Housing Quality Research Articles

Screening for Financial Hardship: Comparing Patient Survey Responses Using Two Different Screening Tools.

Healthcare delivery organizations are increasingly screening patients for social risks using tools that vary in content and length. To compare two screening tools both containing questions related to financial hardship. Cross-sectional survey. Convenience sample of adult patients (n = 471) in three primary care clinics. Participants randomly assigned to self-complete either: (1) a screening tool developed by the Centers for Medicare & Medicaid Services (CMS) consisting of six questions on financial hardship (housing stability, housing quality, food security, transportation security, utilities security); or (2) social and behavioral risk measures recommended by the National Academy of Medicine (NAM), including one question on financial hardship (financial strain). We compared patient acceptability of screening, positive screening rates for financial hardship, patient interest in assistance, and self-rated health. Ninety-one percent of eligible/interested patients completed the relevant survey questions to be included in the study (N = 471/516). Patient acceptability was high for both tools, though more participants reported screening was appropriate when answering the CMS versus NAM questions (87% vs. 79%, p = 0.02). Of respondents completing the CMS tool, 57% (132/232) reported at least one type of financial hardship; on the NAM survey, 52% (125/239) reported financial hardship (p = 0.36). Nearly twice as many respondents indicated interest in assistance related to financial hardship after completing items on the CMS tool than on the NAM question (39% vs. 21%, p < 0.01). Patients reported high acceptability of both social risk assessment tools. While rates of positive screens for financial hardship were similar across the two measures, more patients indicated interest in assistance after answering questions about financial hardship on the CMS tool. This might be because the screening questions on the CMS tool help patients to appreciate the types of assistance related to financial hardship that may be available after screening. Future research should assess the validity and comparative validity of individual measures and measure sets. Tool selection should be based on setting and population served, screening goals, and resources available.

Indoor environmental quality and energy use intensity: an empirical post-occupancy evaluation test of on-campus university student housing in Ghana

PurposeTo significantly adopt and improve indoor energy efficiency in building infrastructure in developing countries can be a challenging venture. Thus, this study aimed to assess the satisfaction of indoor environmental quality and its effect on energy use intensity and efficient among student housing.Design/methodology/approachThe study is quantitative and hinged on the contrast theory. A survey of 1,078 student residents living in purpose-built student housing was contacted. Using Post-Occupancy Evaluation and Multiple Linear Regression, critical variables such as thermal comfort, visual comfort and indoor air quality and 21 indicators were assessed. Data on annual energy consumption and total square metre of the indoor area were utilised to assess energy use intensity.FindingsThe study found a direct relationship between satisfaction with indoor environmental quality and energy use intensity. The study showed that students were more satisfied with thermal comfort conditions than visual and indoor air quality. Overall, these indicators contributed to 75.9% kWh/m2 minimum and 43.2% kWh/m2 maximum energy use intensity in student housing in Ghana. High occupancy and small useable space in student housing resulted in high energy use intensity.Practical implicationsInclusions of sustainable designs and installation of smart mechanical systems are feedback to student housing designers. Again, adaptation to retrofitting ideas can facilitate energy efficiency in the current state of student housing in Ghana.Originality/valueEarlier studies have argued for and against the satisfaction of indoor environmental quality in student housing. However, these studies have neglected to examine the impact on energy use intensity. This is novel because the assessment of energy use intensity in this study has a positive influence on active design incorporation among student housing.

Greater Socioeconomic Disadvantage as Measured by the Area Deprivation Index Is Associated With Failure of Healing Following Arthroscopic Repair of Massive Rotator Cuff Tears but Not With Clinical Outcomes

