Relationship between housing insecurity, diabetes processes of care, and self-care behaviors
Abstract Background The aim of this analysis was to examine the influence of housing insecurity on diabetes processes of care and self-care behaviors and determine if that relationship varied by employment status or race/ethnicity. Methods Using nationally representative data from the Behavioral Ris...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-07468-7 |
| _version_ | 1819006756660969472 |
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| author | Elise Mosley-Johnson Rebekah J. Walker Madhuli Thakkar Jennifer A. Campbell Laura Hawks Sarah Pyzyk Leonard E. Egede |
| author_facet | Elise Mosley-Johnson Rebekah J. Walker Madhuli Thakkar Jennifer A. Campbell Laura Hawks Sarah Pyzyk Leonard E. Egede |
| author_sort | Elise Mosley-Johnson |
| collection | DOAJ |
| description | Abstract Background The aim of this analysis was to examine the influence of housing insecurity on diabetes processes of care and self-care behaviors and determine if that relationship varied by employment status or race/ethnicity. Methods Using nationally representative data from the Behavioral Risk Factor Surveillance System (2014-2015), 16,091 individuals were analyzed for the cross-sectional study. Housing insecurity was defined as how often respondents reported being worried or stressed about having enough money to pay rent/mortgage. Following unadjusted logistic models testing interactions between housing insecurity and either employment or race/ethnicity on diabetes processes of care and self-care behaviors, stratified models were adjusted for demographics, socioeconomic status, health insurance status, and comorbidity count. Results 38.1% of adults with diabetes reported housing insecurity. Those reporting housing insecurity who were employed were less likely to have a physicians visit (0.58, 95%CI 0.37,0.92), A1c check (0.45, 95%CI 0.26,0.78), and eye exam (0.61, 95%CI 0.44,0.83), while unemployed individuals were less likely to have a flu vaccine (0.84, 95%CI 0.70,0.99). Housing insecure White adults were less likely to receive an eye exam (0.67, 95%CI 0.54,0.83), flu vaccine (0.84, 95%CI 0.71,0.99) or engage in physical activity (0.82, 95%CI 0.69,0.96), while housing insecure Non-Hispanic Black adults were less likely to have a physicians visit (0.56, 95%CI 0.32,0.99). Conclusions Housing insecurity had an influence on diabetes processes of care and self-care behaviors, and this relationship varied by employment status and race/ethnicity. Diabetes interventions should incorporate discussion surrounding housing insecurity and consider differences in the impact by demographic factors on diabetes care. |
| first_indexed | 2024-12-21T00:13:45Z |
| format | Article |
| id | doaj.art-87a6dd82785446549c936c2fb37ab7e6 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-21T00:13:45Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-87a6dd82785446549c936c2fb37ab7e62022-12-21T19:22:18ZengBMCBMC Health Services Research1472-69632022-01-012211810.1186/s12913-022-07468-7Relationship between housing insecurity, diabetes processes of care, and self-care behaviorsElise Mosley-Johnson0Rebekah J. Walker1Madhuli Thakkar2Jennifer A. Campbell3Laura Hawks4Sarah Pyzyk5Leonard E. Egede6Division of General Internal Medicine, Department of Medicine, Medical College of WisconsinDivision of General Internal Medicine, Department of Medicine, Medical College of WisconsinDivision of General Internal Medicine, Department of Medicine, Medical College of WisconsinDivision of General Internal Medicine, Department of Medicine, Medical College of WisconsinDivision of General Internal Medicine, Department of Medicine, Medical College of WisconsinDivision of General Internal Medicine, Department of Medicine, Medical College of WisconsinDivision of General Internal Medicine, Department of Medicine, Medical College of WisconsinAbstract Background The aim of this analysis was to examine the influence of housing insecurity on diabetes processes of care and self-care behaviors and determine if that relationship varied by employment status or race/ethnicity. Methods Using nationally representative data from the Behavioral Risk Factor Surveillance System (2014-2015), 16,091 individuals were analyzed for the cross-sectional study. Housing insecurity was defined as how often respondents reported being worried or stressed about having enough money to pay rent/mortgage. Following unadjusted logistic models testing interactions between housing insecurity and either employment or race/ethnicity on diabetes processes of care and self-care behaviors, stratified models were adjusted for demographics, socioeconomic status, health insurance status, and comorbidity count. Results 38.1% of adults with diabetes reported housing insecurity. Those reporting housing insecurity who were employed were less likely to have a physicians visit (0.58, 95%CI 0.37,0.92), A1c check (0.45, 95%CI 0.26,0.78), and eye exam (0.61, 95%CI 0.44,0.83), while unemployed individuals were less likely to have a flu vaccine (0.84, 95%CI 0.70,0.99). Housing insecure White adults were less likely to receive an eye exam (0.67, 95%CI 0.54,0.83), flu vaccine (0.84, 95%CI 0.71,0.99) or engage in physical activity (0.82, 95%CI 0.69,0.96), while housing insecure Non-Hispanic Black adults were less likely to have a physicians visit (0.56, 95%CI 0.32,0.99). Conclusions Housing insecurity had an influence on diabetes processes of care and self-care behaviors, and this relationship varied by employment status and race/ethnicity. Diabetes interventions should incorporate discussion surrounding housing insecurity and consider differences in the impact by demographic factors on diabetes care.https://doi.org/10.1186/s12913-022-07468-7Housing insecurityDiabetesQuality of careDiabetes processes of careDiabetes self-care behaviorsEmployment status |
| spellingShingle | Elise Mosley-Johnson Rebekah J. Walker Madhuli Thakkar Jennifer A. Campbell Laura Hawks Sarah Pyzyk Leonard E. Egede Relationship between housing insecurity, diabetes processes of care, and self-care behaviors BMC Health Services Research Housing insecurity Diabetes Quality of care Diabetes processes of care Diabetes self-care behaviors Employment status |
| title | Relationship between housing insecurity, diabetes processes of care, and self-care behaviors |
| title_full | Relationship between housing insecurity, diabetes processes of care, and self-care behaviors |
| title_fullStr | Relationship between housing insecurity, diabetes processes of care, and self-care behaviors |
| title_full_unstemmed | Relationship between housing insecurity, diabetes processes of care, and self-care behaviors |
| title_short | Relationship between housing insecurity, diabetes processes of care, and self-care behaviors |
| title_sort | relationship between housing insecurity diabetes processes of care and self care behaviors |
| topic | Housing insecurity Diabetes Quality of care Diabetes processes of care Diabetes self-care behaviors Employment status |
| url | https://doi.org/10.1186/s12913-022-07468-7 |
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