Background: COVID-19 has exploited the inequities within the US housing system. Examining the association between housing and health during the pandemic is imperative to reducing health inequities and improving population health.
Methods: We analysed 957 714 responses from the Household Pulse Survey Study, collected between April and July 2020. Using survey-weighted multivariable regression analyses, we assessed the relationships between housing tenure and health, both on average and over time, as well as how these relationships were moderated by COVID-19-related hardships including job loss, food insecurity and inability to afford housing-related costs. We controlled for a variety of potential socioeconomic and demographic confounding factors.
Results: We found that housing tenure was significantly associated with both self-rated health and mental distress. Compared with homeowners without mortgage debt, homeowners with mortgage debt reported worse self-rated health (β=-0.13; 95% CI -0.15 to -0.12, p<0.001) and greater mental distress (β=0.50; 95% CI 0.44 to 0.55, p<0.001). Renters also reported worse self-rated health (β=-0.18; 95% CI -0.20 to -0.16, p<0.001) and greater mental distress (β=0.76; 95% CI 0.69 to 0.83, p<0.001) than homeowners without mortgage debt. Across all tenure groups, self-rated health decreased (β=-0.007; 95% CI -0.011 to -0.004, p<0.001) and mental distress increased (β=0.05; 95% CI 0.05 to 0.06, p<0.001) over this period. Additionally, time and COVID-19-related hardships compounded differences in health status between homeowners and renters.
Conclusions: These results add to a limited body of evidence suggesting that, during this period, housing instability and COVID-19-related hardships have contributed to an increase in health inequities in the USA.
【저자키워드】 COVID-19, mental health, Housing, Self-rated health., Health inequalities,