To analyze the relationship between Area Deprivation Index (ADI) and preoperative status and short-term postoperative clinical outcomes among patients who underwent arthroscopic rotator cuff repair (ARCR) of massive rotator cuff tears (MRCTs). A retrospective review was conducted on prospectively maintained data on patients who underwent ARCR of MRCTs defined as tear size ≥5 cm or complete tear of at least 2 tendons, with a minimum 2-year follow-up and a valid home address between January 2015 and December 2018. Each patient's home address was mapped to the ADI to determine neighborhood disadvantage. This composite index is composed of 17 census-based indicators, including income, education, employment, and housing quality to quantify the level of socioeconomic deprivation. Ratings were recorded and categorized based on the sample's percentile. Patients were then divided into 2 groups: upper quartile (ie, most disadvantaged [≥75th percentile]) and lower 3 quartiles (ie, least disadvantaged [<75th percentile]). Bivariate analysis was performed to associate ADI with patient-reported outcomes (PROs) and range of motion pre- and postoperatively, as well as complications, healing rate, satisfaction, and return to work. Patients reaching or exceeding the minimal clinically important difference for visual analog scale (VAS), American Shoulder and Elbow Surgeons, Veterans Rand 12-Item questionnaire, and subjective shoulder value were recorded for both cohorts. Ninety-nine patients were eligible for study analysis. Preoperative PROs and range of motion were similar, except for a greater VAS for pain (6.3 vs 4.3; P < .01) and lower American Shoulder and Elbow Surgeons score (32.2 vs 45.1; P= .01) in the most disadvantaged group. Both groups showed similar postoperative PROs scores, but greater VAS improvement was seen in the upper quartile group (Δ 4.2 vs Δ 3.0; P= .04). In contrast, only the least-disadvantaged group significantly improved in internal rotation (P= .01) and forward flexion (18°; P < .01) from baseline. Although satisfaction, complications, and return to work were comparable (P > .05), failure of healing occurred more frequently in the most disadvantaged group (21% vs 6%; P= .03). Patients with MRCTs residing in the most disadvantaged neighborhoods as measured by the ADI have more pain and functional limitations before undergoing ARCR but demonstrate similar postoperative functional improvements to patients from other socioeconomic backgrounds. Failure of healing of MRCTs may be more common in disadvantaged groups. Furthermore, both groups reported similar rates of clinically important functional improvement. Level III, retrospective cohort comparison.

Strangers in a strange land: Mapping household and neighbourhood associations with improved wellbeing outcomes in Accra, Ghana

Urban poverty is not limited to informal settlements, rather it extends throughout cities, with the poor and affluent often living in close proximity. Using a novel dataset derived from the full Ghanaian Census, we investigate how neighbourhood versus household socio-economic status (SES) relates to a set of household development outcomes (related to housing quality, energy, water and sanitation, and information technology) in Accra, Ghana. We then assess “stranger” households' outcomes within neighbourhoods: do poor households fare better in affluent neighbourhoods, and are affluent households negatively impacted by being in poor neighbourhoods? Through a simple generalized linear model we estimate the variance components associated with household and neighbourhood status for our outcome measures. Household SES is more closely associated with 13 of the 16 outcomes assessed compared to the neighbourhood average SES. For 9 outcomes poor households in affluent areas fair better, and the affluent in poor areas are worse off. For two outcomes, poor households have worse outcomes in affluent areas, and the affluent have better outcomes in poor areas, on average. For three outcomes “stranger” households do worse in strange neighbourhoods. We discuss implications for mixed development and how to direct resources through households versus location-based targets.

Factors that influence safe water drinking practices among older persons in slums of Kampala: Analyzing disparities in boiling water.

Safe drinking water practice is a key public health promotion strategy for reducing the spread of waterborne diseases. The purpose of this study was to investigate the factors that influence boiling water practice among older persons in informal settlements of Kampala. We collected primary data on "Access to safe water and health services among older persons in informal settlements of Kampala in October 2022. The study interviewed 593 men and women aged 60 years and older. The Complementary log-log multivariable technique was used to establish the association between boiling water practice and selected independent variables. The results show that nearly 8% of the respondents did not boil their water for drinking. The findings show that the female older persons had increased odds of boiling water to make it safe for drinking compared to their male counterparts (OR = 1.859, 95% CI = 1.384-2.495). Other factors associated with boiling water practice among older persons in the informal settlements of Kampala were; living alone, quality of house, and type of water source. Basing on our findings, we find that older women are more likely to use safe drinking water practice (boiling) compared to the male older persons. Health education majorly targeting older men about the importance and health benefits associated with safe water drinking practices should be prioritized by policy makers. There is need to improve housing conditions of older persons to minimize typhoid, diarrhea and other health risks associated with drinking unsafely managed water.

