College of Nursing, 2650University of Cincinnati, OH, USA.
James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, OH, USA.
J Child Health Care. 2021 Dec;25(4):603-615. doi: 10.1177/1367493520975956. Epub 2021 Jan 27.
Housing is considered a core social determinant of health (SDH) through mechanisms such as the quality, affordability, and location of the home. However, few nationally representative studies examine these mechanisms simultaneously with child health and healthcare use. To determine the associations between home quality and child health, a series of logistic regression analyses was employed using the Survey of Income and Program Participation (SIPP). The 2014 SIPP sample is a multistage, stratified sample of 53,070 housing units from 820 sample areas designed to represent the civilian, noninstitutionalized population of the United States. The analytic sample included 12,964 children aged 2-14 years. Poor housing quality was defined as whether the home had holes in the floor, cracks in the ceiling, plumbing issues, and/or pest problems. Outcome measures included child health status, number of medical visits, and hospitalizations. The results indicated that poor housing quality was associated with poorer health (OR = 1.16, 95% CI = 1.05-1.27) and a greater number of medical visits (OR = 1.11, 95% CI = 1.03, 1.20) after controlling for number of persons per household, neighborhood safety, nonmetropolitan status, parent's ability to afford housing-related expenses, and other SDH. Future work investigating and intervening on the SDH in children could specifically include the quality and contexts in which homes are situated.
住房被认为是健康的核心社会决定因素(SDH)之一,其作用机制包括住房的质量、可负担性和位置等。然而,很少有全国性的代表性研究同时考察这些机制与儿童健康和医疗保健利用之间的关系。为了确定住房质量与儿童健康之间的关联,本研究采用了一系列逻辑回归分析,使用了收入和计划参与调查(SIPP)。2014 年的 SIPP 样本是一个多阶段、分层的样本,由 820 个抽样区域的 53070 个住房单元组成,旨在代表美国的平民、非机构化人口。分析样本包括 12964 名 2-14 岁的儿童。住房质量差的定义是指房屋的地板有洞、天花板有裂缝、管道问题和/或害虫问题。结果指标包括儿童的健康状况、就诊次数和住院次数。结果表明,在控制家庭人口数量、社区安全状况、非都市状态、父母支付住房相关费用的能力以及其他 SDH 后,住房质量差与较差的健康状况(OR=1.16,95%CI=1.05-1.27)和更多的就诊次数(OR=1.11,95%CI=1.03,1.20)相关。未来对儿童 SDH 进行调查和干预的工作可以特别包括住房质量和所处环境。