National Clinician Scholars Program at UCLA (University of California, Los Angeles), 1100 Glendon Avenue, Suite 900, Los Angeles, CA, 90024, USA.
Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
J Gen Intern Med. 2023 Sep;38(12):2718-2725. doi: 10.1007/s11606-023-08228-x. Epub 2023 May 25.
US housing policy places a high priority on homeownership, providing large homeowner subsidies that are justified in part by homeownership's purported health benefits. However, studies conducted before, during, and immediately after the 2007-2010 foreclosure crisis found that while homeownership is associated with better health-related outcomes for White households, that association is weaker or non-existent for African-American and Latinx households. It is not known whether those associations persist in the period since the foreclosure crisis changed the US homeownership landscape.
To examine the relationship between homeownership and health and whether that relationship differs by race/ethnicity in the period since the foreclosure crisis.
We conducted a cross-sectional analysis of 8 waves (2011-2018) of the California Health Interview Survey (n = 143,854, response rate 42.3 to 47.5%).
We included all US citizen respondents ages 18 and older.
The primary predictor variable was housing tenure (homeownership or renting). The primary outcomes were self-rated health, psychological distress, number of health conditions, and delays in receiving necessary medical care and/or medications.
Compared to renting, homeownership is associated with lower rates of reporting fair or poor health (OR = 0.86, P < 0.001), fewer health conditions (incidence rate ratio = 0.95, P = 0.03), and fewer delays in receiving medical care (OR = 0.81, P < 0.001) and medication (OR = 0.78, P < 0.001) for the overall study population. Overall, race/ethnicity was not a significant moderator of these associations in the post-crisis period.
Homeownership has the potential to provide significant health-related benefits to minoritized communities, but this potential may be threatened by practices of racial exclusion and predatory inclusion. Further study is needed to elucidate health-promoting mechanisms within homeownership as well as potential harms of specific homeownership-promoting policies to develop healthier, more equitable housing policy.
美国的住房政策高度重视住房拥有率，为住房所有者提供大量补贴，部分原因是住房拥有率据称对健康有益。然而，在 2007-2010 年止赎危机之前、期间和之后进行的研究发现，虽然住房拥有率与白人家庭的健康相关结果更好相关，但这种关联在非裔美国人和拉丁裔家庭中较弱或不存在。目前尚不清楚在止赎危机改变了美国住房拥有率的背景下，这些关联是否仍然存在。
检查住房拥有率与健康之间的关系，以及在止赎危机之后的时期，这种关系是否因种族/民族而异。
我们对加利福尼亚健康访谈调查的 8 个波次（2011-2018 年）进行了横断面分析（n=143854，响应率为 42.3%至 47.5%）。
我们纳入了所有 18 岁及以上的美国公民受访者。
主要预测变量是住房保有情况（住房拥有或租房）。主要结果是自我评估的健康状况、心理困扰、健康状况数量以及接受必要医疗保健和/或药物的延迟。
与租房相比，住房拥有率与报告健康状况不佳或较差的比例较低（OR=0.86，P<0.001）、健康状况较少（发病率比=0.95，P=0.03）、接受医疗保健和/或药物的延迟较少（OR=0.81，P<0.001）和药物（OR=0.78，P<0.001），这是整个研究人群的结果。总体而言，种族/民族在危机后时期并不是这些关联的重要调节因素。
住房拥有率有可能为少数族裔社区带来重大的与健康相关的益处，但这种潜力可能受到种族排斥和掠夺性包容的做法的威胁。需要进一步研究阐明住房拥有率内的健康促进机制以及特定住房拥有率促进政策的潜在危害，以制定更健康、更公平的住房政策。