Partisipasi Masyarakat dalam Program BSPS Melalui Upaya Keswadayaan Demi Mewujudkan Rumah Layak Huni di Desa Pucangombo

This research was conducted to determine community participation in the BSPS program through self-help efforts to create livable houses in Pucangombo Village. The research in this journal article applies a qualitative descriptive method because it is considered that it is easy to find information that can be accessed starting from time constraints, as well as the place to conduct research. Population growth tends to increase every year, conditions like this will result in various problems such as increasing housing needs, poverty rates, and slum areas. The Directorate General of the Ministry of Public Works and Public Housing as the organizer of government affairs issued a breakthrough program in the form of Self-Help Housing Stimulant Assistance which aims to improve decent housing that is healthy, safe, harmonious, orderly and sustainable for people with low incomes supported also by community participation through self-help forms . In this activity, community participation is categorized as enthusiastic, which can be seen from the optimal source of funds by looking at the form of self-help they have. So that the gains from the BSPS program are reducing inadequate housing and increasing the quality of community housing.&#x0D; Keywords: BSPS, livable houses, nongovernmental

Achieving emission reductions without furthering social inequality: Lessons from the 2007 economic crisis and the COVID-19 pandemic

To meet global climate goals, such as limiting global warming to 1.5° Celsius, urgent and substantial reductions of greenhouse gas emissions are needed. From a consumption-based perspective, such measures include a radical reduction of emissions from private households. Despite this urgency, attention must be paid to achieve such reductions without furthering social inequalities. To address these issues, this research looks at consumption-based greenhouse gas emissions of UK households longitudinally, with a particular focus on changes that occurred after the 2007/08 economic crisis and the 2020 COVID-19 lockdowns. Analysing these two events allows us to learn how emissions from different social cohorts are impacted by external shocks, providing a learning for policy. We find significant (p < 0.05) differences in the relationships between income and emissions of some age and income groups, as well as substantial descriptive differences between how age and income groups are impacted at a product-level. Importantly, we also find that despite existing levels of carbon inequality, substantial emission reductions are needed for all social cohorts assessed. However, to avoid further increasing existing inequalities and to make policies more effective, we propose interventions targeted at specific social cohorts. While an income reduction may reduce emissions of high-income households, increased access to high quality housing and public services may help reduce emissions of low-income households, whose emissions are already decoupled from income. Finally, age and income-specific interventions targeting specific consumption categories may reduce the impact of rebound effects, as well as reduce emission overall.

Increased Neighborhood Deprivation Is Associated with Prolonged Hospital Stays After Surgical Fixation of Traumatic Pelvic Ring Injuries.

The purpose of this study was to understand the role of social determinants of health assessed by the Area Deprivation Index (ADI) on hospital length of stay and discharge destination following surgical fixation of pelvic ring fractures. A retrospective chart analysis was performed for all patients who presented to our level-I trauma center with pelvic ring injuries that were treated with surgical fixation. Social determinants of health were determined via use of the ADI, a comprehensive metric of socioeconomic status, education, income, employment, and housing quality. ADI values range from 0 to 100 and are normalized to a U.S. mean of 50, with higher scores representing greater social deprivation. We stratified our cohort into 4 ADI quartiles. Statistical analysis was performed on the bottom (25th percentile and below, least deprived) and top (75th percentile and above, most deprived) ADI quartiles. Significance was set at p < 0.05. There were 134 patients who met the inclusion criteria. Patients in the most deprived group were significantly more likely to have a history of smoking, to self-identify as Black, and to have a lower mean household income (p = 0.001). The most deprived ADI quartile had a significantly longer mean length of stay (and standard deviation) (19.2 ± 19 days) compared with the least deprived ADI quartile (14.7 ± 11 days) (p = 0.04). The least deprived quartile had a significantly higher percentage of patients who were discharged to a resource-intensive skilled nursing facility or inpatient rehabilitation facility compared with those in the most deprived quartile (p = 0.04). Race, insurance, and income were not significant predictors of discharge destination or hospital length of stay. Patients facing greater social determinants of health had longer hospital stays and were less likely to be discharged to resource-intensive facilities when compared with patients of lesser social deprivation. This may be due to socioeconomic barriers that limit access to such facilities. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Hostel takeover: Living conditions, reference dependence, and the well-being of migrant workers

