IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0241327.html
   My bibliography  Save this article

Association of poor housing conditions with COVID-19 incidence and mortality across US counties

Author

Listed:
  • Khansa Ahmad
  • Sebhat Erqou
  • Nishant Shah
  • Umair Nazir
  • Alan R Morrison
  • Gaurav Choudhary
  • Wen-Chih Wu

Abstract

Objective: Poor housing conditions have been linked with worse health outcomes and infectious disease spread. Since the relationship of poor housing conditions with incidence and mortality of COVID-19 is unknown, we investigated the association between poor housing condition and COVID-19 incidence and mortality in US counties. Methods: We conducted cross-sectional analysis of county-level data from the US Centers for Disease Control, US Census Bureau and John Hopkins Coronavirus Resource Center for 3135 US counties. The exposure of interest was percentage of households with poor housing conditions (one or greater of: overcrowding, high housing cost, incomplete kitchen facilities, or incomplete plumbing facilities). Outcomes were incidence rate ratios (IRR) and mortality rate ratios (MRR) of COVID-19 across US counties through 4/21/2020. Multilevel generalized linear modeling (with total population of each county as a denominator) was utilized to estimate relative risk of incidence and mortality related to poor housing conditions with adjustment for population density and county characteristics including demographics, income, education, prevalence of medical comorbidities, access to healthcare insurance and emergency rooms, and state-level COVID-19 test density. We report incidence rate ratios (IRRs) and mortality ratios (MRRs) for a 5% increase in prevalence in households with poor housing conditions. Results: Across 3135 US counties, the mean percentage of households with poor housing conditions was 14.2% (range 2.7% to 60.2%). On April 21st, the mean (SD) number of cases and deaths of COVID-19 were 255.68 (2877.03) cases and 13.90 (272.22) deaths per county, respectively. In the adjusted models standardized by county population, with each 5% increase in percent households with poor housing conditions, there was a 50% higher risk of COVID-19 incidence (IRR 1.50, 95% CI: 1.38–1.62) and a 42% higher risk of COVID-19 mortality (MRR 1.42, 95% CI: 1.25–1.61). Results remained similar using earlier timepoints (3/31/2020 and 4/10/2020). Conclusions and relevance: Counties with a higher percentage of households with poor housing had higher incidence of, and mortality associated with, COVID-19. These findings suggest targeted health policies to support individuals living in poor housing conditions should be considered in further efforts to mitigate adverse outcomes associated with COVID-19.

