Health Services/Policy
Exploring the Impact of Housing Type on Respiratory Health in New York City Adults: The Mediating Role of Indoor Environmental Quality Jin Choi* Jin Choi Byoungjun Kim
Respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD) are major causes of morbidity in urban populations, especially among socioeconomically disadvantaged groups. Housing conditions, particularly in cities like New York, play a critical role in shaping respiratory health outcomes. This study examines the relationship between housing type and respiratory health, focusing on asthma and COPD among adults in New York City. It investigates various housing arrangements, including homeownership, public housing, rental assistance, and rent-controlled housing, and explores the mediating roles of indoor environmental factors, such as mold and cockroach infestations.
Results indicate that adults in public housing have significantly higher odds of asthma (OR = 2.15; 95% CI = 1.25, 2.84) and COPD (OR = 2.02; 95% CI = 1.74, 3.08) compared to homeowners. Similarly, individuals in rental assistance housing exhibit elevated risks for asthma (OR = 2.25; 95% CI = 1.17, 2.73) and COPD (OR = 1.95; 95% CI = 1.17, 2.79). Causal mediation analysis reveals that indoor environmental factors, such as mold and cockroaches, mediate these relationships. Specifically, mold mediates 52% of the asthma association (OR = 1.72) and 54% of the COPD association (OR = 1.61). Cockroach infestations mediate 54% of the asthma association (OR = 1.74) and 55% of the COPD association (OR = 1.51).
These findings underscore the importance of indoor environmental quality in shaping respiratory health, particularly among those in public and subsidized housing. The results highlight the urgent need for public health interventions to improve environmental conditions in these housing sectors. Prioritizing pest control, mold remediation, and building maintenance can reduce the burden of asthma and COPD, improving health outcomes for vulnerable populations.
Public health and housing policies addressing these environmental factors are essential for reducing respiratory health disparities. This research provides actionable insights for urban health policy, offering guidance for interventions in New York City and similar urban environments. By addressing these issues, we can work toward health equity and reduce the adverse effects of poor housing conditions.