We report impacts of a randomized housing quality improvement intervention among Indian migrant workers. Despite modest improvements in conditions, respondents experienced a decline in satisfaction and a large increase in psychological distress as a result of treatment. In contrast, residents who faced the same treatment-induced variation in living conditions as the original sample, but who arrived after treatment had already been initiated, had increased satisfaction. Impacts on turnover echo these patterns. We interpret this as evidence of reference dependence: residents who were primed to expect larger-than-realized improvements in living conditions suffered utility losses, while exposed but unprimed residents experienced gains.

Problems and Solutions of Multi-apartment Housing Management in Latvia

Housing policy is closely related to the well-being and social integration of the population of each country, and has a great impact on the development of various sectors and the entire national economy. An important part of housing policy is the housing management sector, whose processes affect all levels of society. The goals of the housing policy in Latvia are to promote the quality and availability of housing and to ensure the regulatory basis for management. Special attention should be paid to multi-apartment residential buildings, as they occupy more than half of the total residential area in Latvia, and approximately 65% of the population lives in apartments. The tasks of the study are to identify, collect and analyse information on the aspects of managing multi-apartment residential buildings, as well as to provide recommendations for the improvement of the housing policy. The monographic or descriptive method was used for the analysis of the theoretical base. In order to find out the current situation and the main problems related to the management of residential buildings, a survey was conducted in which residents of multi-apartment residential buildings of different series and different in number of apartments participated. Analysing the results of the survey, it was found that the main problems are related to incomplete information, lack of interest, incompetence, lack of communication between apartment owners and the house manager, as well as various legal deficiencies regarding ownership rights. Improvement of the regulatory base, increasing the competence of managers and information measures for apartment owners are offered as solutions.

FIELD TESTS OF IMPACT NOISE INSULATION OF THE FLOOR USING PLANNING THEORY

In modern construction, one of the main indicators of the quality of housing for users of multi-storey buildings is still noise. The task of preventing the noise that occurs in the house itself needs to be given more attention when designing and soundproofing. It is known that extraneous sounds penetrating into a living space cause a negative impact not only on the psychological state of a person, but also on the physical one. In this regard, each user of the premises wants to receive comfortable conditions for staying in them. To achieve this condition, it is necessary to develop effective structural and technological schemes for soundproofing the floor from impact noise, as well as their verification and evaluation using the theory of planning experiments. This article is devoted to solving an important issue of sound insulation of floors in monolithic reinforced concrete multi-storey residential buildings, namely from impact noise. The article considers the structural and technological schemes of sound insulation of the floor of fifteen types, using different materials and their combinations to achieve regulatory requirements for sound insulation from impact noise. It was determined that the thickness of the layer of materials and the density have a significant effect on the insulation performance against shock noise. The work investigated floor constructions based on layers of changing materials. Specifically, such parameters as the thickness (50±10 mm) and density (300±50 kg/m3) of polystyrene concrete "Izolkap" and the thickness of the semi-dry screed (50±10 mm). When choosing the most rational design and technological scheme used the results of planning theory, as well as indicators of reduced impact noise, obtained as a result of field tests, it allowed to choose the most rational and effective version of "floating" floor ‒ based on materials "Akuflex" and "Izolkap" (polystyrene concrete) ‒ scheme №11, the index of the reduced level of impact noise is Lnw = 52 dB. The arrangement of the structural and technological scheme of floor sound insulation №11 allows to reduce the level of initial impact noise in the room by 37.5%.

