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）：拟议项目将对当前止赎危机、急诊室 (ER) 就诊以及特定压力相关病症住院治疗之间的联系进行全面分析。丧失抵押品赎回权代表一种压力事件，通常是一段财务压力时期的顶峰。尽管越来越多的证据表明压力生活事件与不良健康结果之间存在联系，但止赎危机对健康的潜在影响却很少受到关注。当前的止赎流行病为研究止赎对医疗保健利用的影响提供了一个独特的机会，因为最近止赎的大幅增加可以说是由于经济衰退而不是受影响者的个人特征。该项目将汇集 2005 年至 2009 年受危机影响最严重的 10 个州（亚利桑那州、佛罗里达州和新泽西州）中的三个州的所有止赎、急诊就诊和住院数据。有关止赎各个阶段的数据将来自 RealtyTrac。有关急诊室就诊和住院治疗的管理数据将来自医疗保健利用项目。这两个数据集将被合并，以创建一个按邮政编码级别按月频率记录止赎、急诊就诊和住院情况的单一数据库。这个庞大且高频的数据集提供了不同时间和社区的止赎率的巨大差异，这将用于确定在止赎率上升的地区，因压力相关疾病而导致的急诊就诊是否比其他疾病的就诊上升得更快。我们的分析将区分最有可能与压力相关的访问/入院和不太可能与取消抵押品赎回权的直接压力相关的访问/入院。此外，我们还将针对男性和女性以及不同年龄段进行单独分析。特别是，儿童可能会受到丧失抵押品赎回权的不同影响，我们的分析将是第一个检查丧失抵押品赎回权对儿童的影响的分析。我们将通过检查门诊护理的敏感状况，并比较那些略低于和略高于 65 岁的 Medicare 资格界限，来研究财务困境在调节止赎和利用之间关系中的潜在作用。最后，我们将估计少数族裔和低收入个人的单独模型，试图确定他们因丧失抵押品赎回权而面临双重危险的程度：既面临更高的失去房屋的风险，又面临因这些损失而造成负面健康后果的更高风险。 公共健康相关性：该项目旨在评估当前止赎危机对公共健康构成威胁的程度。研究结果有可能让政策制定者了解当前危机的目前被低估的后果。我们的研究结果可能为评估政府减少止赎和稳定房地产市场的努力的效益提供进一步的基础。研究结果还将补充有关压力对健康影响的文献。