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Wallace D, Chamberlain A, Pfeiffer D. The Relationship Between Foreclosures and Intimate Partner Violence During the U.S. Housing Crisis. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6247-6273. [PMID: 30556475 DOI: 10.1177/0886260518818431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The recent U.S. housing crisis led to increases in neighborhood foreclosures and stress. Intimate partner violence (IPV) is linked to neighborhood stress, but less is known about whether foreclosures aggravate neighborhood conditions affecting IPV. Using police, foreclosure, and census data for three cities in the Phoenix region coupled with cross-sectional time series modeling, we find a direct effect of foreclosures on IPV, with the largest effects appearing at the end of the housing crisis. Our findings suggest that households living in communities that recover more slowly from housing downturns may be more prone to IPV.
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Hazekamp C, Yousuf S, Khare M, MacDowell M. Unhealthy behaviours in urban Illinois communities affected by eviction: A descriptive analysis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:867-875. [PMID: 33533076 DOI: 10.1111/hsc.13312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Eviction of renter-occupied homes is an emerging public health crisis adversely impacting populations already at risk. Although housing quality and home-owner foreclosures have been linked to health outcomes, the relationship between eviction of renter-occupied homes and health has not been well established. The demographics and socioeconomic status of renters differs from homeowners, as such any relationship with health outcomes should be distinguished between the two. The aim of this study is to provide a descriptive analysis of the relationship between renter-specific eviction and unhealthy behaviours at the census tract level. Using data from the Centers for Disease Control and Prevention 500 Cities Project, the Eviction Lab and the U.S. Census Bureau, this study assesses the relationship between eviction rates and health indicators for 1,267 urban census tracts in Illinois in 2016. Binge drinking, current smoking, no leisure-time physical activity, obesity and sleeping <7 hr were used as indicators of unhealthy behaviour as categorised by the Centers for Disease Control and Prevention500 Cities Project. Unadjusted and adjusted linear regression models were used to assess and describe the relationship between each of the dependent variables and each of the independent variables. All five of the unhealthy behaviour indicators were found to be significantly associated with eviction rates and eviction filing rates after adjustment for confounding variables. This study contributes to the understudied area of research focused on how eviction rates contribute to the social determinants of health for already at-risk populations.
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Affiliation(s)
- Corey Hazekamp
- University of Illinois College of Medicine Rockford, Rockford, IL, USA
| | - Sana Yousuf
- Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Manorama Khare
- University of Illinois College of Medicine Rockford, Rockford, IL, USA
| | - Martin MacDowell
- University of Illinois College of Medicine Rockford, Rockford, IL, USA
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Effects of Residential Instability of Renters on Their Perceived Health Status: Findings from the Korean Welfare Panel Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197125. [PMID: 33003395 PMCID: PMC7579450 DOI: 10.3390/ijerph17197125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/26/2020] [Accepted: 09/28/2020] [Indexed: 01/21/2023]
Abstract
Identifying the impact of housing instability on the health status of renters with relatively high economic difficulties is important for the improvement of renters’ quality of life and their social security. Accordingly, this study adopted a panel data regression approach to examine the associations between residential instability and perceived health status—including physical and mental health—using 14 waves (2006–2019) of longitudinal data collected by the Korean Welfare Panel Study. The results showed that residential instability significantly affected perceived health status, and renters who experienced residential instability perceived worse health status and had more severe depression than those who did not experience residential instability. Moreover, failure to meet the minimum housing standard worsened depression in renters. Despite assistance benefits from the government, permanent rental housing and the national basic living security were also factors that worsened depression. Dissatisfaction with one’s residential environment and social relationships were also associated with increased depression. We recommend that the overall quality of housing welfare services, including a focus on the mental health of low-income renters, be improved by expanding the range of services, increasing the number of professional housing welfare workers, and supplying community facilities for increasing residential and social relationship satisfactions.
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Jones A, Mamudu HM, Squires GD. Mortgage possessions, spatial inequality, and obesity in large US metropolitan areas. Public Health 2020; 181:86-93. [PMID: 31978778 DOI: 10.1016/j.puhe.2019.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/29/2019] [Accepted: 11/27/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES As social determinants of health, mortgage possessions (primarily foreclosures in the US context) and housing instability have been associated with certain mental and physical health outcomes at the individual level. However, individual risks of foreclosure and of poor health are spatially patterned. The objective of this study is to examine the extent to which area-specific social and economic characteristics help explain the relationship between mortgage possessions and obesity prevalence in 75 of the 100 most populous US metropolitan areas. STUDY DESIGN This is a cross-sectional study. METHODS The study relies on three sources of data: the Selected Metropolitan/Micropolitan Area Risk Trends (SMART) project, RealtyTrac foreclosure data, and the American Community Survey. Focal social and economic characteristics include foreclosure rates, levels of racial residential segregation, and poverty. Obesity prevalence and several control measures for each metropolitan area are also used. Ordinary least squares regression, weighted using the SMART project data, is used, and statistical significance is set at 0.05. RESULTS The results suggest that mortgage possessions are independently associated with higher obesity prevalence and that foreclosures operate through the specific channel of racial residential segregation and its tie to the racial composition of a metropolitan area. Socio-economic status of an area, and not poverty, is related to foreclosures and obesity prevalence. CONCLUSION Mortgage possessions not only are socio-economic but also have negative health consequences, such as obesity. The findings provide an empirical base for other researchers to uncover the relationships between segregation, mortgage possessions, and obesity at the individual level of analysis. The public health community should be engaged in addressing the issue of foreclosures in the US because the failure to engage may have broad financial and health consequences across large cities.
