Housing insecurity of medicaid beneficiaries with cognitive disabilities during the COVID-19 pandemic

Housing and Long-Term Services and Supports for People With Intellectual or Developmental Disabilities From Racially and Culturally Minoritized Communities

This article describes research on the places people with intellectual and developmental disabilities (IDD) live and disparities in housing and long-term services and supports (LTSS) outcomes for people with IDD from racially and culturally minoritized groups. It also summarizes the conclusions and recommendations of the Housing and Long-Term Services and Supports strand of the 2022 State of the Science Conference on the Intersection of Diversity, Equity and Inclusion and Supports and Services for People with IDD, identifies limitations of the available research and recommends strategies to improve research, knowledge translation, and practices.

Association of long COVID with housing insecurity in the United States, 2022-2023

Objectives

To assess the association of Long COVID with housing insecurity in the United States.

Methods

To compare the prevalence of 3 binary indicators of housing insecurity between people with Long COVID (symptoms >3 months) and COVID-19 survivors who did not report long-term symptoms, we used survey-weighted regression models on 206,969 responses from the Household Pulse Survey, a representative cross-sectional survey of US households collected September 2022-April 2023. Among people with Long COVID, we additionally assessed whether functional impairment, current COVID-19 related symptoms, and symptom impact on day-to-day life were associated with a higher prevalence of housing insecurity.

Results

During the study period, 56,353 respondents with prior COVID-19 experienced symptoms lasting 3 months or longer (27%), representing an estimated 28 million US adults. After adjusting for demographic factors, people with Long COVID were 1.5-2 times as likely to experience significant difficulty with household expenses (Prevalence ratio [PR] 1.48, 95% CI 1.42-1.55), be behind on housing payments (PR 1.48, 95% CI 1.36-1.60), and face likely eviction or foreclosure (PR 1.86, 95% CI 1.58-2.18). The risk of housing insecurity was highest among low-income adults with Long COVID. Among people with Long COVID, functional limitation and current symptoms which impact day-to-day life were associated with higher prevalence of housing insecurity.

Conclusions

Compared with COVID-19 survivors who do not experience long-term symptoms, people with Long COVID are more likely to report indicators of housing insecurity, particularly those of lower socio-economic status, and those with functional limitations or long-term COVID-19 related symptoms impacting day-to-day life. Policies are needed to support people living with chronic illnesses following SARS-CoV-2 infection.

Association of Long COVID with housing insecurity in the United States, 2022-2023

Objectives

To assess the association of Long COVID with housing insecurity in the United States.

Methods

To compare the prevalence of 3 binary indicators of housing insecurity between people with Long COVID (symptoms > 3 months) and COVID-19 survivors who don't report long-term symptoms, we used survey-weighted regression models on 203,807 responses from the Household Pulse Survey, a representative cross-sectional survey of US households collected September 2022 - April 2023. Among people with Long COVID, we assessed whether functional impairment, current COVID-19 related symptoms, and symptom impact on day-today life were associated with a higher prevalence of housing insecurity.

Results

During the study period, 54,446 (27.2%) respondents with COVID-19 experienced symptoms lasting 3 months or longer, representing an estimated 27 million US adults. People with Long COVID were nearly twice as likely to experience significant difficulty with household expenses (Prevalence ratio [PR] 1.85, 95% CI 1.74-1.96), be behind on housing payments (PR 1.76, 95% CI 1.57-1.99), and face likely eviction or foreclosure (PR 2.12, 95% CI 1.58-2.86). Functional limitation and current symptoms which impact day-to-day life were associated with higher prevalence of housing insecurity.

Conclusions

Compared with COVID-19 survivors who don't experience long-term symptoms, people with Long COVID are more likely to report indicators housing insecurity, particularly those with functional limitations and long-term COVID-19 related symptoms impacting day-today life. Policies are needed to support people living with chronic illnesses following SARS-CoV-2 infection.