Social Determinants of Housing Quality for U.S. Immigrants: Intersections of Nativity, Race, and Socioeconomic Status

Abstract

BACKGROUND AND AIM: Indoor hazards can cause poor health with disproportionate burdens among racial/ethnic minorities and low socioeconomic status (SES) households. Little research has examined residential environmental exposures by nativity status, despite immigrants being a rapidly growing U.S. population. We investigated residential characteristics and housing quality by nativity and their intersections with race and SES in the national 2015 American Housing Survey (AHS). METHODS: We generated risk scores for 11 poor-housing quality domains from 54 AHS variables: electricity, thermal discomfort, indoor and outdoor structures, lead-paint risk, bathroom and kitchen facilities, pests, mold, combustion sources, and crowding. We examined clustering of demographic and socio-contextual factors using polyserial correlations. We ran negative binomial regressions to evaluate risk scores by nativity, race, SES, and their interactions and adjusted for socio-contextual factors. RESULTS:Socio-contextual factors correlated with poor-housing quality included being a single-parent, older building age, and poor neighborhood quality and were more prevalent among non-white and low SES households. Adjustment for these factors explained some but not all observed demographic disparities in poor-housing quality. Notably, immigrants had higher risks for crowding, combustion sources, pests, thermal discomfort, and mold than U.S.-natives (exp[ß-hat]:1.08-3.15). Black households had higher risks for the most poor-housing quality domains than other race groups (1.07-1.77). Households at 0-100% federal poverty-level had higher risks for almost all domains compared to higher-income households (1.06-4.08). At the intersections of race and nativity, Latinx and Asian immigrants had higher risks of lead-paint exposure and combustion sources, respectively, than their U.S.-native counterparts. In contrast, Black U.S.-natives fared worse for outdoor structure and combustion sources than Black immigrants. CONCLUSIONS:In the U.S., we found significant disparities in housing quality, with non-white immigrant, Black U.S.-native, and low SES households experiencing worse housing conditions. Our findings underscore the importance of an intersectional framework to identify residential environmental exposure disparities and their socio-contextual drivers. KEYWORDS: Exposures, Environmental disparities, Socio-economic factors, Built environment, Housing quality