Housing Wealth and Glycemic Control Among Patients With Type 2 Diabetes.
Housing wealth can be leveraged to maintain economic security when expenses exceed income, allowing households flexibility when managing a new chronic disease diagnosis. We linked housing and electronic health record (EHR) data to examine how housing wealth and stability relate to type 2 diabetes (T2D) outcomes.
EHR data from patients diagnosed with T2D were linked to housing data (tenure, foreclosure, home equity, reverse mortgage, and loan-to-value ratio) using residential address. Multinomial logistic regression models were used to estimate associations between housing variables measured in the year before T2D diagnosis and glycemic control a year or more after T2D diagnosis.
Among 5810 patients with T2D and complete housing data, patients with more home equity [relative risk ratio (rrr)=0.52, 95% CI: 0.323-0.838, P<0.001] were less likely to experience HbA1c >9% 1 year after diagnosis, and owners who were actively extracting home equity through a reverse mortgage (rrr=2.137, 95% CI: 0.008-1.511, P=0.048) were also more likely to have HbA1c >9% compared with patients with HbA1c<6.5%. Homeowners were less likely than renters to experience HbA1c >9% (rrr=0.798, 95% CI: 0.672-0.948, P=0.010).
Patients diagnosed with T2D who had more housing wealth were less likely to experience challenges with glycemic control after diagnosis.
EHR data from patients diagnosed with T2D were linked to housing data (tenure, foreclosure, home equity, reverse mortgage, and loan-to-value ratio) using residential address. Multinomial logistic regression models were used to estimate associations between housing variables measured in the year before T2D diagnosis and glycemic control a year or more after T2D diagnosis.
Among 5810 patients with T2D and complete housing data, patients with more home equity [relative risk ratio (rrr)=0.52, 95% CI: 0.323-0.838, P<0.001] were less likely to experience HbA1c >9% 1 year after diagnosis, and owners who were actively extracting home equity through a reverse mortgage (rrr=2.137, 95% CI: 0.008-1.511, P=0.048) were also more likely to have HbA1c >9% compared with patients with HbA1c<6.5%. Homeowners were less likely than renters to experience HbA1c >9% (rrr=0.798, 95% CI: 0.672-0.948, P=0.010).
Patients diagnosed with T2D who had more housing wealth were less likely to experience challenges with glycemic control after diagnosis.
Authors
Leonard Leonard, Bowen Bowen, Billig Billig, Gunasekaran Gunasekaran, Liao Liao, Masica Masica, Oliveros Oliveros, Velasco Velasco, Hughes Hughes
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