Novick Tessa K, Kushel Margot, Crews Deidra
Division of Nephrology, University of Texas at Austin, Dell Medical School, Austin, TX.
Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA.
Kidney Med. 2022 Mar 7;4(4):100443. doi: 10.1016/j.xkme.2022.100443. eCollection 2022 Apr.
Stable housing is essential for health. Over 580,000 Americans experienced homelessness during one night in 2020, and over 37 million households spend over 30% of their income on housing. Unstable housing has been associated with mortality, acute care utilization, communicable and non-communicable diseases, a higher risk of kidney disease, and kidney disease progression. In this review, we define various forms of unstable housing, provide an overview of the interaction between unstable housing and health, and discuss existing evidence associating housing and kidney disease. We provide historical context for unstable housing in the United States, and detail policy, community, and individual-level factors that contribute to the risk of unstable housing. Unstable housing likely affects kidney health via a complex interplay of individual and structural factors. Various screening tools are available for use by providers. Special considerations should be made when working with individuals experiencing unstable housing to meet their unique needs, facilitate health care engagement, and optimize outcomes. Housing interventions have been shown to improve outcomes and should be examined for their role in kidney disease.
稳定的住房对健康至关重要。2020年的某一晚，超过58万美国人无家可归，超过3700万户家庭将其收入的30%以上用于住房支出。住房不稳定与死亡率、急性医疗服务利用、传染病和非传染病、更高的肾病风险以及肾病进展相关。在本综述中，我们定义了各种形式的住房不稳定，概述了住房不稳定与健康之间的相互作用，并讨论了将住房与肾病联系起来的现有证据。我们提供了美国住房不稳定的历史背景，并详细阐述了导致住房不稳定风险的政策、社区和个人层面的因素。住房不稳定可能通过个体因素和结构因素的复杂相互作用影响肾脏健康。提供者可以使用各种筛查工具。在为住房不稳定的个体提供服务时，应特别考虑满足他们的独特需求、促进医疗保健参与并优化结果。住房干预已被证明能改善结果，应研究其在肾病中的作用。
