PMC10236254 DOI: 10.1177/20552076231178616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/11/2023] [Indexed: 06/06/2023] Open
Abstract
Evidence-based mobile health (mHealth) applications on smartphones are a cost-effective way for employees to take proactive steps to improve well-being and performance. However, little is known about what sustains engagement on these applications and whether they could dynamically improve occupational outcomes such as resilience and mood. Using real-world data, this intensive longitudinal study examines (a) which employees would continually engage with a cognitive behavioural therapy-informed mHealth application ('Intellect'); and (b) if daily engagement of 'Intellect' would relate to better occupational outcomes on the following day. A total of 515 working adults in Singapore and Hong Kong (Mage = 32.4, SDage = 8.17) completed daily in-app items on mood and resilience components (i.e. sleep hours, sleep quality, physical activity, and stress levels). Our results revealed that employees with lower baseline resilience (β = -0.048, odds ratio (OR) = 0.953, p < 0.01), specifically poorer sleep quality (β = -0.212, OR = 0.809, p = 0.001) and/or higher stress levels (β = -0.255, OR = 0.775, p = 0.05), were more likely to resume engagement on the application. Among the 150 active users (i.e. ≥3 consecutive days of engagement) (Mage = 32.2, SDage = 8.17), daily engagement predicted higher resilience (β = 0.122; 95% confidence interval (CI) 0.039-0.206), specifically lower stress levels (β = 0.018; 95% CI 0.004-0.032), higher physical activity (β = 0.079; 95% CI 0.032-0.126), and mood levels (β = 0.020; 95% CI 0.012-0.029) on the following day even after controlling for same-day outcomes. Our preliminary findings suggest that engaging with a mHealth application was associated with higher dynamic resilience and emotional well-being in employees.
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Affiliation(s)
| | - Sze Chi Lee
- Research Department, Intellect Pte Ltd,
Singapore
| | | | - Jia W. Lim
- Department of Psychology, National University of
Singapore, Singapore
| | - Oliver Sündermann
- Research Department, Intellect Pte Ltd,
Singapore
- Department of Psychology, National University of
Singapore, Singapore
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Radfar A, Ferreira MM, Sosa JP, Filip I. Emergent Crisis of COVID-19 Pandemic: Mental Health Challenges and Opportunities. Front Psychiatry 2021; 12:631008. [PMID: 34349675 PMCID: PMC8326372 DOI: 10.3389/fpsyt.2021.631008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
Mental health is a fundamental human right and is part of the well-being of society. The public health burden of mental health disorders affects people's social and economic status around the world. Coronavirus's (COVID-19) negative impact on the economy and mental health worldwide is concerning. This is a worldwide emergency, and there is an urgent need for research about this topic to prevent long-lasting adverse effects on the population. Unpreparedness and inconsistencies in guidelines, lockdowns, containment strategies, unemployment, financial losses, physical distancing, isolation, chaos, and uncertainty are among factors that lead to a rise in emotional distress, anxiety, and depression. Governments' decisions affect the socioeconomic status of a country and the psychological well-being of the people. COVID-19 pandemic exposed disparities in multiple mental health care systems by having adverse mental health effects in people with pre-existing mental health disorders and previously healthy individuals. Aggregation of concurrent or cumulative comorbid risk factors for COVID-19 disease and its psychosocial sequelae could provide invaluable information for the public health stakeholders. This review aims to address the burden and the psychosocial impact of the COVID-19 pandemic, the challenges and opportunities facing mental health systems, and proposes new strategies to improve the mental health outcomes in the post-COVID era.
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Affiliation(s)
- Amir Radfar
- Assistant Professor of Medical Education, University of Central Florida, Orlando, FL, United States
| | - Maria M Ferreira
- Division of Research, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Juan P Sosa
- Division of Research, Universidad Nacional de Tucuman, San Miguel de Tucumán, Argentina
| | - Irina Filip
- Department of Clinical Psychiatry, Western University of Health Sciences, Pomona, CA, United States
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