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. 2018 May 29;18(1):665.
doi: 10.1186/s12889-018-5583-6.

Public rental housing and its association with mortality - a retrospective, cohort study

Jun Jie Benjamin Seng  1 , Yu Heng Kwan  2 , Hendra Goh  3 , Julian Thumboo  4   5   6 , Lian Leng Low  7   8   9
Affiliations

Public rental housing and its association with mortality - a retrospective, cohort study

Jun Jie Benjamin Seng et al. BMC Public Health. .

Abstract

Background: Socioeconomic status (SES) is a well-established determinant of health status and home ownership is a commonly used composite indicator of SES. Patients in low-income households often stay in public rental housing. The association between public rental housing and mortality has not been examined in Singapore.

Methods: A retrospective, cohort study was conducted involving all patients who utilized the healthcare facilities under SingHealth Regional Health (SHRS) Services in Year 2012. Each patient was followed up for 5 years. Patients who were non-citizens or residing in a non-SHRS area were excluded from the study.

Results: A total of 147,004 patients were included in the study, of which 7252 (4.9%) patients died during the study period. The mean age of patients was 50.2 ± 17.2 years old and 7.1% (n = 10,400) of patients stayed in public rental housing. Patients who passed away had higher utilization of healthcare resources in the past 1 year and a higher proportion stayed in public rental housing (p < 0.001). They also had higher rates of co-morbidities such as hypertension, hyperlipidaemia and diabetes. (p < 0.001) After adjustment for demographic and clinical covariates, residence in public rental housing was associated with increased risk of all-cause mortality (Adjusted hazard ratio: 1.568, 95% CI: 1.469-1.673).

Conclusion: Public rental housing was an independent risk factor for all-cause mortality. More studies should be conducted to understand health-seeking behavior and needs of public rental housing patients, to aid policymakers in formulating better plans for improving their health outcomes.

Keywords: Low socioeconomic status; Mortality; Public rental housing; Social determinant of health.

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Conflict of interest statement

Ethics approval and consent to participate

Approval from SingHealth Centralised Institutional review board (CIRB) (Reference number: 2016/2294) was obtained prior to initiation of the study. Waiver of consent was obtained and approved for this study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart for inclusion of patients during study period from January 2012 to December 2016
Fig. 2
Fig. 2
Kaplan-Meier curve for survival probability stratified by residence in public rental housing
See this image and copyright information in PMC

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