Kersten Ellen E, LeWinn Kaja Z, Gottlieb Laura, Jutte Douglas P, Adler Nancy E
Ellen E. Kersten (
Kaja Z. LeWinn is an assistant professor of psychiatry at the University of California, San Francisco.
Health Aff (Millwood). 2014 Dec;33(12):2230-7. doi: 10.1377/hlthaff.2014.1021.
Understanding the links between housing and health is increasingly important. Poor housing quality is a predictor of poor health and developmental problems in low-income children. We examined associations between public housing type and recurrent pediatric emergency and urgent care hospital visits. Children ages 0-18 with public insurance who sought emergency care from any of three large medical systems in San Francisco were categorized by whether they lived in public housing redeveloped through the federal HOPE VI program, nonredeveloped public housing, or nonpublic housing in a census tract that also contained public housing. After we adjusted for potential confounding characteristics, we found that children living in nonredeveloped public housing were 39 percent more likely to have one or more repeat visits within one year for acute health care services unrelated to the initial visit, compared to children who lived in redeveloped HOPE VI housing. We observed no differences in repeat visits between children in redeveloped HOPE VI housing and those in nonpublic housing. These findings support the continued redevelopment of public housing as a means of both improving the health of vulnerable high-risk children from low-income neighborhoods and reducing health care costs.
了解住房与健康之间的联系变得越来越重要。住房质量差是低收入儿童健康状况不佳和发育问题的一个预测指标。我们研究了公共住房类型与儿科反复急诊和紧急护理医院就诊之间的关联。在旧金山的三个大型医疗系统中寻求急诊护理的0至18岁有公共保险的儿童，根据他们是居住在通过联邦希望六号计划重新开发的公共住房、未重新开发的公共住房还是普查区中也包含公共住房的非公共住房进行分类。在我们对潜在的混杂特征进行调整后，我们发现，与居住在希望六号重新开发住房中的儿童相比，居住在未重新开发公共住房中的儿童在一年内因与初次就诊无关的急性医疗服务而进行一次或多次复诊的可能性要高39%。我们观察到希望六号重新开发住房中的儿童与非公共住房中的儿童在复诊方面没有差异。这些发现支持继续对公共住房进行重新开发，以此作为改善低收入社区弱势高风险儿童健康状况和降低医疗成本的一种方式。