Suggested Citation

  • Khansa Ahmad & Sebhat Erqou & Nishant Shah & Umair Nazir & Alan R Morrison & Gaurav Choudhary & Wen-Chih Wu, 2020. "Association of poor housing conditions with COVID-19 incidence and mortality across US counties," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-13, November.
    • Handle: RePEc:plo:pone00:0241327
    DOI: 10.1371/journal.pone.0241327
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241327
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0241327&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0241327?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Dunn, James R. & Hayes, Michael V., 2000. "Social inequality, population health, and housing: a study of two Vancouver neighborhoods," Social Science & Medicine, Elsevier, vol. 51(4), pages 563-587, August.
    2. Krieger, J. & Higgins, D.L., 2002. "Housing and health: Time again for public health action," American Journal of Public Health, American Public Health Association, vol. 92(5), pages 758-768.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Arnab K Ghosh & Sara Venkatraman & Evgeniya Reshetnyak & Mangala Rajan & Anjile An & John K Chae & Mark A Unruh & David Abramson & Charles DiMaggio & Nathaniel Hupert, 2022. "Association between city-wide lockdown and COVID-19 hospitalization rates in multigenerational households in New York City," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-13, March.
    2. Emanuele Giorgi & Lucía Martín López & Ruben Garnica-Monroy & Aleksandra Krstikj & Carlos Cobreros & Miguel A. Montoya, 2021. "Co-Housing Response to Social Isolation of COVID-19 Outbreak, with a Focus on Gender Implications," Sustainability, MDPI, vol. 13(13), pages 1-25, June.
    3. Munasinghe, Lalani L. & Yin, Weijia & Nathani, Hasan & Toy, Junine & Sereda, Paul & Barrios, Rolando & Montaner, Julio S.G. & Lima, Viviane D., 2024. "The impact of the COVID-19 pandemic on HIV treatment gap lengths and viremia among people living with HIV British Columbia, Canada, during the COVID-19 pandemic: Are we ready for the next pandemic?," Social Science & Medicine, Elsevier, vol. 350(C).
    4. Valenzuela-Levi, N. & Echiburu, T. & Correa, J. & Hurtubia, R. & Muñoz, J.C., 2021. "Housing and accessibility after the COVID-19 pandemic: Rebuilding for resilience, equity and sustainable mobility," Transport Policy, Elsevier, vol. 109(C), pages 48-60.
    5. Zidong Yu & Xintao Liu, 2023. "Spatial variations of the third and fourth COVID-19 waves in Hong Kong: A comparative study using built environment and socio-demographic characteristics," Environment and Planning B, , vol. 50(5), pages 1144-1160, June.
    6. ArunKumar, K.E. & Kalaga, Dinesh V. & Kumar, Ch. Mohan Sai & Kawaji, Masahiro & Brenza, Timothy M, 2021. "Forecasting of COVID-19 using deep layer Recurrent Neural Networks (RNNs) with Gated Recurrent Units (GRUs) and Long Short-Term Memory (LSTM) cells," Chaos, Solitons & Fractals, Elsevier, vol. 146(C).
    7. Lateef, Rusan & Alaggia, Ramona & Collin-Vézina, Delphine, 2021. "A scoping review on psychosocial consequences of pandemics on parents and children: Planning for today and the future," Children and Youth Services Review, Elsevier, vol. 125(C).
    8. Isabel Aguilar-Palacio & Lina Maldonado & Sara Malo & Raquel Sánchez-Recio & Iván Marcos-Campos & Rosa Magallón-Botaya & Mª José Rabanaque, 2021. "COVID-19 Inequalities: Individual and Area Socioeconomic Factors (Aragón, Spain)," IJERPH, MDPI, vol. 18(12), pages 1-15, June.
    9. Katharine Robb & Ashley Marcoux & Jorrit de Jong, 2021. "Further Inspection: Integrating Housing Code Enforcement and Social Services to Improve Community Health," IJERPH, MDPI, vol. 18(22), pages 1-13, November.
    10. Jianwei Huang & Mei-Po Kwan, 2022. "Examining the Influence of Housing Conditions and Daily Greenspace Exposure on People’s Perceived COVID-19 Risk and Distress," IJERPH, MDPI, vol. 19(14), pages 1-19, July.
    11. Pilar Mercader-Moyano & Ana Mª Estable-Reifs & Homero Pellicer, 2021. "Toward the Renewal of the Sustainable Urban Indicators’ System after a Global Health Crisis. Practical Application in Granada, Spain," Energies, MDPI, vol. 14(19), pages 1-43, September.
