Housing insecurity among urban populations may increase kidney disease risk
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Published research found that, for people living in Baltimore, housing insecurity was associated with a greater risk for developing albuminuria, which is a marker of kidney disease.
According to Tessa K. Novick, MD, MSW, of the University of Texas at Austin, and colleagues, “housing insecurity is characterized by high housing costs or unsafe living conditions that prevent general self-care and threaten independence.” As defined here, high housing costs were greater than 30% of a household’s monthly income, while unsafe living conditions also included overcrowded housing. More specifically to this study, participants were considered to have housing insecurity if they responded negatively to the question, “Are you able to afford a home suitable for you and your family?”
While prior studies have demonstrated that housing insecurity is associated with delayed health care visits and poor health status, as well as risk factors for kidney disease (eg, hypertension and “diabetes self-efficacy”), the researchers pointed out that the potential association between housing insecurity and incident kidney disease remains under investigated.
While housing insecurity peaked in 2011 after the Great Recession, the researchers wrote that it is still a significant and prevalent issue for many Americans, especially for minorities living in metropolitan areas.
To better gauge the risk for kidney disease posed by housing insecurity, researchers included 1,262 people living in Baltimore who had participated in the Healthy Aging in Neighborhoods of Diversity across the Life Span study (mean age, 52 years; 40% were men; 57% were black). Rapid kidney function decline, incident reduced kidney function and incident albuminuria were considered during a median follow-up period of 3.5 years.
Of the total study population, 32% reported housing insecurity. Factors most strongly associated with housing insecurity included male sex, black race, current use of cigarettes, unemployment, food insecurity and inability to afford medical care.
Rapid kidney function decline, incident reduced kidney function and incident albuminuria occurred in 16%, 5%, and 7% of participants, respectively.
While no associations were observed for rapid kidney function decline or reduced kidney function, the researchers determined housing insecurity was associated with an increased odds of incident albuminuria (adjusted OR = 3.23).
In a related press release, Novick called for further research in this area that includes larger cohorts and longer periods of follow-up.
“Housing insecurity is increasing across America,” she said. “Here we show that housing insecurity may be affecting the health of Americans, and it potentially increases risk for subsequent development of kidney disease.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.
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