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Affiliation(s)
- A Jones
- Department of Sociology, The George Washington University, USA; Department of Epidemiology, Department of Biostatistics and Bioinformatics, The George Washington University, USA.
| | - H M Mamudu
- College of Public Health, East Tennessee State University, USA
| | - G D Squires
- Department of Sociology, The George Washington University, USA
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Schaff K, Dorfman L. Local Health Departments Addressing the Social Determinants of Health: A National Survey on the Foreclosure Crisis. Health Equity 2019; 3:30-35. [PMID: 30793093 PMCID: PMC6382054 DOI: 10.1089/heq.2018.0066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To examine local health department (LHD) engagement in addressing the social determinants of health by using the foreclosure crisis as an example. Methods: National survey of 166 LHD staff on the foreclosure crisis (2006-2014). Results: About one quarter (28%) of respondents reported that their LHD had engaged in work related to the foreclosure crisis, 7% planned to engage, and 65% did not or were not planning to engage. Views about the role of LHDs in addressing the foreclosure crisis varied: 30% stated that LHDs should work on foreclosure. Conclusions: A substantial number of respondents reported that their LHD addressed foreclosure, or supported engagement, yet there are divergent perceptions of appropriate LHD roles. LHDs follow a pattern described by the diffusion of innovations theory: Innovative LHDs can share their work on foreclosure and housing, early adopters are poised to act, and others may follow if they have support.
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Affiliation(s)
- Katherine Schaff
- Alameda County Public Health Department, Oakland, California
- Berkeley Media Studies Group—A Project of Public Health Institute, Berkeley, California
| | - Lori Dorfman
- Berkeley Media Studies Group—A Project of Public Health Institute, Berkeley, California
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Spatial Analysis of Clustering of Foreclosures in the Poorest-Quality Housing Urban Areas: Evidence from Catalan Cities. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2018. [DOI: 10.3390/ijgi7010023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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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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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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Christine PJ, Moore K, Crawford ND, Barrientos-Gutierrez T, Sánchez BN, Seeman T, Diez Roux AV. Exposure to Neighborhood Foreclosures and Changes in Cardiometabolic Health: Results From MESA. Am J Epidemiol 2017; 185:106-114. [PMID: 27986705 DOI: 10.1093/aje/kww186] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 04/11/2016] [Indexed: 11/12/2022] Open
Abstract
Home foreclosures can precipitate declines in health among the individuals who lost their homes. Whether home foreclosures can "spillover" to affect the health of other neighborhood residents is largely unknown. Using longitudinal data from the Multi-Ethnic Study of Atherosclerosis that were linked to foreclosure data from 2005 to 2012, we assessed whether greater exposure to neighborhood foreclosures was associated with temporal changes in 3 objectively measured cardiometabolic risk factors: body mass index, systolic blood pressure, and fasting glucose level. We used fixed-effects models to estimate mean changes in cardiometabolic risk factors associated with changes in neighborhood foreclosures over time. In models in which we controlled for time-varying income, working status, medication use, neighborhood poverty, neighborhood unemployment, and interactions of age, sex, race, and state foreclosure laws with time, a standard-deviation increase in neighborhood foreclosures (1.9 foreclosures per quarter mile) was associated with increases in fasting glucose (mean = 0.22 mg/dL, 95% confidence interval: -0.05, 0.50) and decreases in blood pressure (mean = -0.27 mm Hg, 95% confidence interval: -0.49, -0.04). Changes in neighborhood foreclosure rates were not associated with changes in body mass index. Overall, greater exposure to neighborhood foreclosures had mixed associations with cardiometabolic risk factors over time. Given the millions of mortgages still in default, further research clarifying the potential health effects of neighborhood foreclosures is needed.
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Charters TJ, Harper S, Strumpf EC, Subramanian SV, Arcaya M, Nandi A. The effect of metropolitan-area mortgage delinquency on health behaviors, access to health services, and self-rated health in the United States, 2003-2010. Soc Sci Med 2016; 161:74-82. [PMID: 27261531 DOI: 10.1016/j.socscimed.2016.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/11/2016] [Accepted: 05/13/2016] [Indexed: 01/08/2023]
Abstract
The recent housing crisis offers the opportunity to understand the effects of unique indicators of macroeconomic conditions on health. We linked data on the proportion of mortgage borrowers per US metropolitan-area who were at least 90 days delinquent on their payments with individual-level outcomes from a representative sample of 1,021,341 adults surveyed through the Behavioral Risk Factor Surveillance System (BRFSS) between 2003 and 2010. We estimated the effects of metropolitan-area mortgage delinquency on individual health behaviors, medical coverage, and health status, as well as whether effects varied by race/ethnicity. Results showed that increases in the metropolitan-area delinquency rate resulted in decreases in heavy alcohol consumption and increases in exercise and health insurance coverage. However, the delinquency rate was also associated with increases in smoking and obesity in some population groups, suggesting the housing crisis may have induced stress-related behavioral change. Overall, the effects of metropolitan-area mortgage delinquency on population health were relatively modest.
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Affiliation(s)
- Thomas J Charters
- Department of Epidemiology, Biostatistics and Occupational Health & Institute for Health and Social Policy, McGill University, Charles Meredith House Room B8, 1030 Pine Ave. West, Montreal, QC H3A 1A3, Canada.
| | - Sam Harper
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall 34B, 1020 Pine Ave. West, Montreal, QC H3A 1A2, Canada.
| | - Erin C Strumpf
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall 36C, 1020 Pine Ave. West, Montreal, QC H3A 1A2, Canada; Department of Economics, McGill University, Leacock 418, 855 Sherbrooke St. West, Montreal, QC H3A 2T7, Canada.
