Of the estimated 58 million Americans over age 65, about three million live in publicly supported, reduced-cost housing, intended to make living situations safer, more stable and affordable for people with lower incomes, so that they have less stress and more money for what they need, including health care. But for many, life-long disadvantages and inequities still take a toll.

Based on a 10-year retrospective analysis of a representative sample of Medicare enrollees participating in the National Health and Aging Trends Study, a recent study compared 295 participants living in subsidized housing to 5,999 participants living in other community settings.

Those in subsidized housing:

• Had more health disparities—including more frailty, functional impairment, and dementia.
• Had higher rates of hospitalization and short-term and long-term nursing home placement, particularly related to functional and cognitive impairment.
• Were older and less likely to have completed high school.
• Were more likely to identify as a racial/ethnic minority.
• Were more likely to be socially isolated.

Mitigating Disparities With Housing-Based Interventions

The study’s evidence-based findings can help inform interventions to improve health outcomes for this population, such as housing-based interventions that may involve regular visits in the home with a health care provider, such as an occupational therapist, social worker, or registered nurse, the researchers suggest.

As part of the study, the team reviewed the available evidence for these interventions. They found that the most successful ones share several key components:

• They are individualized to the specific needs of each older adult.
• They deliver services on-site.
• They aim to address environmental factors that influence function and physical activity for older people, as well as individual factors such as health-related behaviors.

The team is now testing the efficacy of some of these interventions, aiming to see how housing can serve as a platform to improve health for older adults, and how housing programs can be combined with geriatric models of care to improve health outcomes.

To download the full study, published in the Journal of the American Geriatrics Society, click here