03/03/2023
By Maureen Martin

The Zuckerberg College of Health Sciences, Solomont School of Nursing, invites you to attend a doctoral dissertation defense by Mary (Beth) Kantz on " The Relationship between Health and Housing in Low-Income Older Adults."

Date: Friday, March 17, 2023
Time: 3 to 6 p.m.
Location: This will be a virtual defense via Zoom. Those interested in attending should email Mary_Kantz@student.uml.edu and committee Chair Comfort_Enah@uml.edu at least 24 hours prior to the defense to request access to the meeting.

Committee Chair: Comfort Enah, Ph.D., RN, FAAN, Donna Manning Endowed Chair, Associate Professor, Solomont School of Nursing, University of Massachusetts, Lowell

Committee Members:

  • Lisa Abdallah, Ph.D., RN, FAAN, Professor, Solomont School of Nursing, University of Massachusetts Lowell
  • Jason Rydberg, Ph.D., Associate Professor, College of Fine Arts, Humanities and Social Sciences, University of Massachusetts Lowell

Abstract:
Background: Housing and neighborhood are key social determinants of health and have been linked to health problems ranging from infectious disease to depression. Marginalized groups are more likely to experience housing problems due to societal and structural barriers that restrict access to financial and social resources. Low-income older adults are especially vulnerable due to their heightened risk for poor health, and economic constraints that limit their ability to secure affordable, good quality housing. Despite these vulnerabilities, research examining the relationship between housing and the health of low-income older adults is limited.

Aim: To examine the relationship between health and housing in low-income older adults.

Method: This study involved a secondary analysis of longitudinal survey data collected in 2014-2017 for the Survey of Income and Program Participation (SIPP) conducted by the U.S. Census Bureau. The social ecological model was used as a framework for the study and guided the development of research questions and approach to analysis. The study sample consisted of 10,858 adults 62 and older who were enrolled in the SIPP at baseline and completed at least one wave of data collection (n=37,333 observations). The household income-to-poverty ratio was used to categorize participants as low-income or higher-income older adults. Baseline statistics were computed for the full sample and subsamples of interest. Hierarchical logistic regression was used to evaluate the relationship between self-rated health and variables representing housing quality, affordability, stability, and neighborhood in low-income older adults, and evaluate whether the relationship was different in higher-income older adults, and low-income older adults who did and did not receive housing assistance.

Results: The mean age of the study sample at baseline was 72.0 years; 55.4% were female, and 16.2% were non-white. Compared to higher-income older adults, a significantly (p<.001) greater percentage of low-income older adults were non-White; rated their health fair or poor; and reported problems with housing quality, paying the rent/mortgage or utilities, and neighborhood safety. In both the low-income and higher-income groups, housing quality problems, increased household size, and living in an unsafe neighborhood were associated with significantly greater odds of poor health. Comparisons of low-income older adults who did and did not receive housing assistance indicated that the housing assistance group was significantly (p<.001) poorer, less healthy, and more likely to experience food insecurity; however, the relationship between health and housing was not different in the two groups.

Conclusion: Housing problems were associated with poor health in both low-income and higher-income older adults, suggesting that housing is a health concern that crosses income boundaries. The data also suggested that housing assistance programs reach individuals within the intended population, though many older adults eligible for assistance did not receive it. Further research is needed to clarify the health impact of housing assistance, and the relationship between health and housing in low-income older adult subgroups. Findings from this study may enhance nurses’ understanding of housing as a multi-dimensional construct and social determinant of health, and inform their efforts to address housing concerns in patient assessment and treatment plans