title: Housing conditions and mortality in older patients hospitalized for heart failure.
abstract: BACKGROUND
  Although decent housing is recognized as a prerequisite for good health, very few studies in developed countries have examined the influence of housing characteristics on disease prognosis. This work examined whether housing conditions predict mortality in older adults with heart failure (HF).
  
  
  METHODS
  This is a cohort study comprising 433 patients hospitalized for HF-related emergencies in 4 Spanish hospitals between January 1, 2000, and June 30, 2001. At baseline, patients reported whether their homes lacked an elevator (in an apartment building), hot water, heating, an indoor bathroom, a bathtub or shower, individual bedroom, automatic washing machine, and telephone and whether they frequently felt cold. Analyses included all-cause deaths identified prospectively until January 1, 2005.
  
  
  RESULTS
  Among study participants, 165 (38.1%) lived in a home without one of the services considered; and 111 (25.6%) lacked ≥2 services. During follow-up, 260 deaths (60%) occurred. After adjustment for the main confounders, mortality was higher in those who lived in homes without an elevator (hazard ratio [HR] 1.39, 95% CI 1.07-1.80) and in those who frequently felt cold (HR 1.39, 95% CI 1.01-1.92). In comparison with living in a home with all the services considered, mortality was higher for persons living in a home lacking 1 service (HR 1.42, 95% CI 1.10-1.93) or ≥2 services (HR 1.94, 95% CI 1.37-2.74). Patients living in homes lacking any of the services more often had poor functional status, higher comorbidity, lower educational level, and less income.
  
  
  CONCLUSIONS
  Poor housing conditions are associated with higher mortality in HF. Patients living in these homes are especially vulnerable because they have poorer clinical situation and lower socioeconomic position.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz, CIBERESP, Spain.
authors.forename: María C
authors.initials: MC
authors.lastname: Zuluaga
authors.forename: Pilar
authors.initials: P
authors.lastname: Guallar-Castillón
authors.forename: Pedro
authors.initials: P
authors.lastname: Conthe
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Pascual
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Graciani
authors.forename: Luz M
authors.initials: LM
authors.lastname: León-Muñoz
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Gutiérrez-Fisac
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization; D016852:Housing for the Elderly / Q000592:standards*; D006801:Humans; D007297:Inpatients; D008297:Male; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends