Housing and Urban Research Institute, Alpharetta, GA, USA.
Georgia Institute of Technology, Atlanta, GA, USA.
J Racial Ethn Health Disparities. 2022 Dec;9(6):2451-2467. doi: 10.1007/s40615-021-01181-7. Epub 2021 Nov 26.
While a number of studies have observed the effects of housing instability on health outcomes, fewer have emphasized pre-existing socioeconomic disparities in health and the influence of housing instability on subsequent health outcomes in the wake of the economic recession. Using national data on six adult health indictors and foreclosure data aggregated by census tract, this study examines the association between neighborhood housing insecurity and health outcomes, particularly focusing on various income levels and racial groups in about 200 U.S. metropolitan areas after the 2008 housing crisis. Results suggest that high levels of housing instability induced by high levels of foreclosed properties in certain neighborhoods were strongly associated with more health problems among residents, but the results varied according to the income level and the dominant racial group in these neighborhoods. With regard to income levels, adverse health conditions in lower income neighborhoods remained longer and became stronger than those in higher income neighborhoods. The findings also show variation among racial groups: While multiple health problems plagued all income levels in white tracts, more severe and worsening pre-existing health problems appeared in lower income minority tracts. In addition, neighborhood housing instability generated by mortgage foreclosures was strongly associated with heart-related diseases, particularly in middle-income White neighborhoods, and mental health problems, particularly in upper-income Hispanic tracts. Finally, among multiple health indicators, mental health problems were the most common health conditions during the U.S. economic recession. In light of the socioeconomic disparities in health, policy makers should establish effective policy tools that integrate health and urban and housing planning.
虽然许多研究都观察到住房不稳定对健康结果的影响，但较少强调健康方面先前存在的社会经济差异，以及经济衰退后住房不稳定对随后健康结果的影响。本研究利用全国关于六个成人健康指标的数据和按普查地段汇总的丧失抵押品赎回权数据，考察了邻里住房不安全与健康结果之间的关系，特别是在 2008 年住房危机之后，关注了美国约 200 个大都市区的不同收入水平和种族群体。研究结果表明，某些社区被取消赎回权的房产数量较高导致的住房高度不稳定，与居民中出现更多健康问题密切相关，但结果因这些社区的收入水平和主导种族群体而异。关于收入水平，较低收入社区的不利健康状况持续时间更长，且比较高收入社区的更严重。研究结果还显示出不同种族群体之间的差异：虽然多种健康问题困扰着白人地段的所有收入水平，但在较低收入的少数族裔地段，先前存在的健康问题更为严重且恶化。此外，抵押贷款丧失赎回权导致的邻里住房不稳定与心脏病，特别是中高收入白人社区的心脏病，以及心理健康问题，特别是高收入西班牙裔社区的心理健康问题密切相关。最后，在多种健康指标中，心理健康问题是美国经济衰退期间最常见的健康状况。鉴于健康方面存在社会经济差异，政策制定者应制定有效的政策工具，将健康与城市和住房规划结合起来。