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Kresge Building 716, 677 Huntington Avenue, Boston, MA 02115-6096, USA.
| | - Mariana Arcaya
- Harvard Center for Population and Development Studies, Harvard School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA.
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics and Occupational Health & Institute for Health and Social Policy, McGill University, Charles Meredith House Room 102, 1030 Pine Ave. West, Montreal, QC H3A 1A3, Canada.
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Daponte Codina A, Mateo Rodríguez I, Vásquez-Vera H. [Evictions and health, a response from the public health in Spain is needed]. GACETA SANITARIA 2016; 30:239-41. [PMID: 27184757 DOI: 10.1016/j.gaceta.2016.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Antonio Daponte Codina
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN), Escuela Andaluza de Salud Pública, Granada, España.
| | - Inmaculada Mateo Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN), Escuela Andaluza de Salud Pública, Granada, España
| | - Hugo Vásquez-Vera
- Agència de Salut Pública de Barcelona, Barcelona, España; Universitat Pompeu Fabra, Barcelona, España; Centro de Estudios para la Equidad en Salud, Universidad de La Frontera, Chile
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Downing J, Karter A, Rodriguez H, Dow WH, Adler N, Schillinger D, Warton M, Laraia B. No Spillover Effect of the Foreclosure Crisis on Weight Change: The Diabetes Study of Northern California (DISTANCE). PLoS One 2016; 11:e0151334. [PMID: 26985671 PMCID: PMC4795787 DOI: 10.1371/journal.pone.0151334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/26/2016] [Indexed: 11/23/2022] Open
Abstract
The emerging body of research suggests the unprecedented increase in housing foreclosures and unemployment between 2007 and 2009 had detrimental effects on health. Using data from electronic health records of 105,919 patients with diabetes in Northern California, this study examined how increases in foreclosure rates from 2006 to 2010 affected weight change. We anticipated that two of the pathways that explain how the spike in foreclosure rates affects weight gain-increasing stress and declining salutary health behaviors- would be acute in a population with diabetes because of metabolic sensitivity to stressors and health behaviors. Controlling for unemployment, housing prices, temporal trends, and time-invariant confounders with individual fixed effects, we found no evidence of an association between the foreclosure rate in each patient's census block of residence and body mass index. Our results suggest, although more than half of the population was exposed to at least one foreclosure within their census block, the foreclosure crisis did not independently impact weight change.
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Affiliation(s)
- Janelle Downing
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Andrew Karter
- Division of Research, Kaiser Permanente, Oakland, California, United States of America
| | - Hector Rodriguez
- School of Public Health, University of California, Berkeley, California, United States of America
| | - William H Dow
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Nancy Adler
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
| | - Dean Schillinger
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Margaret Warton
- Division of Research, Kaiser Permanente, Oakland, California, United States of America
| | - Barbara Laraia
- School of Public Health, University of California, Berkeley, California, United States of America
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[The health of adults undergoing an eviction process]. GACETA SANITARIA 2015; 30:4-10. [PMID: 26548977 DOI: 10.1016/j.gaceta.2015.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/23/2015] [Accepted: 10/01/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To analyze perceived health status and other health-related indicators in the adult population in Granada (Spain) undergoing an eviction process from their homes, whether rented or owned, in comparison with health indicators in the general adult population in Andalusia. METHODS A cross-sectional survey was administered by trained staff. The survey included instruments from the Andalusian Health Survey 2011 for measuring variables related to physical and mental health, as well as health-related habits. We compared the results with those obtained from the Andalusian general population through the Andalusian Health Survey. A bivariate analysis using the χ2 test and a multivariate logistic regression analysis were conducted. RESULTS We obtained a total sample of 205 people in the process of eviction. A total of 59.5% (n=122) were women, and 40.5% (n=83) were men. Participants were more likely to have poor health (odds ratio [OR]: 12.63, 95% confidence interval [95%CI]: 8.74-18.27), have cardiovascular diseases (OR: 3.08; 95%CI: 1.54- 6.16), or to smoke (OR: 1.68; 95% CI: 1.21-2.33) compared with the Andalusian general population. Most of the health indicators analyzed showed a worse outcome for women undergoing an eviction process. CONCLUSIONS Our results suggest that, in the current context of economic crisis, people undergoing a process of eviction in Granada and its metropolitan area show poorer health than the Andalusian general population. Further research is needed on health and evictions from different methodological approaches, for a better understanding of the topic.
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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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Fowler KA, Gladden RM, Vagi KJ, Barnes J, Frazier L. Increase in suicides associated with home eviction and foreclosure during the US housing crisis: findings from 16 National Violent Death Reporting System States, 2005-2010. Am J Public Health 2015; 105:311-6. [PMID: 25033148 DOI: 10.2105/ajph.2014.301945] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to determine the frequency, characteristics, and precipitating circumstances of eviction- and foreclosure-related suicides during the US housing crisis, which resulted in historically high foreclosures and increased evictions beginning in 2006. METHODS We examined all eviction- and foreclosure-related suicides in the years 2005 to 2010 in 16 states in the National Violent Death Reporting System, a surveillance system for all violent deaths within participating states that abstracts information across multiple investigative sources (e.g., law enforcement, coroners, medical examiners). RESULTS We identified 929 eviction- or foreclosure-related suicides. Eviction- and foreclosure-related suicides doubled from 2005 to 2010 (n=88 in 2005; n=176 in 2010), mostly because of foreclosure-related suicides, which increased 253% from 2005 (n=30) to 2010 (n=106). Most suicides occurred before the actual housing loss (79%), and 37% of decedents experienced acute eviction or foreclosure crises within 2 weeks of the suicide. CONCLUSIONS Housing loss is a significant crisis that can precipitate suicide. Prevention strategies include support for those projected to lose homes, intervention before move-out date, training financial professionals to recognize warning signs, and strengthening population-wide suicide prevention measures during economic crises.
