Disparities in Health-Related Quality of Life Related to Home Ownership

Background Previous studies have shown that home ownership, an often overlooked social determinant of health (SDoH), is associated with various health outcomes. Home ownership is also closely related to socio-economic status (SES). We examined whether home ownership was associated with measures of health related quality of life (HRQoL) independent of SES. Methods Analyses included 65,930 respondents aged 35 years and older from 12 states in the 2009 Behavior Risk Factor Surveillance System (BRFSS). Measures of HRQoL included self-reported health status, physically unhealthy days, mentally unhealthy days, and days with activity limitations. We categorized each HRQoL measure into 4 levels: poor/fair, good, very good, and excellent for self-reported health status, and 0, 1-10, 11-20, and 21-30 unhealthy days in the past month for physical health, mental health, and activity limitations. Cumulative logit regression models were performed adjusting for age, gender, race/ethnicity, marital status, education, household income, household size, and employment status. Results Comparing non-home owners with home owners, the adjusted odds ratios were 1.33 (95% CI, 1.18-1.49) for lower self-reported health status, 1.27 (95% CI, 1.12-1.43) for more physically unhealthy days, 1.20 (95% CI, 1.04-1.37) for more mentally unhealthy days, and 1.30 (95% CI, 1.06-1.60) for more days with activity limitations. Conclusions Home ownership is related to better HRQoL, in part explaining health disparities between home owners and non-homeowners after controlling for SES. The BRFSS homeownership question is a population-based measure of SDoH that allows one to quantify the effects of homeownership on health and potentially evaluate interventions targeted at improving HRQoL.