Mental health and prolonged exposure to unaffordable housing: a longitudinal analysis
Mental health and prolonged exposure to unaffordable housing: a longitudinal analysis
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DOI：
10.1007/s00127-020-01849-1
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发表时间：
2020-03-05
影响因子：
4.4
通讯作者：
Bentley, Rebecca
中科院分区：
文献类型：
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作者：
Baker, Emma;Lester, Laurence;Bentley, Rebecca
目的当住房不足、质量差或负担不起时，就会对健康产生公认的影响。尽管住房负担能力问题（被广泛称为住房负担能力压力）普遍存在，但很少有定量工作分析长期的心理健康影响。我们研究了心理健康的影响（长期和间歇性）模式暴露于住房负担能力的问题。方法：我们分析了一个大型的，具有全国代表性的纵向人口样本的个人，他们在五年的时间内，以评估相对心理健康的影响，不同的模式暴露于住房负担能力的问题。为了最大限度地增加观察次数和结果的稳健性，我们使用了15年（2002-2016年）的数据，跨越了三个合并的暴露窗口。采用Mundlak校正的纵向回归分析来估计长期（5年内恒定）和间歇性暴露于HAS与心理健康（使用SF-36 MCS测量）之间的关联。结果我们发现，平均而言，长期和间歇性暴露与较低的心理健康（Beta =-1.338（95%CI- 2.178-0.488）和Beta =-0.516（95%CI- 0.868-0.164），分别）。当我们额外调整基线心理健康时，从而解释初始心理健康状态，系数被削弱，但仍然显着。结论长期和间歇性暴露于HAS对心理健康都有负面影响，无论基线心理健康如何。针对负担得起的住房的干预措施将有利于人口的心理健康。心理健康干预措施的设计应考虑到人们的住房情况。
Purpose When housing is insufficient, or poor quality, or unaffordable there are well established health effects. Despite the pervasiveness of housing affordability problems (widely referred to as Housing Affordability Stress-HAS), little quantitative work has analysed long-term mental health effects. We examine the mental health effects of (prolonged and intermittent) patterns of exposure to housing affordability problems. Methods We analysed a large, nationally representative longitudinal population sample of individuals, following them over five-year periods to assess the relative mental health effects of different patterns of exposure to housing affordability problems. To maximise the number of observations and the robustness of findings, we used 15 years (2002-2016) of data, across three pooled exposure windows. Longitudinal regression analysis with Mundlak adjustment was used to estimate the association between prolonged (constant over a 5-year period) and intermittent exposure to HAS, and mental health (as measured using the SF-36 MCS). Results We found that, on average, both prolonged and intermittent exposure were associated with lower mental health (Beta = - 1.338 (95% CI - 2.178-0.488) and Beta = - 0.516 (95% CI - 0.868-0.164), respectively). When we additionally adjusted for baseline mental health, thereby accounting for initial mental health status, coefficients were attenuated but remained significant. Conclusions Both prolonged and intermittent exposure to HAS negatively impact mental health, irrespective of baseline mental health. Interventions that target affordable housing would benefit population mental health. Mental health interventions should be designed with people's housing context in mind.