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识别与老年人近期住房不稳定相关的已确诊主要慢性病:来自“我们所有人”研究项目的数据。

Identifying diagnosed major chronic diseases associated with recent housing instability among aging adults: data from the 'All of Us' research program.

作者信息

Beydoun Hind A, Mayno Vieytes Christian A, Beydoun May A, Lampros Austin, Tsai Jack

机构信息

National Center on Homelessness among Veterans (NCHAV), Veterans Health Administration, U.S. Department of Veterans Affairs, 810 Vermont Ave NW, Washington, DC 20420, USA.

Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St., Houston, TX 77030, USA.

出版信息

J Public Health (Oxf). 2025 Feb 28;47(1):15-23. doi: 10.1093/pubmed/fdae300.

Abstract

BACKGROUND

Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults.

METHODS

Cross-sectional data on 147 465 participants of the 'All of Us' Research Program (6 May 2018-1 July 2022), ≥50 years of age at enrollment, were analyzed. Self-reported housing instability over the past 6 months was examined in relation to diagnosed conditions at age ≥50 years based on electronic health records. Multivariable logistic regression models sequentially adjusting for demographic and socioeconomic characteristics were constructed to estimate odds ratios (OR) with their 95% confidence intervals (CI).

RESULTS

After adjusting for confounders, past 6 months housing instability was associated with lower odds of diagnosed cardiovascular disease (OR = 0.89, 95% CI: 0.87, 0.93) and cancer (OR = 0.82, 95% CI: 0.78, 0.86), higher odds of diagnosed psychiatric (OR = 1.35, 95% CI: 1.30, 1.40) conditions, but was unrelated to diagnosed diabetes (OR = 0.98, 95% CI: 0.94, 1.01).

CONCLUSIONS

Recent housing instability among aging adults is positively associated with psychiatric diagnoses, but negatively associated with cardiovascular and cancer diagnoses, with implications for chronic disease prevention.

摘要

背景

住房不稳定是医疗保健利用的一个已知障碍,可能影响不同成年人群体中慢性病的预防、诊断和治疗。我们研究了近期住房不稳定与老年成年人中普遍存在的心血管疾病、糖尿病、癌症和精神疾病诊断之间的交叉关系。

方法

分析了“我们所有人”研究计划(2018年5月6日至2022年7月1日)中147465名年龄≥50岁参与者的横断面数据。根据电子健康记录,研究了过去6个月自我报告的住房不稳定情况与≥50岁时确诊疾病的关系。构建了依次调整人口统计学和社会经济特征的多变量逻辑回归模型,以估计优势比(OR)及其95%置信区间(CI)。

结果

在调整混杂因素后,过去6个月的住房不稳定与确诊心血管疾病(OR = 0.89,95% CI:0.87,0.93)和癌症(OR = 0.82,95% CI:0.78,0.86)的较低几率相关,与确诊精神疾病(OR = 1.35,95% CI:1.30,1.40)的较高几率相关,但与确诊糖尿病(OR = 0.98,95% CI:0.94,1.01)无关。

结论

老年成年人近期的住房不稳定与精神疾病诊断呈正相关,但与心血管疾病和癌症诊断呈负相关,这对慢性病预防具有启示意义。

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