142 Identifying common housing conditions affecting older people relevant to integrated Care for Older Persons in Ireland

Abstract Background The health and well-being of older people is significantly affected by housing, representing an essential aspect of preventative healthcare in the community. Good quality housing is an important factor in a person’s ability to maintain mental and physical health, as well as sustain optimal quality of life. This is particularly true for older people who may spend more time at home than other demographic groups. This study explores the linkages between housing conditions and the health and wellbeing of older people with the aim to inform housing designers, providers, and policy makers about the key aspects of healthy homes and common housing hazards, affecting older people. Methods The qualitative research programme involved an in-depth stakeholder engagement strategy, with activities including focus groups, diaries, and interviews to place the perspectives of older people at the centre of the work. The research also included a series of case study visits to the homes of patients of an Integrated Care Programme for Older People, where the research team conducted a series of qualitative semi-structured interviews with the patient, as well as a technical and quantitative survey of the home. Results Key themes identified throughout the research programme include overarching themes such as healthy ageing and housing and ageing in place; themes related to the hospital and integrated care, and the local authority; housing conditions and hazards; and built environment issues across the key spatial scales. Conclusion There is a need for better, more accessible data on the housing issues, conditions, and hazards for older people throughout Ireland. Additionally, it is essential to consider the needs of patients with additional care requirements, such as those living with dementia, as the built environment greatly impacts them.

“Asthma is a very bully disease” – patient experiences of living with chronic respiratory diseases in Cape Town, South Africa

BackgroundChronic respiratory diseases are common in Cape Town, South Africa. Yet the experiences of how adults with these conditions, such as asthma or COPD (chronic obstructive pulmonary disease), negotiate the health system are poorly understood. Qualitative methodology lends itself to investigate this question.Aim of studyTo explore the “emic” experiences of adults with CRDs in Cape Town when they were negotiating the health system using semi-structured interviews.MethodsInterviews were conducted following informed consent with purposively sampled adults who had attended public hospitals in Cape Town with chronic respiratory disease flare-ups. This work was nested in the quantitative “Diagnosing Airways Disease” study. The topic guide explored patients’ experiences of accessing healthcare including receiving and interpretations of the diagnosis and management, and impacts on daily life. Interviews were conducted in Afrikaans, isiXhosa, or English; transcribed, and translated into English and thematically analysed until saturation.ResultsThirty-two interviews (16 in Afrikaans, 8 in isiXhosa, 8 in English) were completed in 2022. 17 women and 15 men participated. Most participants were older than 50 years (25/32), and most were unemployed (13/32) or retired (11/32).The identified themes were: Perceived causes of illness; experiences of healthcare; perceived risks and barriers when accessing healthcare; and impact on earnings. The perceived causes of their illness and risks were structural, and included air pollution, poor quality housing, occupational exposures, limited healthcare services, and fear of violence. These factors led to self-treatment, sharing of medicines, and delay in receiving a diagnosis. Many paid privately for treatments or services to overcome identified shortcomings of the public healthcare system, and many reported additional significant indirect costs. Being ill had a profound impact on income. The identified themes were explored through the lens of “structural violence”, where “social structures stop individuals … from reaching their full potential” (Galtung, 1969).ConclusionIn Cape Town structural elements such as stretched healthcare professionals, insufficiently enforced policies on e.g., housing or work-place exposures, poverty and crime made it difficult for participants to successfully navigate their illness experience. It forced some to pay out of pocket to receive perceived better healthcare privately.

Exploring the Challenges Faced by the Urban Squatter Dwellers in Sentul, Kuala Lumpur, Malaysia

Malaysia has experienced rapid urbanization, leading to congestion and a shortage of adequate housing. For those who cannot afford housing due to the high prices of houses, such as marginalized and low-income groups, squatting becomes an alternative for viable housing solutions. Many have moved into urban squatter zones in search of alternate housing. Drawing on Malaysia as a case study, this study explores the challenges urban squatter dwellers face and how it affects their well-being. This study used Participatory Action Research (PAR) and Delphi Techniques to conduct in-depth interviews with fourteen key informants in Kuala Lumpur. It analyzed the results using the thematic analysis method. Findings revealed that they faced challenges associated with social issues, housing quality, housing environment, and finances. These challenges have affected their safety, comfort, social relationships, and health. It is suggested that the government should adequately design inclusive policies and programs to resolve this predicament and enhance these dwellers’ quality of life. Since studies on urban squatters in Malaysia are scarce, this study provides insight into the country’s urban poverty problem. Furthermore, the findings can be applied to other developing countries with characteristics like Malaysia.

