Association of US County-Level Eviction Rates and All-Cause Mortality.
Association of US County-Level Eviction Rates and All-Cause Mortality.
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美国县级驱逐率与全因死亡率的关联
DOI：
10.1007/s11606-022-07892-9
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发表时间：
2023-04
影响因子：
5.7
通讯作者：
Sumarsono, Andrew
中科院分区：
文献类型：
--
作者：
Rao, Shreya;Essien, Utibe R.;Powell-Wiley, Tiffany M.;Maddineni, Bhumika;Das, Sandeep R.;Halm, Ethan A.;Pandey, Ambarish;Sumarsono, Andrew
住房不稳定是健康的一个关键社会决定因素，与不利的短期和长期健康有关。驱逐反映了一种严重的住房不稳定形式，对美国少数民族和妇女居民的影响不成比例；然而，它与死亡率的关系以前没有被描述过。在调整了县人口、社会经济和健康相关特征后，评估美国县级驱逐率与全因死亡率的独立关联。横截面。美国686个县拥有2016年县级驱逐和死亡率数据。2016年美国县级驱逐率。2016年美国县级年龄调整全因死亡率。2016年，在686个县（6610万居民，50.5%[49.7-51.2]女性，2%[0.5-11.1]黑人）中，我们观察到县级驱逐率与全因死亡率之间存在显著的分级关系。被驱逐率最高的县，黑人和妇女的居民比例更高，贫困和合并症的发生率更高。在调整了县级社会人口统计学特征和普遍的合并症健康状况后，年龄调整后的全因死亡率在最高驱逐tile的县中最高（tile 3 vs 1（每10万人）33.57:95% CI: 10.5-56.6 p= 0.004）。在驱逐的连续分析中观察到一致的结果，驱逐率每增加1%，全因死亡率每10万人增加9.32人（4.77,13.89,p< 0.0001）。在驱逐和全因死亡率的关系中，黑人和女性居民的比例观察到显著的相互作用。在这一横断面分析中，县级驱逐率与全因死亡率显著相关，在黑人和女性居民比例最高的县中观察到的影响最强。州和联邦对驱逐的保护可能有助于减少住房不稳定对健康的影响，并解决健康结果方面的差异。在线版本包含补充资料，下载地址：10.1007/s11606-022-07892-9。
Housing instability is a key social determinant of health and has been linked to adverse short- and long-term health. Eviction reflects a severe form of housing instability and disproportionately affects minority and women residents in the USA; however, its relationship with mortality has not previously been described. To evaluate the independent association of county-level eviction rates with all-cause mortality in the USA after adjustment for county demographic, socioeconomic, and health-related characteristics. Cross-sectional. Six hundred eighty-six US counties with available 2016 county-level eviction and mortality data. 2016 US county-level eviction rate. 2016 US county-level age-adjusted all-cause mortality. Among 686 counties (66.1 million residents, 50.5% [49.7–51.2] women, 2% [0.5–11.1] Black race) with available eviction and mortality data in 2016, we observed a significant and graded relationship between county-level eviction rate and all-cause mortality. Counties in the highest eviction tertile demonstrated a greater proportion of residents of Black race and women and a higher prevalence of poverty and comorbid health conditions. After adjustment for county-level sociodemographic traits and prevalent comorbid health conditions, age-adjusted all-cause mortality was highest among counties in the highest eviction tertile (Tertile 3 vs 1 (per 100,000 people) 33.57: 95% CI: 10.5–56.6 p=.004). Consistent results were observed in continuous analysis of eviction, with all-cause mortality increasing by 9.32 deaths per 100,000 people (4.77, 13.89, p<.0001) for every 1% increase in eviction rates. Significant interaction in the relationship between eviction and all-cause mortality was observed by the proportion of Black and women residents. In this cross-sectional analysis, county-level eviction rates were significantly associated with all-cause mortality with the strongest effects observed among counties with the highest proportion of Black and women residents. State and federal protections from evictions may help to reduce the health consequences of housing instability and address disparities in health outcomes. The online version contains supplementary material available at 10.1007/s11606-022-07892-9.
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