Health Consequences of Foreclosure Crisis: Effects on ER Visits & Hospitalization

止赎危机的健康后果：对急诊室就诊的影响

• 批准号: 8227229
• 负责人: Janet M. Currie
• 金额: $ 22.12万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8227229
• 关键词: Accident and Emergency department; Admission activity; Adverse event; Affect; Age; Ambulatory Care; Area; Arizona; Attention; Caring; Characteristics; Child; Child health care; Code; Communities; Costs and Benefits; County; Data; Data Set; Databases; Demographic Analyses; Diagnosis-Related Groups; Disease; Distress; Eligibility Determination; Epidemic; Ethnic Origin; Event; Female; Florida; Foreclosure; Frequencies; Goals; Government; Health; Health behavior; Home environment; Hormones; Hospitalization; Hospitals; Housing; Hydrocortisone; Income; Individual; Investigation; Legal; Life; Life Experience; Link; Literature; Low Income Population; Low income; Marketing; Measures; Mediating; Medicaid; Medical; Medical Records; Medicare; Mental Depression; Mental disorders; Minority; Modeling; Monitor; Neighborhoods; New Jersey; Outcome; Patients; Pharmaceutical Preparations; Policies; Policy Maker; Population; Preventive; Price; Process; Proxy; Public Health; Race; Research; Role; Sales; Sampling; Smoke; Staging; Stress; Stressful Event; Time; Unemployment; Uninsured; United States; Variant; Visit; age group; base; design; drinking; health care service utilization; high risk; male; meetings; psychologic; residence; response; stress related disorder

DESCRIPTION (provided by applicant): The proposed project will provide a comprehensive analysis of the link between the current foreclosure crisis, Emergency Room (ER) visits, and hospitalizations for specific stress-related conditions. Foreclosure represents a stressful event that is often the culmination of a period of financial stress. Despite mounting evidence pointing to a link between stressful life events and adverse health outcomes, the potential health implications of the foreclosure crisis have received little attention. The current foreclosure epidemic presents a unique opportunity to study the impact of foreclosures on health care utilization because the recent massive rise in foreclosures is arguably due to the recession rather than to personal characteristics of those affected. The project will bring together data on all of the foreclosures, ER visits, and hospitalizations from 2005 to 2009 in three states that are among the 10 that have been most affected by the crisis (Arizona, Florida, and New Jersey). Data on various stages of foreclosure will come from RealtyTrac. Administrative data on ER visits and hospitalizations will come from Health Care Utilization Project. These two data sets will be merged to create a single data base of foreclosures, ER visits and hospitalizations at the zip code level with a monthly frequency. This large and high frequency data set offers great variation in foreclosure rates across time and neighborhoods, which will be utilized to determine whether ER visits for stress related disorders rise faster than visits for other disorders in areas where foreclosures have been rising. Our analysis will distinguish between those visits/admissions that are most likely to be due to stress-related and those which are less likely to be related to the immediate stress of foreclosure. Furthermore, we will conduct separate analyses for males and females as well as different age groups. In particular, children may be differentially affected by foreclosure and our analysis will be the first to examine the effects of foreclosure on children. We will investigate the potential role of financial distress in mediating the relationship between foreclosure and utilization by examining ambulatory care sensitive conditions, and by comparing those just below and just above the age 65 cutoff for Medicare eligibility. Finally, we will estimate separate models for minority and low income individuals in an attempt to determine the extent to which they are at double jeopardy from foreclosure: Both at higher risk of losing their homes, and at higher risk of negative health consequences from these losses. PUBLIC HEALTH RELEVANCE: The project aims to assess the extent to which the current foreclosure crisis represents a threat to public health. The findings have the potential to inform policy makers of a currently underappreciated consequence of the current crisis. Our findings may provide a further basis for assessing the benefits of government efforts to reduce foreclosures and stabilize the housing market. The results will also add to the literature regarding the effects of stress on health.

描述（由申请人提供）：拟议的项目将对当前的止赎危机，急诊室（ER）访问和针对特定压力相关条件的住院治疗之间的联系进行全面分析。止赎是一个压力大的事件，通常是财务压力时期的高潮。尽管有越来越多的证据表明压力大的生活事件与不良健康结果之间存在联系，但止赎危机的潜在健康影响很少受到关注。目前的止赎流行为止提供了一个独特的机会来研究止赎对医疗保健利用的影响，因为最近止赎的大规模上升可以说是由于经济衰退而不是由于受影响者的个人特征。该项目将汇总2005年至2009年所有止赎，急诊室访问和住院的数据，这是三个受到危机影响最大的州之一（亚利桑那州，佛罗里达州和新泽西州）。丧失抵押品赎回权的各个阶段的数据将来自RealtyTrac。有关急诊就诊和住院治疗的行政数据将来自医疗保健利用项目。这两个数据集将合并，以每月的频率在邮政编码级别创建单个止赎，急诊就诊和住院的数据库。这个较大的高频数据集为跨时间和社区提供了止赎率的巨大变化，这些丧失抵押品赎回权的率将用于确定与压力相关疾病的ER访问是否比丧失抵押品赎回权上升的地区的其他疾病访问更快。我们的分析将区分最有可能是由于压力相关的访问/入院以及与止赎的直接应力有关的访问/入院。此外，我们将对男性和女性以及不同年龄段进行单独的分析。特别是，儿童可能会受到丧失抵押品赎回权的差异影响，我们的分析将是第一个检查止赎对儿童的影响的人。我们将通过检查卧床护理敏感条件，并比较下方的隔离敏感条件，并将其与Medicare合格的65岁截止年龄相比，研究财务困扰在调解止赎和利用之间的关系中的潜在作用。最后，我们将估算少数族裔和低收入人士的单独模型，以试图确定止赎造成的双重危害的程度：既有丧失家园的风险较高，又有较高的损失造成负面影响的风险。 公共卫生相关性：该项目旨在评估当前止赎危机对公共卫生构成威胁的程度。这些发现有可能告知决策者当前危机的后果。我们的发现可能为评估政府减少丧失抵押品赎回权和稳定住房市场的努力的好处提供进一步的依据。结果还将增加有关压力对健康影响的文献。