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Affiliation(s)
- Katherine A Fowler
- The authors are with the Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Tsai AC. Home foreclosure, health, and mental health: a systematic review of individual, aggregate, and contextual associations. PLoS One 2015; 10:e0123182. [PMID: 25849962 PMCID: PMC4388711 DOI: 10.1371/journal.pone.0123182] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/01/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The U.S. foreclosure crisis intensified markedly during the Great Recession of 2007-09, and currently an estimated five percent of U.S. residential properties are more than 90 days past due or in the process of foreclosure. Yet there has been no systematic assessment of the effects of foreclosure on health and mental health. METHODS AND FINDINGS I applied systematic search terms to PubMed and PsycINFO to identify quantitative or qualitative studies about the relationship between home foreclosure and health or mental health. After screening the titles and abstracts of 930 publications and reviewing the full text of 76 articles, dissertations, and other reports, I identified 42 publications representing 35 unique studies about foreclosure, health, and mental health. The majority of studies (32 [91%]) concluded that foreclosure had adverse effects on health or mental health, while three studies yielded null or mixed findings. Only two studies examined the extent to which foreclosure may have disproportionate impacts on ethnic or racial minority populations. CONCLUSIONS Home foreclosure adversely affects health and mental health through channels operating at multiple levels: at the individual level, the stress of personally experiencing foreclosure was associated with worsened mental health and adverse health behaviors, which were in turn linked to poorer health status; at the community level, increasing degradation of the neighborhood environment had indirect, cross-level adverse effects on health and mental health. Early intervention may be able to prevent acute economic shocks from eventually developing into the chronic stress of foreclosure, with all of the attendant benefits this implies for health and mental health status. Programs designed to encourage early return of foreclosed properties back into productive use may have similar health and mental health benefits.
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Affiliation(s)
- Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Mbarara University of Science and Technology, Mbarara, Uganda
- * E-mail:
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Freudenberg N, Franzosa E, Chisholm J, Libman K. New Approaches for Moving Upstream. HEALTH EDUCATION & BEHAVIOR 2015; 42:46S-56S. [DOI: 10.1177/1090198114568304] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are “upstream” drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on “downstream” behavioral risks. Three factors explain the difficulty in translating this knowledge into practice. First, in their allegiance to the status quo, powerful elites often resist upstream policies and programs that redistribute wealth and power. Second, public health practice is often grounded in dominant biomedical and behavioral paradigms, and health departments also face legal and political limits on expanding their scope of activities. Finally, the evidence for the impact of upstream interventions is limited, in part because methodologies for evaluating upstream interventions are less developed. To illustrate strategies to overcome these obstacles, we profile recent campaigns in the United States to enact living wages, prevent mortgage foreclosures, and reduce exposure to air pollution. We then examine how health educators working in state and local health departments can transform their practice to contribute to campaigns that reallocate the wealth and power that shape the living conditions that determine health and health inequalities. We also consider health educators’ role in producing the evidence that can guide transformative expansion of upstream interventions to reduce health inequalities.
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Kaplan MS, Huguet N, Caetano R, Giesbrecht N, Kerr WC, McFarland BH. Economic contraction, alcohol intoxication and suicide: analysis of the National Violent Death Reporting System. Inj Prev 2014; 21:35-41. [PMID: 25024394 DOI: 10.1136/injuryprev-2014-041215] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Although there is a large and growing body of evidence concerning the impact of contracting economies on suicide mortality risk, far less is known about the role alcohol consumption plays in the complex relationship between economic conditions and suicide. The aims were to compare the postmortem alcohol intoxication rates among male and female suicide decedents before (2005-2007), during (2008-2009) and after (2010-2011) the economic contraction in the USA. METHODS Data from the restricted National Violent Death Reporting System (2005-2011) for male and female suicide decedents aged 20 years and older were analysed by Poisson regression analysis to test whether there was significant change in the fractions of suicide decedents who were acutely intoxicated at the time of death (defined as blood alcohol content ≥0.08 g/dL) prior, during and after the downturn. RESULTS The fraction of all suicide decedents with alcohol intoxication increased by 7% after the onset of the recession from 22.2% in 2005-2007 to 23.9% in 2008-2011. Compared with the years prior to the recession, male suicide decedents showed a 1.09-fold increased risk of alcohol intoxication within the first 2 years of the recession. Surprisingly, there was evidence of a lag effect among female suicide decedents, who had a 1.14-fold (95% CI 1.02 to 1.27) increased risk of intoxication in 2010-2011 compared with 2005-2007. CONCLUSIONS These findings suggest that acute alcohol intoxication in suicide interacts with economic conditions, becoming more prevalent during contractions.
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Affiliation(s)
- M S Kaplan
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, California, USA
| | - N Huguet
- Center for Public Health Studies, Portland State University, Portland, Oregon, USA
| | - R Caetano
- School of Public Health, University of Texas, Dallas, Texas, USA
| | - N Giesbrecht
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - W C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - B H McFarland
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
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Houle JN, Light MT. The home foreclosure crisis and rising suicide rates, 2005 to 2010. Am J Public Health 2014; 104:1073-9. [PMID: 24825209 PMCID: PMC4062039 DOI: 10.2105/ajph.2013.301774] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between state-level foreclosure and suicide rates from 2005 to 2010 and considered variation in the effect of foreclosure on suicide by age. METHODS We used hybrid random- and fixed-effects models to examine the relation between state foreclosure rates and total and age-specific suicide rates from 2005 to 2010 (n = 306 state-years). RESULTS Net of other factors, an increase in the within-state total foreclosure rate was associated with a within-state increase in the crude suicide rates (b = 0.04; P < .1), and effects were stronger for the real estate-owned foreclosure rate (b = 0.16; P < .05). Analysis of age-specific suicide rates indicated that the effects were strongest among the middle-aged (46-64 years: total foreclosure rate, b = 0.21; P < .001; real estate-owned foreclosure rate, b = 0.83; P < .001). Rising home foreclosure rates explained 18% of the variance in the middle-aged suicide rate between 2005 and 2010. CONCLUSIONS The foreclosure crisis has likely contributed to increased suicides, independent of other economic factors associated with the recession. Rising foreclosure rates may be partially responsible for the recent uptick in suicide among middle-aged adults.
