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BMC Public Health. 2018 May 29;18(1):665. doi: 10.1186/s12889-018-5583-6.

Public rental housing and its association with mortality - a retrospective, cohort study.

Author information

1
Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
2
Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
3
Faculty of Science, National University of Singapore, Singapore, Singapore.
4
Health Services Research Centre, Singapore Health Services, Singapore, Singapore.
5
Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
6
SingHealth Regional Health System, Singapore Health Services, Singapore, Singapore.
7
SingHealth Regional Health System, Singapore Health Services, Singapore, Singapore. low.lian.leng@singhealth.com.sg.
8
Department of Family Medicine and Continuing Care, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. low.lian.leng@singhealth.com.sg.
9
SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, Singapore. low.lian.leng@singhealth.com.sg.

Abstract

BACKGROUND:

Socioeconomic status (SES) is a well-established determinant of health status and home ownership is a commonly used composite indicator of SES. Patients in low-income households often stay in public rental housing. The association between public rental housing and mortality has not been examined in Singapore.

METHODS:

A retrospective, cohort study was conducted involving all patients who utilized the healthcare facilities under SingHealth Regional Health (SHRS) Services in Year 2012. Each patient was followed up for 5 years. Patients who were non-citizens or residing in a non-SHRS area were excluded from the study.

RESULTS:

A total of 147,004 patients were included in the study, of which 7252 (4.9%) patients died during the study period. The mean age of patients was 50.2 ± 17.2 years old and 7.1% (n = 10,400) of patients stayed in public rental housing. Patients who passed away had higher utilization of healthcare resources in the past 1 year and a higher proportion stayed in public rental housing (p < 0.001). They also had higher rates of co-morbidities such as hypertension, hyperlipidaemia and diabetes. (p < 0.001) After adjustment for demographic and clinical covariates, residence in public rental housing was associated with increased risk of all-cause mortality (Adjusted hazard ratio: 1.568, 95% CI: 1.469-1.673).

CONCLUSION:

Public rental housing was an independent risk factor for all-cause mortality. More studies should be conducted to understand health-seeking behavior and needs of public rental housing patients, to aid policymakers in formulating better plans for improving their health outcomes.

KEYWORDS:

Low socioeconomic status; Mortality; Public rental housing; Social determinant of health

PMID:
29843652
PMCID:
PMC5975624
DOI:
10.1186/s12889-018-5583-6
[Indexed for MEDLINE]
Free PMC Article

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