Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.
Prev Chronic Dis. 2023 Nov 30;20:E111. doi: 10.5888/pcd20.230144.
Housing insecurity is associated with poor health outcomes. Characterization of chronic disease outcomes among adults with and without housing assistance would enable housing programs to better understand their population's health care needs.
We used National Health and Nutrition Examination Survey (NHANES) data from 2005 through 2018 linked to US Department of Housing and Urban Development (HUD) administrative records to estimate the prevalence of obesity, diabetes, and hypertension and to assess the independent associations between housing assistance and chronic conditions among adults receiving HUD assistance and HUD-assistance-eligible adults not receiving HUD assistance at the time of their NHANES examination. We estimated propensity scores to adjust for potential confounders among linkage-eligible adults who had an income-to-poverty ratio less than 2 and were not receiving HUD assistance. Sensitivity analysis used 2013-2018 NHANES cycles to account for disability status.
Adults not receiving HUD assistance had a significantly lower adjusted prevalence of obesity (42.1%; 95% CI, 40.4%-43.8%) compared with adults receiving HUD assistance (47.5%; 95% CI, 44.8%-50.3%), but we found no differences for diabetes and hypertension. We found significant associations between housing assistance and obesity (adjusted odds ratio = 1.29; 95% CI, 1.12-1.47), but these were not significant in the sensitivity analysis with and without controlling for disability status. We found no significant associations between housing assistance and diabetes or hypertension.
Based on data from a cross-sectional survey, we observed a higher prevalence of obesity among adults with HUD assistance compared with HUD-assistance-eligible adults without HUD assistance. Results from this study can help inform research on understanding the prevalence of chronic disease among adults with HUD assistance.
住房无保障与健康状况不佳有关。描述有住房援助和无住房援助的成年人的慢性病结果，将使住房计划能够更好地了解其人群的医疗保健需求。
我们使用了 2005 年至 2018 年的国家健康和营养检查调查（NHANES）数据，并将其与美国住房和城市发展部（HUD）的行政记录相关联，以估计肥胖、糖尿病和高血压的患病率，并评估在接受 HUD 援助的成年人和在 NHANES 检查时未接受 HUD 援助但有资格获得 HUD 援助的成年人中，住房援助与慢性疾病之间的独立关联。我们估计了倾向得分，以调整符合链接条件的成年人中潜在的混杂因素，这些成年人的收入与贫困比率低于 2 倍，且未接受 HUD 援助。敏感性分析使用了 2013-2018 年的 NHANES 周期，以考虑残疾状况。
未接受 HUD 援助的成年人的肥胖症调整后患病率明显较低（42.1%；95%CI，40.4%-43.8%），而接受 HUD 援助的成年人的肥胖症患病率为 47.5%（95%CI，44.8%-50.3%），但我们发现糖尿病和高血压没有差异。我们发现住房援助与肥胖之间存在显著关联（调整后的优势比=1.29；95%CI，1.12-1.47），但在敏感性分析中，无论是否控制残疾状况，这些关联均不显著。我们发现住房援助与糖尿病或高血压之间没有显著关联。
基于横断面调查的数据，我们观察到接受 HUD 援助的成年人中肥胖症的患病率高于有资格但未接受 HUD 援助的成年人。本研究结果有助于了解 HUD 援助成年人慢性病的患病率。