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Affiliation(s)
- Jason N Houle
- At the time of the study, Jason N. Houle was with the University of Wisconsin-Madison. Michael T. Light is with the Department of Sociology, Purdue University, West Lafayette, IN
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Arcaya M, Glymour MM, Chakrabarti P, Christakis NA, Kawachi I, Subramanian SV. Effects of proximate foreclosed properties on individuals' systolic blood pressure in Massachusetts, 1987 to 2008. Circulation 2014; 129:2262-8. [PMID: 24891622 DOI: 10.1161/circulationaha.113.006205] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND No studies have examined the effects of local foreclosure activity on neighbors' blood pressure, despite the fact that spillover effects of nearby foreclosures include many known risk factors for increased blood pressure. We assessed the extent to which living near foreclosed properties is associated with subsequent systolic blood pressure (SBP) measurements. METHODS AND RESULTS We used 6590 geocoded observations collected from 1740 participants in the Framingham Offspring Cohort across 5 waves (1987-2008) of the Framingham Heart Study to create a longitudinal record of exposure to nearby foreclosure activity. We distinguished between real estate-owned foreclosures, which typically sit vacant, and foreclosures purchased by third-party buyers, which are generally put into productive use. Counts of lender-owned foreclosed properties within 100 m of participants' homes were used to predict measured SBP and odds of being hypertensive. We assessed whether self-reported alcoholic drinks per week and measured body mass index helped to explain the relationship between foreclosure activity and SBP. Each additional real estate-owned foreclosure located within 100 m of a participant's home was associated with an increase in SBP of 1.71 mm Hg (P=0.03; 95% confidence interval, 0.18-3.24) after adjustment for individual- and area-level confounders but not with odds of hypertension. The presence of foreclosures purchased by third-party buyers was not associated with SBP or with hypertension. Body mass index and alcohol consumption attenuated the effect of living near real estate-owned foreclosures on SBP in fully adjusted models. CONCLUSIONS Real estate-owned foreclosed properties may put nearby neighbors at risk for increased SBP, with higher alcohol consumption and body mass index partially mediating this relationship.
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Affiliation(s)
- Mariana Arcaya
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA (M.A., I.K., S.V.S.); Department of Epidemiology and Biostatistics, University of California-San Francisco School of Medicine (M.M.G.); Federal Reserve Bank of Boston, Boston, MA (P.C.); and Yale Institute for Network Science, Yale University, New Haven, CT (N.A.C.).
| | - M Maria Glymour
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA (M.A., I.K., S.V.S.); Department of Epidemiology and Biostatistics, University of California-San Francisco School of Medicine (M.M.G.); Federal Reserve Bank of Boston, Boston, MA (P.C.); and Yale Institute for Network Science, Yale University, New Haven, CT (N.A.C.)
| | - Prabal Chakrabarti
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA (M.A., I.K., S.V.S.); Department of Epidemiology and Biostatistics, University of California-San Francisco School of Medicine (M.M.G.); Federal Reserve Bank of Boston, Boston, MA (P.C.); and Yale Institute for Network Science, Yale University, New Haven, CT (N.A.C.)
| | - Nicholas A Christakis
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA (M.A., I.K., S.V.S.); Department of Epidemiology and Biostatistics, University of California-San Francisco School of Medicine (M.M.G.); Federal Reserve Bank of Boston, Boston, MA (P.C.); and Yale Institute for Network Science, Yale University, New Haven, CT (N.A.C.)
| | - Ichiro Kawachi
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA (M.A., I.K., S.V.S.); Department of Epidemiology and Biostatistics, University of California-San Francisco School of Medicine (M.M.G.); Federal Reserve Bank of Boston, Boston, MA (P.C.); and Yale Institute for Network Science, Yale University, New Haven, CT (N.A.C.)
| | - S V Subramanian
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA (M.A., I.K., S.V.S.); Department of Epidemiology and Biostatistics, University of California-San Francisco School of Medicine (M.M.G.); Federal Reserve Bank of Boston, Boston, MA (P.C.); and Yale Institute for Network Science, Yale University, New Haven, CT (N.A.C.)
