Housing mobility, hypertension self-management, and healthcare utilization among Bronx Latinos

Project Summary/ Abstract Moving residence is a major life event and associated with health outcomes at all levels of socio-economic status. In some instances, moving to a better housing unit in a desirable neighborhood may bring more access to quality health care. Among low-income residents, however, the negative health consequences of mobility are more likely. Low-income residents are nearly 3 times more likely to move residence in the last 12 months than high-income residents. Moving frequently can break established social networks and other supportive ties with friends and family, healthcare providers, and community-based organizations that serve the health care needs of low-income residents. Residents that move are more likely to use emergency departments and require hospitalization for health conditions. While change of address is easy to measure in healthcare databases, it provides only limited information as the reasons for the move are not captured. In order to target those most in need of services, detailed information is needed about the reasons people move and the related health consequences. Latino residents are often new arrivals to the US, and as such they are a mobile population particularly susceptible to housing instability. Latinos are known to be 2 to 3 times more likely to be evicted than non-Latino whites, however, no prior study has examined the health outcomes associated with unstable housing in this population. The current proposal is an ancillary study to Hispanic Community Health Study/ Study of Latinos (HCHS/SOL) that will leverage the extensive data on health status and health care utilization measured through the efforts of the parent study. In 2008-2011, HCHS/SOL recruited a probability sample of non-institutionalized Latino adults in four US regions. This R03 proposal will take advantage of existing data from the HCHS/SOL Bronx Field Center, including longitudinal tracking of place of residence over up to a decade. The specific aims of the study are: 1) To describe the relationship of socio-demographic, socio-economic, and health-related factors with mobility among Latino adults with hypertension; and 2) to examine the relationship between housing mobility and health care utilization and blood pressure control and self- management during HCHS/SOL follow-up. This work will add important housing related data to the HCHS/SOL cohort that can inform our understanding of the effects of housing as a social and economic determinant of health. Furthermore, there is need for research that can show the health implications of housing instability. Government public health departments and hospital systems have an interest in unstably housed residents as they continually strain social services and disproportionately burden health care systems.