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For low-income older adults, where they live may affect how long they live, according to new research from Washington University in St. Louis.
The , forthcoming in the September print issue of the journal Social Science & Medicine, examined the relationship between housing, social isolation and risk of death among low-income renters age 65 and older. Researchers analyzed 12 years of nationally representative data from the National Health and Aging Trends Study, following 2,790 older renters across 9,337 observations.
Sojung Park, an associate professor at the Brown School and co-author of the study, said the findings point to the importance of considering housing as part of the broader social environment that shapes health.
鈥淥ur findings show that housing and social connection work together to shape health and survival in later life, particularly for low-income older adults,鈥� she said.
How does housing type affect risk of death?
Researchers compared subsidized housing for low-income older adults; non-subsidized congregate housing communities; and traditional rental housing.
In this study, non-subsidized congregate housing means market-rate or private-pay senior or independent living communities. Subsidized senior housing is senior housing for low-income residents that receives public housing support or government rental assistance.
After accounting for demographic, socioeconomic and health characteristics, residents of traditional rental housing were 56% more likely to die over time than those in subsidized senior housing. The estimated death rate over time among residents of private-pay senior housing communities fell between the rates observed in subsidized senior housing and traditional rental housing.
Social isolation also independently was associated with higher risk of death. Isolated residents had a 51% higher death rate.
The study suggests that housing and health policies are closely linked.
鈥淭he findings can inform housing policies by showing that socially embedded and affordable housing environments may be associated with lower mortality risk and with longer, healthier lives,鈥� Park and her co-authors wrote.
Why does social isolation matter differently depending on where people live?
Among socially connected older adults, predicted death rates were similar across housing types, at 6% to 7%. But as social isolation increased, those risks rose to 9% to 13% among residents of non-subsidized and traditional housing, while remaining lowest among residents of subsidized senior housing.
Among socially isolated residents of non-subsidized housing, the risk of death was nearly twice that of socially connected residents of subsidized senior housing.
The findings suggest that housing that is affordable, stable and supportive may help older adults stay connected to others and to needed services, Park said. However, because this was an observational study, it cannot determine that housing type caused the differences in risk of death, she cautioned. The data also did not measure specific on-site services, service coordination or the quality of residents鈥� social connections, so researchers need to do more work to identify which features of subsidized senior housing may be most helpful.
鈥淪ocial connectedness matters for late-life survival, but its protective effect is fundamentally shaped by residential context,鈥� Park and her co-authors wrote.
This study is the latest in Park鈥檚 longstanding research program examining how housing and community environments shape aging in place among low-income and other vulnerable older adults. Her work investigates how affordability, social connection, neighborhood resources and links to services within and around housing relate to healthcare use, cognitive function, well-being, end-of-life resources and survival. Across this research, Park asks which housing features matter, for whom and under what conditions.
鈥淭his study suggests that housing context matters,鈥� Park said. 鈥淭he policy relevance lies in identifying the housing and support conditions that may merit further investment and evaluation across different residential settings.鈥