%0 Journal Article %J Am J Public Health %D 2011 %T Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years. %A Dawn E Alley %A Jennifer Lloyd %A José A Pagán %A Craig E Pollack %A Michelle Shardell %A Carolyn Cannuscio %K depression %K Drug Costs %K Economic Recession %K Female %K Health Services Accessibility %K Health Status %K Housing %K Humans %K Male %K Medication Adherence %K Middle Aged %K Socioeconomic factors %K Stress, Psychological %K United States %X

OBJECTIVES: We evaluated associations between mortgage delinquency and changes in health and health-relevant resources over 2 years, with data from the Health and Retirement Study, a longitudinal survey representative of US adults older than 50 years.

METHODS: In 2008, participants reported whether they had fallen behind on mortgage payments since 2006 (n = 2474). We used logistic regression to compare changes in health (incidence of elevated depressive symptoms, major declines in self-rated health) and access to health-relevant resources (food, prescription medications) between participants who fell behind on their mortgage payments and those who did not.

RESULTS: Compared with nondelinquent participants, the mortgage-delinquent group had worse health status and less access to health-relevant resources at baseline. They were also significantly more likely to develop incident depressive symptoms (odds ratio [OR] = 8.60; 95% confidence interval [CI] = 3.38, 21.85), food insecurity (OR = 7.53; 95% CI = 3.01, 18.84), and cost-related medication nonadherence (OR = 8.66; 95% CI = 3.72, 20.16) during follow-up.

CONCLUSIONS: Mortgage delinquency was associated with significant elevations in the incidence of mental health impairments and health-relevant material disadvantage. Widespread mortgage default may have important public health implications.

%B Am J Public Health %I 101 %V 101 %P 2293-8 %8 2011 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/22021301?dopt=Abstract %2 PMC3222434 %R 10.2105/AJPH.2011.300245 %0 Journal Article %J Am J Public Health %D 2009 %T Material resources and population health: disadvantages in health care, housing, and food among adults over 50 years of age. %A Dawn E Alley %A Beth J Soldo %A José A Pagán %A John McCabe %A deBlois, Madeleine %A Samuel H Field %A David A Asch %A Carolyn Cannuscio %K Aged %K Female %K Food Supply %K Health Status Disparities %K Health Surveys %K Healthcare Disparities %K Housing %K Humans %K Logistic Models %K Male %K Middle Aged %K Poverty %K United States %X

OBJECTIVES: We examined associations between material resources and late-life declines in health.

METHODS: We used logistic regression to estimate the odds of declines in self-rated health and incident walking limitations associated with material disadvantages in a prospective panel representative of US adults aged 51 years and older (N = 15,441).

RESULTS: Disadvantages in health care (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.23, 1.58), food (OR = 1.69; 95% CI = 1.29, 2.22), and housing (OR = 1.20; 95% CI = 1.07, 1.35) were independently associated with declines in self-rated health, whereas only health care (OR = 1.43; 95% CI = 1.29, 1.58) and food (OR = 1.64; 95% CI = 1.31, 2.05) disadvantage predicted incident walking limitations. Participants experiencing multiple material disadvantages were particularly susceptible to worsening health and functional decline. These effects were sustained after we controlled for numerous covariates, including baseline health status and comorbidities. The relations between health declines and non-Hispanic Black race/ethnicity, poverty, marital status, and education were attenuated or eliminated after we controlled for material disadvantage.

CONCLUSIONS: Material disadvantages, which are highly policy relevant, appear related to health in ways not captured by education and poverty. Policies to improve health should address a range of basic human needs, rather than health care alone.

%B Am J Public Health %I 99 %V 99 Suppl 3 %P S693-701 %8 2009 Nov %G eng %N Suppl 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/19890175?dopt=Abstract %2 PMC2774171 %R 10.2105/AJPH.2009.161877