Housing Assistance and Blood Lead Levels: Children in the United States, 2005–2012

Ahrens, Katherine A.; Haley, Barbara A.; Rossen, Lauren M.; Lloyd, Patricia C.; Aoki, Yutaka

doi:10.2105/ajph.2016.303432

Cited by 33 publications

(24 citation statements)

References 17 publications

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“…We performed several sensitivity analyses, including 1) re-running our analyses with physical activity as a continuous variable and 2) including individuals living in households with an income-to-poverty ratio greater than 200%. Additionally, consistent with a previous study of this population ( 5 ), we used a propensity-score approach to compare physical activity among adults who received housing assistance when surveyed to a comparable group of adults not receiving housing assistance at that time. The propensity-score approach allowed for a larger control group than did the pseudo–wait-list, because it was not limited to people who eventually received housing.…”

Section: Methodsmentioning

confidence: 99%

“…The US Department of Housing and Urban Development (HUD) manages and oversees federal housing assistance programs, which can include the provision of housing vouchers (eg, Housing Choice Vouchers), which help people rent private homes, or the provision of public housing ( 2 ). The receipt of housing assistance is linked with better overall self-rated health, less psychological distress ( 3 ), and lower rates of uninsurance and unmet medical needs ( 4 ) among adults, as well as lower blood-lead levels in young children ( 5 ). The extent to which housing assistance may also lead to healthier behaviors, such as physical activity, is uncertain.…”

Section: Introductionmentioning

confidence: 99%

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HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

et al. 2018

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IntroductionReceipt of housing assistance from the US Department of Housing and Urban Development (HUD) is associated with improved health among adults and lower rates of unmet medical need among adults and young children. However, it is unclear whether HUD housing assistance is associated with healthier behaviors. The objective of our study was to assess whether participation in HUD housing assistance programs is associated with increased physical activity among low-income adults.MethodsIn 2017, we pooled cross-sectional data from the 2004–2012 National Health Interview Survey (NHIS) linked to administrative records of HUD housing assistance participation. Our primary sample was low-income adults (aged ≥18; <200% of federal poverty level). Using multivariate logistic regression, we calculated the odds of being physically active (≥150 min/week of moderate-intensity activity or equivalent combination of moderate- and vigorous-intensity activity) among current HUD housing assistance residents compared with a control group of future residents (adults who would receive assistance within the next 2 years). In a secondary analyses, we examined neighborhood socioeconomic status as a modifier and conducted a subanalysis among nonsenior adults (aged <65).ResultsAmong all low-income adults, the adjusted odds of being physically active were similar for current and future residents (odds ratio =1.17; 95% confidence interval, 0.95–1.46). Among nonseniors, current residents were more likely to be physically active than future residents (odds ratio = 1.47; 95% confidence interval, 1.10–1.97). Associations did not differ by neighborhood socioeconomic status.ConclusionReceiving HUD housing assistance is associated with being physically active among nonsenior low-income adults.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

et al. 2018

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“…Important programs for the prevention of early childhood Pb exposure in the US include the 1988 Childhood Lead Poisoning Prevention Program from the CDC to eliminate childhood exposure to Pb, in addition to the 1999 Healthy Homes Initiative (HHI) from the Department of Housing and Urban Development (HUD) that coordinates the identification and elimination of Pb hazards related to housing and childhood Pb exposure. Federally-owned or -subsidized housing must comply with stricter regulations of leaded paint hazards and their remediation under the 1999 Lead Safe Housing Rule by HUD, while children who reside in housing that receives public assistance from HUD at the national level or locally from the New York City Housing Authority (NYCHA) have significantly lower blood Pb [80,81]. Any alterations to buildings with leaded paint hazards are further regulated under the 1992 Renovation, Repair, and Painting Rule from the EPA.…”

Section: Safe Housing and Environmental Justicementioning

confidence: 99%

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Yeter¹,

Banks

Aschner

2020

IJERPH

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There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1-5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.

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“…Except for an extensive literature on asthma and lead poisoning, chronic conditions among children living in public housing are less frequently examined. 10 - 15 If the burden of chronic conditions among adults is any indication, children living in public housing are also likely to suffer disproportionately from chronic conditions. There is some evidence that youth living in public housing are at risk for health problems like unintended injuries, 16 , 17 mental health problems, 18 , 19 and less access to behavioral health services.…”

Section: Introductionmentioning

confidence: 99%

Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY

Chambers

Heller

Fiori

et al. 2020

Global Pediatric Health

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This study compared the prevalence of chronic pediatric health conditions for youth in public housing with youth not in public housing using clinical electronic health record (EHR) and housing data. Youth (ages 2-17 years) in a large urban health system were identified and categorized into two housing types—public housing (n = 10 770) and not in public housing (n = 84 883) by age (young childhood, middle childhood, young adolescence). The prevalence of some pediatric conditions was higher in public housing but varied by age. Disparities in health conditions among youth in public housing were more common in early adolescence: asthma (26.4 vs 18.6; P < .001); obesity (28.5 vs 24.6; P < .001); depression/anxiety (19.2 vs 17.3; P = .008); behavioral disorders (8.1 vs 5.3; P < .001). These results show that chronic pediatric conditions like asthma and obesity that lead to significant morbidity into adulthood are more common among youth living in public housing. However, this pattern is not consistent across all chronic conditions.

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Housing Assistance and Blood Lead Levels: Children in the United States, 2005–2012

Abstract: Children aged 1 to 5 years during 2005 to 2012 who were living in HUD-assisted housing had lower BLLs than expected given their demographic, socioeconomic, and family characteristics.

Cited by 33 publications

References 17 publications

HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

Chronic pediatric health conditions among youth living in public housing and receiving care in a large hospital system in Bronx, NY

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