Changes in healthcare use among individuals who move into public housing: a population-based investigation

Abstract

BackgroundResidence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use.MethodsWe used linked population-based administrative data housed in the Population Research Data Repository at the Manitoba Centre for Health Policy. The cohort consisted of individuals who moved into public housing in 2009 and 2010. We counted the number of hospitalizations, general practitioner (GP) visits, specialist visits, emergency department visits, and prescriptions drugs dispensed in the twelve 30-day intervals (i.e., months) immediately preceding and following the public housing move-in date. Generalized linear models with generalized estimating equations tested for a period (pre/post-move-in) by month interaction. Odds ratios (ORs), incident rate ratios (IRRs), and means are reported along with 95% confidence intervals (95% CIs).ResultsThe cohort included 1942 individuals; the majority were female (73.4%) who lived in low income areas and received government assistance (68.1%). On average, the cohort had more than four health conditions. Over the 24 30-day intervals, the percentage of the cohort that visited a GP, specialist, and an emergency department ranged between 37.0% and 43.0%, 10.0% and 14.0%, and 6.0% and 10.0%, respectively, while the percentage of the cohort hospitalized ranged from 1.0% to 5.0%. Generally, these percentages were highest in the few months before the move-in date and lowest in the few months after the move-in date. The period by month interaction was statistically significant for hospitalizations, GP visits, and prescription drug use. The average change in the odds, rate, or mean was smaller in the post-move-in period than in the pre-move-in period.ConclusionsUse of some healthcare services declined after people moved into public housing; however, the decrease was only observed in the first few months and utilization rebounded. Knowledge of healthcare trends before individuals move in are informative for ensuring the appropriate supports are available to new public housing residents. Further study is needed to determine if decreased healthcare utilization following a move is attributable to decreased access.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3109-7) contains supplementary material, which is available to authorized users.

Health care utilization among women of reproductive age living in public housing: Associations across six public housing sites in San Francisco

“…Some literature suggests that individuals in public housing are sicker than comparable populations and health status may select individuals into public housing. ( Biederman et al, 2022 , Hinds et al, 2019 , Hinds et al, 2018 , Hinds et al, 2016 ) However, other studies indicate that differences in health care utilization persist after adjusting for baseline health status,( Digenis-Bury et al, 2008 , Hinds et al, 2019 , Hinds et al, 2018 ) although we were not able to assess this in our study. Nonetheless, more research is needed to robustly understand implications for bias.…”

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