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Althouse BM, Allem JP, Childers MA, Dredze M, Ayers JW. Population health concerns during the United States' Great Recession. Am J Prev Med 2014; 46:166-70. [PMID: 24439350 DOI: 10.1016/j.amepre.2013.10.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/31/2013] [Accepted: 10/14/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Associations between economic conditions and health are usually derived from cost-intensive surveys that are intermittently collected with nonspecific measures (i.e., self-rated health). PURPOSE This study identified how precise health concerns changed during the U.S. Great Recession analyzing Google search queries to identify the concern by the query content and their prevalence by the query volume. METHODS Excess health concerns were estimated during the Great Recession (December 2008 through 2011) by comparing the cumulative difference between observed and expected (based on linear projections from pre-existing trends) query volume for hundreds of individual terms. As performed in 2013, the 100 queries with the greatest excess were ranked and then clustered into themes based on query content. RESULTS The specific queries with the greatest relative excess were stomach ulcer symptoms and headache symptoms, respectively, 228% (95% CI=35, 363) and 193% (95% CI=60, 275) greater than expected. Queries typically involved symptomology (i.e., gas symptoms) and diagnostics (i.e., heart monitor) naturally coalescing into themes. Among top themes, headache queries were 41% (95% CI=3, 148); hernia 37% (95% CI=16, 142); chest pain 35% (95% CI=6, 313); and arrhythmia 32% (95% CI=3, 149) greater than expected. Pain was common with back, gastric, joint, and tooth foci, with the latter 19% (95% CI=4, 46) higher. Among just the top 100, there were roughly 205 million excess health concern queries during the Great Recession. CONCLUSIONS Google queries indicate that the Great Recession coincided with substantial increases in health concerns, hinting at how population health specifically changed during that time.
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Affiliation(s)
| | - Jon-Patrick Allem
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Matthew A Childers
- School of Public and International Affairs, University of Georgia, Athens, Georgia
| | - Mark Dredze
- Human Language Technology Center of Excellence, Johns Hopkins University Baltimore, Maryland
| | - John W Ayers
- Graduate School of Public Health, San Diego State University, San Diego, California.
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22
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Arcaya M, Glymour MM, Chakrabarti P, Christakis NA, Kawachi I, Subramanian SV. Effects of proximate foreclosed properties on individuals' weight gain in Massachusetts, 1987-2008. Am J Public Health 2013; 103:e50-6. [PMID: 23865706 DOI: 10.2105/ajph.2013.301460] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the extent to which living near foreclosed properties is associated with individuals' subsequent weight gain. METHODS We linked health and address information on 2068 Framingham Offspring Cohort members (7830 assessments) across 5 waves (1987-2008) to records of all Massachusetts foreclosures during that period. We used counts of lender-owned foreclosed properties within 100 meters of participants' homes to predict body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) and the odds of being overweight (BMI ≥ 25), adjusted for individual and area-level covariates. RESULTS Mean BMI increased from 26.6 in 1987-1991 to 28.5 in 2005-2008; overweight prevalence increased from 59.0% to 71.3%. Foreclosures were within 100 meters of 159 (7.8%) participants' homes on 187 occasions (1.8%), in 42 municipalities (21%). For each additional foreclosure, BMI increased by 0.20 units (95% confidence interval [CI] = 0.03, 0.36), and the odds ratio for being overweight associated with proximity to a foreclosure was 1.77 (95% CI = 1.02, 3.05). CONCLUSIONS We found a robust association between living near foreclosures and BMI, suggesting that neighbors' foreclosures may spur weight gain.
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Affiliation(s)
- Mariana Arcaya
- Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA.
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23
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Ayers JW, Althouse BM, Allem JP, Childers MA, Zafar W, Latkin C, Ribisl KM, Brownstein JS. Novel surveillance of psychological distress during the great recession. J Affect Disord 2012; 142:323-30. [PMID: 22835843 PMCID: PMC4670615 DOI: 10.1016/j.jad.2012.05.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 04/22/2012] [Accepted: 05/01/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Economic stressors have been retrospectively associated with net population increases in nonspecific psychological distress (PD). However, no sentinels exist to evaluate contemporaneous associations. Aggregate Internet search query surveillance was used to monitor population changes in PD around the United States' Great Recession. METHODS Monthly PD query trends were compared with unemployment, underemployment, homes in delinquency and foreclosure, median home value or sale prices, and S&P 500 trends for 2004-2010. Time series analyses, where economic indicators predicted PD one to seven months into the future, were performed in 2011. RESULT PD queries surpassed 1,000,000 per month, of which 300,000 may be attributable to the Great Recession. A one percentage point increase in mortgage delinquencies and foreclosures was associated with a 16% (95%CI, 9-24) increase in PD queries one-month, and 11% (95%CI, 3-18) four months later, in reference to a pre-Great Recession mean. Unemployment and underemployment had similar associations half and one-quarter the intensity. "Anxiety disorder", "what is depression", "signs of depression", "depression symptoms", and "symptoms of depression" were the queries exhibiting the strongest associations with mortgage delinquencies and foreclosures, unemployment or underemployment. Housing prices and S&P 500 trends were not associated with PD queries. LIMITATIONS A non-traditional measure of PD was used. It is unclear if actual clinically significant depression or anxiety increased during the Great Recession. Alternative explanations for strong associations between the Great Recession and PD queries, such as media, were explored and rejected. CONCLUSIONS Because the economy is constantly changing, this work not only provides a snapshot of recent associations between the economy and PD queries but also a framework and toolkit for real-time surveillance going forward. Health resources, clinician screening patterns, and policy debate may be informed by changes in PD query trends.
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Affiliation(s)
- John W Ayers
- Children's Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA.
