Abstract
The emerging body of research suggests the unprecedented increase in housing foreclosures and unemployment between 2007 and 2009 had detrimental effects on health. Using data from electronic health records of 105,919 patients with diabetes in Northern California, this study examined how increases in foreclosure rates from 2006 to 2010 affected weight change. We anticipated that two of the pathways that explain how the spike in foreclosure rates affects weight gain—increasing stress and declining salutary health behaviors- would be acute in a population with diabetes because of metabolic sensitivity to stressors and health behaviors. Controlling for unemployment, housing prices, temporal trends, and time-invariant confounders with individual fixed effects, we found no evidence of an association between the foreclosure rate in each patient's census block of residence and body mass index. Our results suggest, although more than half of the population was exposed to at least one foreclosure within their census block, the foreclosure crisis did not independently impact weight change.
Highlights
The decline of the U.S economy between 2007 and 2009 was the largest since the Great Depression
The clinical data was obtained from electronic health records of patients with diabetes receiving uniform access to care within a large, integrated, healthcare delivery system Kaiser Permanente Northern California (KPNC) from 2007 to 2011
The general form of the model was specified as: Yit = βo + β1Fit−1 + β2Zit−1 + β3Cit + β4Xi + β5yearDt + ui + vit, where Yit is a measure of the mean body mass index (BMI) level of individual i in year t; Fit−1 is the block annual foreclosure rate for individual i in year t-1; Zit−1 is a vector of lagged area-level controls for individual i in year t-1; Cit is a vector of individual time-variant covariates including indicators for Medicaid status and medication use; Xi is a vector of individual time-invariant covariates such as sex and race; yearD are dummies for year t; ui is an individual fixed-effect, and vit is the time and individual specific error term
Summary
The decline of the U.S economy between 2007 and 2009 was the largest since the Great Depression. The housing market collapse, later known as the foreclosure crisis, contributed to the rise in unemployment during the Great Recession [1, 2]. Despite the interdependence between the housing and labor markets, research on economic recessions and health has often omitted foreclosures from the discussion. Research has demonstrated the financial spillover effects of a foreclosure in a neighborhood [14, 15], but only a small number of studies of the spillover effects of foreclosures on health exist [16,17,18,19,20,21]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
