Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD 21287, USA.
J Urban Health. 2011 Jun;88(3):469-78. doi: 10.1007/s11524-011-9564-7.
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.
尽管止赎率处于历史高位，但人们对止赎与健康之间的联系知之甚少。我们进行了一项病例对照研究，以检查在止赎前的时间段内的健康状况和医疗保健利用情况。2005 年至 2008 年间收到房屋止赎通知的房主与费城的一家大学医院系统进行了匹配（按姓名和地址），并与从该医院系统接受治疗且居住在与病例相同邮政编码区域的对照组进行了比较。结果衡量指标包括在止赎前的 2 年内普遍存在的健康状况和就诊史。我们发现，与对照组相比，正在经历止赎的人在年龄、性别和保险状况方面相似，但他们更有可能是非洲裔美国人。在调整社会人口特征后，高血压和肾脏疾病的发病率在病例中明显更高。在止赎前的 2 年内，病例更有可能去急诊室就诊、进行门诊就诊和预约但未出现。在收到止赎通知前的 6 个月内，病例接受初级保健医生（PCP）就诊的可能性较小。结果表明，在止赎前的时间段内，医疗保健的利用情况发生了变化。旨在降低房屋止赎发生率并在这一过程中为人们提供支持的政策应考虑其与健康状况不佳和医疗保健利用变化之间的关系。
