title: Financial hardship and self-rated health among low-income housing residents.
abstract: BACKGROUND
  Self-rated health (SRH) has been shown to be predictive of morbidity and mortality. Evidence also shows that SRH is socioeconomically patterned, although this association differs depending on the indicator of socioeconomic status used. The purpose of this study was to determine the association between SRH and financial hardship among residents of low-income housing.
  
  
  METHODS
  We analyzed cross-sectional data from the Health in Common Study (N = 828), an observational study to investigate social and physical determinants of cancer risk-related behaviors among residents of low-income housing in three cities in the Boston metropolitan area. Modified Poisson regression models were used to obtain the relative risk of low SRH (fair or poor), adjusting for demographic and socioeconomic characteristics.
  
  
  RESULTS
  Unadjusted models revealed that the respondents reporting financial hardship were 53% more likely to report low SRH compared with those not reporting financial hardship. After controlling for demographic characteristics, socioeconomic characteristics, and psychological distress, the results showed that those reporting financial hardship were 44% more likely to report low SRH.
  
  
  CONCLUSIONS
  Our results suggest that financial hardship is a robust predictor of SRH; and over and above the influence of demographic and traditional socioeconomic indicators, and even psychological distress, financial hardship remains strongly associated with low SRH. Additional research needs to be conducted to further elucidate this pathway and to better understand the determinants of variability in financial hardship among low-income housing residents to ensure the most appropriate policy levers (e.g., housing-related policy, food-related policy) are chosen to improve health outcomes in this population.
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA 02215, USA. reginald_tucker-seeley@dfci.harvard.edu
authors.forename: Reginald D
authors.initials: RD
authors.lastname: Tucker-Seeley
authors.forename: Amy E
authors.initials: AE
authors.lastname: Harley
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stoddard
authors.forename: Glorian G
authors.initials: GG
authors.lastname: Sorensen
mesh_terms: D000293:Adolescent; D000328:Adult; D001900:Boston; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D054525:Minority Health / Q000191:economics* / Q000706:statistics & numerical data; D009369:Neoplasms / Q000209:etiology*; D011638:Public Housing; D012309:Risk-Taking; D057566:Self Report; D012923:Social Class; D055815:Young Adult
keywords: community health; health disparities; mental health; social determinants; social inequalities