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英国家庭居住类型及其与东伦敦劳动年龄成年人多种长期疾病的相关性:利用初级保健和地方政府记录进行的横断面分析。

Household Tenure and Its Associations with Multiple Long-Term Conditions amongst Working-Age Adults in East London: A Cross-Sectional Analysis Using Linked Primary Care and Local Government Records.

机构信息

Department of Applied Health Research, University College London, London WC1E 7HB, UK.

London Boroughs of Camden and Islington, London N1 1XR, UK.

出版信息

Int J Environ Res Public Health. 2022 Mar 31;19(7):4155. doi: 10.3390/ijerph19074155.

Abstract

Multiple long-term conditions (MLTCs) are influenced in extent and nature by social determinants of health. Few studies have explored associations between household tenure and different definitions of MLTCs. This study aimed to examine associations between household tenure and MLTCs amongst working-age adults (16 to 64 years old, inclusive). This cross-sectional study used the 2019−2020 wave of an innovative dataset that links administrative data across health and local government for residents of a deprived borough in East London. Three definitions of MLTCs were operationalised based on a list of 38 conditions. Multilevel logistic regression models were built for each outcome and adjusted for a range of health and sociodemographic factors. Compared to working-age owner-occupiers, odds of basic MLTCs were 36% higher for social housing tenants and 19% lower for private renters (OR 1.36; 95% CI 1.30−1.42; p < 0.001 and OR 0.81, 95% CI 0.77−0.84, p < 0.001, respectively). Results were consistent across different definitions of MLTCs, although associations were stronger for social housing tenants with physical-mental MLTCs. This study finds strong evidence that household tenure is associated with MLTCs, emphasising the importance of understanding household-level determinants of health. Resources to prevent and tackle MLTCs among working-age adults could be differentially targeted by tenure type.

摘要

多种长期疾病(MLTCs)在很大程度上受到健康的社会决定因素的影响。很少有研究探讨家庭所有权与不同 MLTCs 定义之间的关联。本研究旨在探讨工作年龄段成年人(16 至 64 岁,含)中家庭所有权与 MLTCs 之间的关联。这项横断面研究使用了一个创新数据集的 2019-2020 年波次,该数据集将健康和地方政府的行政数据链接在一起,用于伦敦东部一个贫困行政区的居民。根据一份包含 38 种疾病的清单,对三种 MLTCs 定义进行了操作化。为每个结果构建了多水平逻辑回归模型,并调整了一系列健康和社会人口因素。与工作年龄段的自有住房者相比,社会住房租户基本 MLTCs 的可能性高 36%,私人租户的可能性低 19%(OR 1.36;95%CI 1.30-1.42;p<0.001 和 OR 0.81,95%CI 0.77-0.84,p<0.001)。结果在不同的 MLTCs 定义中是一致的,尽管社会住房租户的身体-精神 MLTCs 关联更强。本研究发现强有力的证据表明,家庭所有权与 MLTCs 相关,强调了理解家庭层面健康决定因素的重要性。针对工作年龄段成年人预防和解决 MLTCs 的资源可以根据所有权类型进行有区别的靶向。

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