Abstract
Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods. We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between 2005 and 2008. There was a marked spike in bipolar and depressive disorders in 2007 in all zip codes. Conclusions. The sharp rise for bipolar and depressive disorders in 2007 coincides with the doubling of foreclosure filings nationally. There are many confounding factors affecting hospital discharge data, which limit its specificity for assessing the health effects of foreclosure.
Highlights
Home loan foreclosures have impacted most parts of the USA, with the most recent yearly statistics revealing that one in every 45 housing units received a foreclosure filing in 2010 [1], exceeding by over four times the number of homes receiving a foreclosure in 2005 (Figure 1). (Foreclosure filings include default notices, scheduled foreclosure auctions, and bank repossessions.) It seems probable that loss of such housing would have negative health effects
Institutional Review Board, we used this database to conduct an assessment of Clark County, Nevada, hospital discharge data using the principal diagnosis for 25 diagnostic-related groups (DRGs), based on the International Classification of Diseases, Ninth Revision, Clinical Modification
We limited our assessment to the DRGs associated with stress, as well as some of the DRGs associated with lack of access to health resources, see Table 1
Summary
A barrier to assessing the health effects of foreclosure over time is lack of publicly available data on the incidence and prevalence of the conditions most likely to be associated with this stressor. One study conducted during the marked increase in foreclosures in 2008 found significantly more hypertension and psychiatric disorders ( depression) in Philadelphia residents undergoing mortgage foreclosure as compared to community norms [5]. A related case-control study of Philadelphia residents undergoing foreclosure found elevated rates of hypertension and renal disease among cases [6]. A more recent study found an increase in foreclosures in a zip code increased hospital utilization for psychiatric conditions (anxiety and suicide attempts), hypertension, and stressrelated physical complaints [7]
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