Health Consequences of Foreclosure Crisis: Effects on ER Visits & Hospitalization

描述(由申请人提供)：拟议的项目将对当前的止赎危机、急诊室就诊和因特定压力相关情况而住院之间的联系进行全面分析。丧失抵押品赎回权代表着一种压力事件，往往是一段时期财务压力的顶峰。尽管越来越多的证据表明，应激性生活事件与不利的健康后果之间存在联系，但止赎危机对健康的潜在影响几乎没有受到关注。目前的止赎流行病为研究止赎对医疗保健利用的影响提供了一个独特的机会，因为最近止赎大幅上升可以说是由于经济衰退，而不是受影响者的个人特征。该项目将汇集2005至2009年间受危机影响最大的10个州(亚利桑那州、佛罗里达州和新泽西州)的所有止赎、急诊室就诊和住院治疗的数据。有关丧失抵押品赎回权各个阶段的数据将来自RealtyTrac。急诊室就诊和住院的行政数据将来自医疗保健利用项目。这两个数据集将被合并，以创建一个邮政编码级别的单一数据库，其中包括丧失抵押品赎回权、急诊室就诊和住院治疗，并每月一次。这个庞大而高频的数据集提供了不同时间和社区的止赎率的巨大差异，这将被用来确定在止赎一直在上升的地区，压力相关障碍的急诊率是否比其他障碍的就诊率上升得更快。我们的分析将区分那些最有可能是由于压力相关的就诊/入院，以及那些不太可能与止赎的直接压力相关的就诊/入院。此外，我们将对男性和女性以及不同的年龄组进行单独的分析。特别是，儿童可能会受到丧失抵押品赎回权的不同影响，我们的分析将第一次检查丧失抵押品赎回权对儿童的影响。我们将通过检查非卧床护理敏感条件，并通过比较刚好低于和略高于65岁的联邦医疗保险资格截止年龄，来调查财务困境在调解止赎和使用之间的关系中的潜在作用。最后，我们将评估少数族裔和低收入个人的不同模型，以试图确定他们因丧失抵押品赎回权而处于双重危险的程度：既有更高的失去房屋的风险，也有更高的风险因这些损失而产生负面的健康后果。 公共卫生相关性：该项目旨在评估当前丧失抵押品赎回权危机对公共卫生构成威胁的程度。这些发现有可能让政策制定者了解当前危机目前被低估的后果。我们的发现可能为评估政府减少丧失抵押品赎回权和稳定房地产市场的努力的好处提供进一步的基础。这一结果还将增加有关压力对健康影响的文献。

DESCRIPTION (provided by applicant): The proposed project will provide a comprehensive analysis of the link between the current foreclosure crisis, Emergency Room (ER) visits, and hospitalizations for specific stress-related conditions. Foreclosure represents a stressful event that is often the culmination of a period of financial stress. Despite mounting evidence pointing to a link between stressful life events and adverse health outcomes, the potential health implications of the foreclosure crisis have received little attention. The current foreclosure epidemic presents a unique opportunity to study the impact of foreclosures on health care utilization because the recent massive rise in foreclosures is arguably due to the recession rather than to personal characteristics of those affected. The project will bring together data on all of the foreclosures, ER visits, and hospitalizations from 2005 to 2009 in three states that are among the 10 that have been most affected by the crisis (Arizona, Florida, and New Jersey). Data on various stages of foreclosure will come from RealtyTrac. Administrative data on ER visits and hospitalizations will come from Health Care Utilization Project. These two data sets will be merged to create a single data base of foreclosures, ER visits and hospitalizations at the zip code level with a monthly frequency. This large and high frequency data set offers great variation in foreclosure rates across time and neighborhoods, which will be utilized to determine whether ER visits for stress related disorders rise faster than visits for other disorders in areas where foreclosures have been rising. Our analysis will distinguish between those visits/admissions that are most likely to be due to stress-related and those which are less likely to be related to the immediate stress of foreclosure. Furthermore, we will conduct separate analyses for males and females as well as different age groups. In particular, children may be differentially affected by foreclosure and our analysis will be the first to examine the effects of foreclosure on children. We will investigate the potential role of financial distress in mediating the relationship between foreclosure and utilization by examining ambulatory care sensitive conditions, and by comparing those just below and just above the age 65 cutoff for Medicare eligibility. Finally, we will estimate separate models for minority and low income individuals in an attempt to determine the extent to which they are at double jeopardy from foreclosure: Both at higher risk of losing their homes, and at higher risk of negative health consequences from these losses. PUBLIC HEALTH RELEVANCE: The project aims to assess the extent to which the current foreclosure crisis represents a threat to public health. The findings have the potential to inform policy makers of a currently underappreciated consequence of the current crisis. Our findings may provide a further basis for assessing the benefits of government efforts to reduce foreclosures and stabilize the housing market. The results will also add to the literature regarding the effects of stress on health.