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24
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Shah DV, McLeod DM, Rojas H, Sayre BG, Vraga E, Scholl RM, Jones C, Shaw A. Public broadcasting, media engagement, and 2-1-1: using mass communication to increase the use of social services. Am J Prev Med 2012; 43:S443-9. [PMID: 23157763 DOI: 10.1016/j.amepre.2012.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 08/15/2012] [Accepted: 08/29/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND The 2008-2009 subprime mortgage crisis was catastrophic, not only for the global economy but for families across the social spectrum. The resultant economic upheaval threatened the livelihoods, well-being, and health of many citizens, who were often unsure where to turn for help. At this critical juncture, public broadcasting stations worked to connect viewers to support resources through 2-1-1. PURPOSE This study was designed to evaluate the ability of public broadcasting to increase the use of information and referral services. METHODS Autoregressive integrated moving average (ARIMA) modeling and regression analysis document the relationship between public broadcasting initiatives and 2-1-1 call volume in 35 highly affected U.S. markets. Time-series data from St. Louis MO were collected and analyzed in 2008. Station-level data from across the nation were collected during 2009-2010 and analyzed in 2010. RESULTS ARIMA results show a distinct linkage between the timing and duration of Channel 9 in St. Louis MO (KETC) programming and a subsequent (approximately 400%) increase in 2-1-1 calls regarding financial services and assistance. Regression path analysis not only found evidence of this same effect nationally but also showed that differences in the broadcaster's orientation and approach mediated effects. Specifically, stations' orientations toward engagement were mediated through strong outreach strategies to increase 2-1-1 use. CONCLUSIONS This study documents the ability of public broadcasting to help citizens in need connect with social resources through 2-1-1 services. By focusing attention on the mortgage crisis and its attendant consequences, and by publicizing 2-1-1 services as a gateway to supportive resources, public broadcasters fostered linkages between those in need and social resources. Moreover, the level of a station's commitment to engaging citizens had a strong bearing on the success of its programming initiatives and community partnerships with organizations such as 2-1-1.
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Affiliation(s)
- Dhavan V Shah
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA.
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25
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Burgard SA, Seefeldt KS, Zelner S. Housing instability and health: Findings from the Michigan recession and recovery study. Soc Sci Med 2012; 75:2215-24. [PMID: 22981839 DOI: 10.1016/j.socscimed.2012.08.020] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 07/17/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
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Menzel NN, Moonie S, Thompson-Robinson M. Health Effects Associated with Foreclosure: A Secondary Analysis of Hospital Discharge Data. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/740731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods. We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between 2005 and 2008. There was a marked spike in bipolar and depressive disorders in 2007 in all zip codes. Conclusions. The sharp rise for bipolar and depressive disorders in 2007 coincides with the doubling of foreclosure filings nationally. There are many confounding factors affecting hospital discharge data, which limit its specificity for assessing the health effects of foreclosure.
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Affiliation(s)
- Nancy N. Menzel
- School of Nursing, University of Nevada, Las Vegas, 4505 South Maryland Parkway, P.O. Box 453018, Las Vegas, NV 89154-3018, USA
| | - Sheniz Moonie
- School of Community Health Sciences, University of Nevada, Las Vegas, NV 89154-3063, USA
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Osypuk TL, Caldwell CH, Platt RW, Misra DP. The consequences of foreclosure for depressive symptomatology. Ann Epidemiol 2012; 22:379-87. [PMID: 22625995 DOI: 10.1016/j.annepidem.2012.04.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 04/04/2012] [Accepted: 04/15/2012] [Indexed: 11/17/2022]
Abstract
PURPOSE We tested whether experiencing the stressful event of a home mortgage foreclosure was associated with depressive symptomatology. METHODS Data derive from a cohort study of 662 new mothers in the Life-course Influences on Fetal Environment (LIFE) Study. Eligibility included black/African-American mothers, ages 18 to 45 years, who had just given birth to a singleton baby. Mothers enrolled June 2009 to December 2010 were interviewed immediately after giving birth. Our outcome measure was depressive symptoms based on the Center for Epidemiologic Studies-Depression Scale, dichotomized to measure severe depressive symptomatology during the week prior to the interview. RESULTS A total of 8% of the sample experienced foreclosure in the past 2 years. Covariate-adjusted Poisson regression models showed that women experiencing a recent foreclosure had 1.76 times greater risk for severe depressive symptoms during the week prior to birth compared to women not experiencing foreclosure (95% confidence interval 1.25-2.47, p = .001); foreclosure was also associated with higher excess absolute risk for depressive symptoms (adjusted risk difference 0.173, 95% confidence interval 0.044-0.301, p = .008). CONCLUSIONS Women who have recently experienced foreclosure are at risk for severe depressive symptoms. The mental health needs of pregnant women experiencing foreclosure or other housing stressors should be considered in clinical practice.
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Affiliation(s)
- Theresa L Osypuk
- Department of Health Sciences, Northeastern University, Bouve College of Health Sciences, Boston, MA, 02115, USA.
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McLaughlin KA, Nandi A, Keyes KM, Uddin M, Aiello AE, Galea S, Koenen KC. Home foreclosure and risk of psychiatric morbidity during the recent financial crisis. Psychol Med 2012; 42:1441-1448. [PMID: 22099861 PMCID: PMC3438142 DOI: 10.1017/s0033291711002613] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A defining feature of the US economic downturn of 2008-2010 was the alarming rate of home foreclosure. Although a substantial number of US households have experienced foreclosure since 2008, the effects of foreclosure on mental health are unknown. We examined the effects of foreclosure on psychiatric symptomatology in a prospective, population-based community survey. METHOD Data were drawn from the Detroit Neighborhoods and Health Study (DNHS), waves 1 and 2 (2008-2010). A probability sample of predominantly African-American adults in Detroit, Michigan participated (n=1547). We examined the association between home foreclosure between waves 1 and 2 and increases in symptoms of DSM-IV major depression and generalized anxiety disorder (GAD). RESULTS The most common reasons for foreclosure were an increase in monthly payments, an increase in non-medical expenses and a reduction in family income. Exposure to foreclosure between waves 1 and 2 predicted symptoms of major depression and GAD at wave 2, controlling for symptoms at wave 1. Even after adjusting for wave 1 symptoms, sociodemographics, lifetime history of psychiatric disorder at wave 1 and exposure to other financial stressors between waves 1 and 2, foreclosure was associated with an increased rate of symptoms of major depression [incidence density ratio (IDR) 2.4, 95% confidence interval (CI) 1.6-3.6] and GAD (IDR 1.9, 95% CI 1.4-2.6). CONCLUSIONS We provide the first prospective evidence linking foreclosure to the onset of mental health problems. These results, combined with the high rate of home foreclosure since 2008, suggest that the foreclosure crisis may have adverse effects on the mental health of the US population.
