How do housing asset and income relate to mortality? A population-based cohort study of 881220 older adults in Canada. (December 2022)

• Record Type: Journal Article
• Authors: Park, Gum-Ryeong; Grignon, Michel; Young, Marisa; Dunn, James R.
• Is Part Of: Social science & medicine. Volume 314(2022)
• Publication Date: 2022-12
• Subjects: Socioeconomic inequality -- Housing asset poverty -- Income poverty -- Mortality -- Older adults -- Canada; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2022.115429
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Objective: A growing body of research has documented a well-established link between socioeconomic conditions and mortality among older adults. This study aims to understand (a) whether housing assets and income are associated with mortality and (b) if the value of housing assets affects the relationship between income and mortality; both questions are studied among older adults aged 65 or over in Canada. Methods: Using the population-based linked dataset (2011 Canadian Census Health and Environment Cohorts) of 881, 220 older adults over six years of follow-up (2011–2017), this study uses survival analysis to estimate the link between housing assets, income level and mortality. We also assess the potential moderating effect of housing asset levels on the association between income and mortality by categorizing individuals along two dimensions: whether they are income-poor and whether they are housing assets-poor. Results: The mortality rate was higher among both the lowest asset ( HR = 1.346) and the lowest income group ( HR = 1.203). The association is pronounced for older adults aged 65 to 74. Assets did not significantly moderate the link between income and mortality. Income-related inequalities in mortality are observed among each group of housing asset level. Compared to those who are neither income-poor nor housing assets-poor, individuals who were income poor but not housing assets-poor were more likely to die ( HR = 1.067) over seven years of follow-up, and people who were housing assets-poor only were more likely to die ( HR = 1.210). Being housing-assets poor and income-poor yielded a higher hazard ratio ( HR = 1.291). Conclusions: Housing assets and income are associated with mortality of older adults. It is important to identify people who are assets poor and/or income poor who are at higher risks of mortality. Social policies aimed at reducing income insecurity and housing insecurity can reduce mortality inequalities. Highlights: The levels of housing assets and income predicted mortality risks of older adults. The observed association was manifest in older adults aged 65 to 74. Housing assets did not moderate the association between income and mortality. Housing asset poor and income poor were the most vulnerable to mortality risks.