The relationship between health and housing in low-income older adults: A secondary analysis of survey data

Objective: To examine the health-housing relationship in low-income older adults, and differences by income and receipt of housing assistance. Design: Secondary analysis of longitudinal survey data. Sample: About 10,858 adults aged 62+ who completed at least one wave of the 2014 Survey of Income and Program Participation (SIPP) (n = 37,333 observations). Measurements: SIPP variables representing demographics and housing quality, affordability, stability, and neighborhood were analyzed. Low-income and higher-income participants were differentiated by the household income-to-poverty ratio. Results: Low-income participants were significantly more likely to be in poor health and report problems with housing quality, affordability, and neighborhood safety compared to higher-income participants (p <.001). Increased household size and problems with housing quality and neighborhood safety were associated with poor health in both groups (p <.05). Low-income participants who received housing assistance were significantly poorer, less healthy, and food insecure than participants not receiving assistance (p <.001); however, the health-housing relationship was not different in the two groups. Conclusions: Results provide additional support for housing as a social determinant of older adult health. Though housing assistance programs reached a subset of low-income older adults, the results suggest a housing assistance shortfall. Implications for public health nurses and researchers are explored.