title: Material resources and population health: disadvantages in health care, housing, and food among adults over 50 years of age.
abstract: OBJECTIVE
  We examined associations between material resources and late-life declines in health.
  
  
  METHODS
  We used logistic regression to estimate the odds of declines in self-rated health and incident walking limitations associated with material disadvantages in a prospective panel representative of US adults aged 51 years and older (N = 15,441).
  
  
  RESULTS
  Disadvantages in health care (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.23, 1.58), food (OR = 1.69; 95% CI = 1.29, 2.22), and housing (OR = 1.20; 95% CI = 1.07, 1.35) were independently associated with declines in self-rated health, whereas only health care (OR = 1.43; 95% CI = 1.29, 1.58) and food (OR = 1.64; 95% CI = 1.31, 2.05) disadvantage predicted incident walking limitations. Participants experiencing multiple material disadvantages were particularly susceptible to worsening health and functional decline. These effects were sustained after we controlled for numerous covariates, including baseline health status and comorbidities. The relations between health declines and non-Hispanic Black race/ethnicity, poverty, marital status, and education were attenuated or eliminated after we controlled for material disadvantage.
  
  
  CONCLUSIONS
  Material disadvantages, which are highly policy relevant, appear related to health in ways not captured by education and poverty. Policies to improve health should address a range of basic human needs, rather than health care alone.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD, USA. dalley@epi.umaryland.edu
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Alley
authors.forename: Beth J
authors.initials: BJ
authors.lastname: Soldo
authors.forename: José A
authors.initials: JA
authors.lastname: Pagán
authors.forename: John
authors.initials: J
authors.lastname: McCabe
authors.forename: Madeleine
authors.initials: M
authors.lastname: DeBlois
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Field
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
authors.forename: Carolyn
authors.initials: C
authors.lastname: Cannuscio
mesh_terms: D000368:Aged; D005260:Female; D005523:Food Supply; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities; D006798:Housing; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011203:Poverty; D014481:United States