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Affiliation(s)
- K A McLaughlin
- Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
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Alley DE, Lloyd J, Pagán JA, Pollack CE, Shardell M, Cannuscio C. Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years. Am J Public Health 2011; 101:2293-8. [PMID: 22021301 DOI: 10.2105/ajph.2011.300245] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES We evaluated associations between mortgage delinquency and changes in health and health-relevant resources over 2 years, with data from the Health and Retirement Study, a longitudinal survey representative of US adults older than 50 years. METHODS In 2008, participants reported whether they had fallen behind on mortgage payments since 2006 (n = 2474). We used logistic regression to compare changes in health (incidence of elevated depressive symptoms, major declines in self-rated health) and access to health-relevant resources (food, prescription medications) between participants who fell behind on their mortgage payments and those who did not. RESULTS Compared with nondelinquent participants, the mortgage-delinquent group had worse health status and less access to health-relevant resources at baseline. They were also significantly more likely to develop incident depressive symptoms (odds ratio [OR] = 8.60; 95% confidence interval [CI] = 3.38, 21.85), food insecurity (OR = 7.53; 95% CI = 3.01, 18.84), and cost-related medication nonadherence (OR = 8.66; 95% CI = 3.72, 20.16) during follow-up. CONCLUSIONS Mortgage delinquency was associated with significant elevations in the incidence of mental health impairments and health-relevant material disadvantage. Widespread mortgage default may have important public health implications.
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Affiliation(s)
- Dawn E Alley
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA.
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Huang J. Work Disability, Mortgage Default, and Life Satisfaction in the Economic Downturn. JOURNAL OF DISABILITY POLICY STUDIES 2011. [DOI: 10.1177/1044207311410428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study examined the relationship between work disability and mortgage default in the latest economic downturn in the United States and further assessed the associations of work disability and mortgage default with life satisfaction. Work disability was measured by self-reported health-related work limitations. Mortgage default was defined as delaying home mortgage payment for more than 30 days in the study. The data were obtained from the 2007 and 2009 Panel Study of Income Dynamics, and logistic regression was used to test research questions. Of the 2,361 homeowners who had a mortgage, nearly 6% had mortgage default in 2009, and 14.5% of householders or their spouses had work disabilities in 2007. The disability group was significantly more likely than the non-disability group to have mortgage default, AOR = 1.80, 95% CI = (1.02, 3.16). Both work disability and mortgage default had significant and negative associations with life satisfaction. Results suggest that mortgage assistance services should be provided for individuals with work disabilities and their families to prevent housing distress and improve quality of life.
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Affiliation(s)
- Jin Huang
- Washington University, St. Louis, MO, USA
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Abstract
Though rates of foreclosure are at a historic high, relatively little is known about the link between foreclosure and health. We performed a case-control study to examine health conditions and health care utilization in the time period prior to foreclosure. Homeowners who received a home foreclosure notice from 2005 to 2008 were matched (by name and address) to a university hospital system in Philadelphia and compared with controls who received care from the hospital system and who lived in the same zip code as cases. Outcome measures included prevalent health conditions and visit history in the 2 years prior to foreclosure. We found that people undergoing foreclosure were similar to controls with regard to age, gender, and insurance status but significantly more likely to be African American. Rates of hypertension and renal disease were significantly higher among cases after adjustment for sociodemographic characteristics. In the 2 years prior to foreclosure, cases were more likely to visit the emergency department, have an outpatient visit, and have a no-show appointment. Cases were less likely to have a primary care physicians (PCP) visit in the 6 months immediately prior to the receipt of a foreclosure notice. The results suggest changes in health care utilization in the time period prior to foreclosure. Policies designed to decrease the incidence of home foreclosure and support people during the process should consider its association with poor health and changes in health care utilization.
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Neighborhood foreclosures and self-rated health among breast cancer survivors. Qual Life Res 2011; 21:133-41. [PMID: 21590510 DOI: 10.1007/s11136-011-9929-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE We determined the association of neighborhood foreclosure risk on the health status of a statewide sample of breast cancer survivors (n = 1047) and the extent to which covariates accounted for observed associations. METHODS Measures of self-rated health and several covariates were obtained by telephone interview 1 year after diagnosis. We used the federal Housing and Urban Development agency's estimated census-tract foreclosure-abandonment-risk score and multilevel, logistic regression to determine the association of foreclosure risk (high, moderate versus low) with self-rated health (fair-poor versus good, very good, excellent) and whether covariates could explain the observed association. RESULTS Women who resided in high-foreclosure-risk (HFR) areas were 2.39 times (95% CI: 1.83-3.13) more likely to report being in fair-poor health than women who lived in low-foreclosure-risk areas. The odds ratio (OR) was reduced for women who lived in high-foreclosure-risk versus low-foreclosure-risk areas after adjusting for income (HFR OR: 1.78; 95% CI: 1.01-3.15), physical activity (HFR OR: 1.74; 95% CI: 0.98-3.08), and perceived neighborhood conditions (HFR OR: 1.76; 95% CI: 1.02-3.05). CONCLUSIONS Breast cancer survivors who lived in census tracts with high- versus low-foreclosure risk reported poorer health status. This association was explained by differences in household income, physical activity, and perceived neighborhood conditions.
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