Needle exchange programs and their impact on HIV incidence in West Virginia: Is it working?

ABSTRACT The opioid epidemic has had a strong impact on West Virginia, due to various social, economic, cultural, and environmental hardships. To aid users, Needle Exchange Programs (NEPs) were created to exchange used needles for new sterile ones and provide awareness of treatment and rehabilitation options. This study aimed to assess the effectiveness of NEPs in reducing HIV and Hepatitis C infections in West Virginia, and the subsequent decrease in healthcare costs. In 2018 and 2019, there was an HIV outbreak in Cabell County, with 85 cases requiring CDC intervention in 2019. This occurred after the county-run needle exchange was reduced. Kanawha County also shut down its NEPs in 2018, followed by another HIV outbreak between 1 January 2019 and 13 March 2021, with 65 people testing positive for HIV linked to injection drug use, which required CDC intervention. To rehabilitate the opioid addict population, research on relapse, quality of life, social inclusion, stable housing, habilitation, and treatment adherence should be conducted. Policymakers should also revise existing policies surrounding the provision of harm reduction services to document adequate procedures for SSP procedures. This research suggests that suspending and scaling down NEPs in West Virginia has increased HIV/HCV incidence.

Space standards in affordable housing in England

ABSTRACT This paper examines the state of affordable housing in England, with a focus on regional variations in space standards and standardized dwelling layouts widely used by volume housebuilders. Space standards are not statutory and therefore adopted inconsistently across development types or building typologies in England. The study draws on data obtained from planning applications, analysing 153 housing developments and 9876 newly constructed affordable housing units from different regions in England that were completed and marketed in 2021. Based on this, the study compares space standards and their effectiveness as well as the use of standardized unit types. The analysis reveals that apart from London, the most recent Nationally Described Space Standard (2015) is not yet widely used. Instead, Housing Quality Indicators that preceded the new national standards continue to be the norm for houses built outside of London. The findings demonstrate that there is a high level of standardization in affordable housing in terms of dwelling size and layout, with widely used standard house types often determining the design and size of dwellings more than space standards.

Innovative housing models that reflect the needs of contemporary society. (Post-pandemic context)

This article is concerned with understanding the need for housing in the context of the Covid-19 pandemic and suggesting alternatives to provide solutions for housing in a demanding post-pandemic society and a new lifestyle. Since this pandemic hit the world, the issues revealed tackled primarily general societal health, followed by social distancing, change of transportation concepts, and a new remote work model within the housing unit; putting into a tangible discussion, the overall quality of housing. An emergent need to re-address a new concept for housing, sustaining the actual socio- economic model of living, is frequently being discussed between academics alternating between provision for flexible internal spaces, innovative and resilient houses as well as re- adaptations. In this context of global societal changes, ‘The Housing Unit’, has been positioned under pressure to meet the extra needs of the inhabitants, like better indoor physical comfort and air quality, natural light and ventilation, wider spaces, and flexible interiors, needs which were previously addressed in the outdoor environment. Whiles the impact of the pandemic in regard to housing as the primary unit responsible for the overall quality of life imposes researchers and different professionals in design fields to attend to and forecast changes within the housing as the primary “nucleus” driving the general health and quality of life for the citizens; the situation challenged every component of the urban environment, including the uses of public space, public transportation and movement within the city, which already seeks to be redefined. This research is conducted during a two-week workshop, in the framework of the doctoral program in Architecture and Urban Planning, concerning the context Northern Albanian Region of Lezha, with the participation of the students: Rine Zogiani, Nicola Talamonti, Elena Verzella, Luca Lanzoni, Bianka Madhi,, Armela Lamaj. The results of the workshop, after a thorough investigation of existing housing typologies, the relation of public spaces with residential buildings, and other aspects like sustainability, through the objective of providing innovative housing solutions. generated variable models of housing in two main directions: a) adaptations of existing housing units; and b) new proposals for contemporary, post-pandemic housing. The proposals integrate the use of near public space and the incorporation of auto-sufficient buildings concepts.

