Roberts Mary K, Bhat Aarti C, Fenelon Andrew
Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, 42-43 Park End Street, Oxford, OX1 1JD, UK.
Population Research Institute, The Pennsylvania State University, 601 Oswald Tower, University Park, PA, 16802, USA; Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA; Center for Healthy Aging, The Pennsylvania State University, 4th Floor Biobehavioral Health Building, University Park, PA, 16802, USA.
Soc Sci Med. 2025 Feb;367:117761. doi: 10.1016/j.socscimed.2025.117761. Epub 2025 Jan 25.
Economic and material hardship, including housing insecurity - limited or uncertain availability or access to safe, quality, and affordable housing - is strongly linked to negative physical and mental health outcomes among adolescents and adults. However, data limitations and the inherent selectivity of housing insecurity have hindered comprehensive analysis of its long-term effects on physiological and mental health. This study uses data from The National Longitudinal Study of Adolescent to Adult Health (Add Health) to construct a sample of participants who experienced housing insecurity between the ages of 18-26 (Wave III) to a suitable control group using propensity score matching. We assess the effects of housing insecurity on (1) material hardship at Wave IV (ages 24-32), (2) allostatic load (AL) and depression symptoms at Waves IV and V (ages 33-43), and (3) the change in allostatic load and depression symptoms from Wave IV to V. Further, we evaluate whether effects differ by sex. Experiencing housing insecurity is associated with a significantly higher likelihood of experiencing material hardship at Wave IV and significantly worse depressive symptoms at both Waves IV and V. The treatment effects are more pronounced among women, with housing insecurity being linked to a significant increase in allostatic load from Wave IV to Wave V exclusively for women. Our results provide crucial support that housing insecurity is not just an outcome of economic hardship but a cause of it in the future, with downstream effects on health and well-being, particularly for women.
经济和物质困难,包括住房无保障——获得安全、优质且负担得起的住房的可能性有限或不确定——与青少年和成年人的负面身心健康结果密切相关。然而,数据限制以及住房无保障的内在选择性阻碍了对其对生理和心理健康长期影响的全面分析。本研究使用来自全国青少年至成人健康纵向研究(Add Health)的数据,通过倾向得分匹配为18至26岁(第三波)经历住房无保障的参与者构建一个合适的对照组样本。我们评估住房无保障对以下方面的影响:(1)第四波(24至32岁)时的物质困难,(2)第四波和第五波(33至43岁)时的压力负荷(AL)和抑郁症状,以及(3)从第四波到第五波压力负荷和抑郁症状的变化。此外,我们评估影响是否因性别而异。经历住房无保障与在第四波经历物质困难的可能性显著更高以及在第四波和第五波时抑郁症状显著更严重相关。治疗效果在女性中更为明显,住房无保障仅与女性从第四波到第五波压力负荷的显著增加有关。我们的结果提供了关键支持,即住房无保障不仅是经济困难的结果,而且是未来经济困难的一个原因,对健康和幸福有下游影响,尤其是对女性。