Prevalence of Housing Issues for Disabled Adults: Social Determinants of Health Time Series Regression Analysis 2019-2022

Research Objectives: To examine the relationship between state-level disabled housing issues and cost, both within a given year and by preceding years.

Design: Testing American Community Survey (ACS) data of disabled households, using multiple regression models.

Setting: Data are state level aggregates of the ACS put forth by the Annual Disability Statistics Compendium.

Participants: Disabled US Adults (~3,500,000) via the ACS from the US Census Bureau.

Interventions: None.

Main Outcome Measures: State-level housing cost burden for disabled adults.
Housing cost burden is defined as spending more than one-third of their income on their rent/mortgage. Time series regression analysis is conducted with data from 2019-2022, predicting housing cost burden by housing issue prevalence.

Results: The 4-phase Time Series Analysis predicts state-level housing cost burden percent in 2022, via housing issues annually, from 2019-2022. We demonstrate carry-over effects as well as intra-year effects of housing issues on housing cost burden for disabled adults.
Results demonstrate a clear carry-over effect of housing issues from 2019-2021 when predicting housing cost burden 2022. In 2019, states with more disabled adults in poor housing have higher cost burden (β=.0827,p <.001). In 2020, higher rates of poor housing (β=.709,p <.001) and overcrowded housing (β=.521,p <.05) have higher housing cost burden. Higher rates of old housing in 2020 have lower housing cost burden (β=-.069,p <.10). In 2021, higher rates of incomplete plumbing (β=-1.679,p <.10) and old housing (β=-0.684,p <.05) have lower housing cost burden while states with more overcrowding (β=.631,p <.05) and poor housing (β=.658,p <.01) have higher housing cost burden.
Intra-year effects demonstrate an inverse relationship to housing cost burden for older housing (β=-0.142,p <.01) and positive relationship with overcrowding (β=1.351,p <.001).

Conclusions: Housing issues manifest both immediately and over time. Therefore, it is essential to highlight housing issues as both independent and composite measures, indicating how housing issues temporally exacerbate cost burden.
Many disabled people do not live in a livable and affordable home. Disabled adults often have untreated deficiencies in their home, as a result creating both carryover and intra-year effects for state’s housing cost burden. Understanding long-term consequences are important for both aging in place and return to home rehabilitation. Housing issues and high housing costs will impede the ability to return home and age in place, posing understudied threats to a successful rehabilitation. Overall, case workers and occupational therapists should actively consider housing issues and cost burdens to facilitate disabled adults returning to their homes, rehabilitate in their homes, and remain connected to their community.

Author(s) Disclosures: None.