Housing and Indoor Factor Influencing Spread of COVID-19

There has been growing recognition linking spread of COVID-19 with environmental factors. One of the environmental factors with robust epidemiological literature supporting its role in diseases is the housing or built environment. COVID-19 spread has been found to occur mostly at homes through secondary household transmission. As most people spend more times inside homes during the pandemic, household remains an important site of COVID-19 spread. The aim of this study is to examine how housing and indoor factors affect the transmission and spread of COVID-19. This article summarizes the housing indoor factors involved in COVID-19 transmission, including the role of transmission from contaminated household surfaces. Indoor transmission of COVID-19 is found to be more likely due to contact transmission and close-contact aerosol transmission in a crowded, confined, and poorly ventilated indoor environment, related to poor housing condition. Whilst role of spread through contaminated household surfaces is of low probability. Based on this review, it can be suggested that besides the existing measures including avoiding crowding, close contacts and proper ventilation, specific standards for indoor environmental quality control and housing condition might be required. Housing is a public health issue and healthy housing is of universal concern.

Spatial and Environmental Antecedents of Prevalence of Teenage Pregnancy in Yenagoa, Bayelsa State

This paper examines the spatial and environmental dynamics of teenage pregnancy in Yenagoa, intending to understand the complexity of spatial and environmental antecedents of teenage pregnancy to reduce early childbearing and improve the livelihood and wellbeing of young women. A multi-stage sampling technique involving three stages was adopted. A set of structured questionnaire was administered systematically upon 415 statistically determined respondents. Results revealed that 46.3% of the respondents are less than 14 years, 48.4% are between 15-19 years and 5.3% are over 20 years. Result of ANOVA showed that teenage pregnancy varies significantly over space with f values of location/neighbourhood (F=3.700), education (F= 3.694), household size (F=1.059) at 0.5 significance level. Result of the logistic regression revealed that the likelihood of teenage pregnancy in Yenagoa is influenced by wrong use of contraceptives with exponential beta (Exp?) ratio of 4.994, followed by household size (1.293), housing quality (1.175) and neighborhood (1.119). Teenage pregnancy as a complex problem requires a comprehensive approach to reduce its occurrence, enhance life opportunities and actualize the life plans of these young mothers.

Does Subsidized Housing Prevent Health Decline and 2-Year Mortality Among Low-Income Older Renters?

A growing number of older adults in the United States need subsidized housing, but only 36% of eligible households receive assistance. The purpose of this study is to examine if older renters living in subsidized housing are less likely to experience health decline and mortality over 2 years compared to low-income older renters who are likely eligible, but do not receive assistance. Baseline data include 671 subsidized and unsubsidized low-income older renters from the 2015 National Health and Aging Trends Study. Outcomes of interest include self-rated health decline, developing a new activity limitation, or 2-year mortality between 2015 and 2017. Weighted stepwise logistic regression models test (a) if subsidized older renters were less likely to experience health decline or 2-year mortality compared to unsubsidized older renters, and (b) if housing quality and neighborhood factors mediate the association between subsidized housing and health decline/mortality. Subsidized older renters were less likely to develop a new activity limitation compared to unsubsidized older renters, but there was not a statistically significant difference in experiencing self-rated health decline or 2-year mortality by subsidized housing status. Housing quality and neighborhood factors did not significantly mediate this association. The results provide some support that improving access to subsidized housing for low-income older renters may have additional health benefits, even in the short term. To inform program improvements and maximize potential health benefits, more research is needed to understand the specific health-promoting features of subsidized housing.