    12. Andrew C Stokes & Dielle J Lundberg & Irma T Elo & Katherine Hempstead & Jacob Bor & Samuel H Preston, 2021. "COVID-19 and excess mortality in the United States: A county-level analysis," PLOS Medicine, Public Library of Science, vol. 18(5), pages 1-18, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jens Kandt & Shu-Sen Chang & Paul Yip & Ricky Burdett, 2017. "The spatial pattern of premature mortality in Hong Kong: How does it relate to public housing?," Urban Studies, Urban Studies Journal Limited, vol. 54(5), pages 1211-1234, April.
    2. Amy Clair, 2019. "Housing: an Under-Explored Influence on Children’s Well-Being and Becoming," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 12(2), pages 609-626, April.
    3. Kaylee Ramage & Meaghan Bell & Lisa Zaretsky & Laura Lee & Katrina Milaney, 2021. "Is the Right to Housing Being Realized in Canada? Learning from the Experiences of Tenants in Affordable Housing Units in a Large Canadian City," Societies, MDPI, vol. 11(2), pages 1-9, June.
    4. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    5. Carolina Navarro & Luis Ayala & José Labeaga, 2010. "Housing deprivation and health status: evidence from Spain," Empirical Economics, Springer, vol. 38(3), pages 555-582, June.
    6. Sima Alizadeh & Catherine E. Bridge & Bruce H. Judd & Valsamma Eapen, 2023. "Home Indoor Environmental Quality and Attention Deficit Hyperactivity Disorder," Sustainability, MDPI, vol. 15(4), pages 1-25, February.
    7. Milovanska-Farrington, Stefani, 2020. "Parents labor supply and childhood obesity: Evidence from Scotland," Economics & Human Biology, Elsevier, vol. 38(C).
    8. Dragan Gjorgjev & Mirjana Dimovska & George Morris & John Howie & Mirjana Borota Popovska & Marija Topuzovska Latkovikj, 2019. "How Good Is our Place—Implementation of the Place Standard Tool in North Macedonia," IJERPH, MDPI, vol. 17(1), pages 1-16, December.
    9. Lee, Christopher Thomas & Guzman, David & Ponath, Claudia & Tieu, Lina & Riley, Elise & Kushel, Margot, 2016. "Residential patterns in older homeless adults: Results of a cluster analysis," Social Science & Medicine, Elsevier, vol. 153(C), pages 131-140.
    10. Philipp Ager & James J Feigenbaum & Casper W Hansen & Hui Ren Tan, 2024. "How the Other Half Died: Immigration and Mortality in U.S. Cities," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(1), pages 1-44.
    11. Judith Schröder & Susanne Moebus & Julita Skodra, 2022. "Selected Research Issues of Urban Public Health," IJERPH, MDPI, vol. 19(9), pages 1-28, May.
    12. Juan Pablo Díaz-Sánchez & Moisés Obaco & Javier Romaní, 2022. "Measuring Overcrowding in Households with Children: Official vs. Actual Thresholds in the Ecuadorian Case," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 15(2), pages 383-398, April.
    13. Min Zhou & Wei Guo, 2023. "Self-rated Health and Objective Health Status Among Rural-to-Urban Migrants in China: A Healthy Housing Perspective," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(1), pages 1-24, February.
    14. Sungwoo Lim & Pui Ying Chan & Sarah Walters & Gretchen Culp & Mary Huynh & L Hannah Gould, 2017. "Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-12, December.
    15. Völker, Sebastian & Kistemann, Thomas, 2013. "Reprint of: “I'm always entirely happy when I'm here!” Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany," Social Science & Medicine, Elsevier, vol. 91(C), pages 141-152.
    16. Stefan Angel & Benjamin Bittschi, 2019. "Housing and Health," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 65(3), pages 495-513, September.
    17. Quinonez, Pablo, 2022. "Social spending and income inequality in Latin America. A panel data approach," MPRA Paper 113538, University Library of Munich, Germany.
    18. Yang Xiao & Siyu Miao & Chinmoy Sarkar & Huizhi Geng & Yi Lu, 2018. "Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach," IJERPH, MDPI, vol. 15(2), pages 1-14, January.
    19. Badland, Hannah & Whitzman, Carolyn & Lowe, Melanie & Davern, Melanie & Aye, Lu & Butterworth, Iain & Hes, Dominique & Giles-Corti, Billie, 2014. "Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health," Social Science & Medicine, Elsevier, vol. 111(C), pages 64-73.
    20. Emma J. Kuhn & G. Stewart Walker & Harriet Whiley & Jackie Wright & Kirstin E. Ross, 2019. "Household Contamination with Methamphetamine: Knowledge and Uncertainties," IJERPH, MDPI, vol. 16(23), pages 1-15, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0241327. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.