“That wasn't really a place to worry about diabetes”: Housing access and diabetes self-management among low-income adults

Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing chall...

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Vydáno v:	Social science & medicine (1982) Ročník 197; s. 71 - 77
Hlavní autoři:	Keene, Danya E., Guo, Monica, Murillo, Sascha
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England Elsevier Ltd 01.01.2018 Pergamon Press Inc
Témata:	Access Adult Adults Affordable housing Blood Chronic illnesses Cities Connecticut Diabetes Diabetes Mellitus, Type 2 - psychology Diabetes Mellitus, Type 2 - therapy Disease Disease management Female Glucose Grounded theory Health disparities Health inequalities Health promotion Homeless people Homelessness Households Housing - economics Housing - statistics & numerical data Housing affordability Housing costs Housing subsidies Humans Ill-Housed Persons - psychology Ill-Housed Persons - statistics & numerical data Low income groups Male Management Medical diagnosis Middle Aged Poverty Public Housing - statistics & numerical data Qualitative Research Self-Management - psychology Selfmanagement Type 2 diabetes mellitus United States > US Housing affordability Homelessness Diabetes Health inequalities
ISSN:	0277-9536, 1873-5347, 1873-5347
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Abstract	Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing. We purposively constructed our sample to include a range of housing experiences (subsidized, unsubsidized, homeless) and treatment regimes. We analyzed the data using grounded theory techniques of inductive coding and memo writing. Our findings suggest multiple ways that housing access can affect diabetes self-management with implications for blood glucose levels and future complications. Specifically, we describe the ways that housing access affected participants’ ability to: 1) prioritize their diabetes care, 2) establish and maintain diabetes routines, and 3) afford diabetes-related expenses. Together, our findings show how housing challenges increased the cost of adherence to diabetes management regimes such that inadequately housed individuals had to both invest and sacrifice more for the same outcomes. Our findings suggest that improved affordable housing access may represent an opportunity to improve outcomes and reduce socioeconomic disparities among those living with type 2 diabetes. •Housing access affects the prioritization of diabetes self-management.•Housing access affects the routinization of diabetes behaviors.•High housing costs compete with diabetes related expenses to affect self-management.•Improved affordable housing access may reduce disparities in diabetes outcomes.
AbstractList	Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing. We purposively constructed our sample to include a range of housing experiences (subsidized, unsubsidized, homeless) and treatment regimes. We analyzed the data using grounded theory techniques of inductive coding and memo writing. Our findings suggest multiple ways that housing access can affect diabetes self-management with implications for blood glucose levels and future complications. Specifically, we describe the ways that housing access affected participants’ ability to: 1) prioritize their diabetes care, 2) establish and maintain diabetes routines, and 3) afford diabetes-related expenses. Together, our findings show how housing challenges increased the cost of adherence to diabetes management regimes such that inadequately housed individuals had to both invest and sacrifice more for the same outcomes. Our findings suggest that improved affordable housing access may represent an opportunity to improve outcomes and reduce socioeconomic disparities among those living with type 2 diabetes. Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing. We purposively constructed our sample to include a range of housing experiences (subsidized, unsubsidized, homeless) and treatment regimes. We analyzed the data using grounded theory techniques of inductive coding and memo writing. Our findings suggest multiple ways that housing access can affect diabetes self-management with implications for blood glucose levels and future complications. Specifically, we describe the ways that housing access affected participants’ ability to: 1) prioritize their diabetes care, 2) establish and maintain diabetes routines, and 3) afford diabetes-related expenses. Together, our findings show how housing challenges increased the cost of adherence to diabetes management regimes such that inadequately housed individuals had to both invest and sacrifice more for the same outcomes. Our findings suggest that improved affordable housing access may represent an opportunity to improve outcomes and reduce socioeconomic disparities among those living with type 2 diabetes. •Housing access affects the prioritization of diabetes self-management.•Housing access affects the routinization of diabetes behaviors.•High housing costs compete with diabetes related expenses to affect self-management.•Improved affordable housing access may reduce disparities in diabetes outcomes. Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing. We purposively constructed our sample to include a range of housing experiences (subsidized, unsubsidized, homeless) and treatment regimes. We analyzed the data using grounded theory techniques of inductive coding and memo writing. Our findings suggest multiple ways that housing access can affect diabetes self-management with implications for blood glucose levels and future complications. Specifically, we describe the ways that housing access affected participants' ability to: 1) prioritize their diabetes care, 2) establish and maintain diabetes routines, and 3) afford diabetes-related expenses. Together, our findings show how housing challenges increased the cost of adherence to diabetes management regimes such that inadequately housed individuals had to both invest and sacrifice more for the same outcomes. Our findings suggest that improved affordable housing access may represent an opportunity to improve outcomes and reduce socioeconomic disparities among those living with type 2 diabetes.Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may present barriers to the management of chronic diseases such as type 2 diabetes. In this qualitative study, we examined how both housing challenges and housing resources shaped diabetes self-management behaviors. We conducted semi-structured interviews with 40 low-income residents of one US city, New Haven, Connecticut, who had a diagnosis of type 2 diabetes and either resided in or qualified for subsidized housing. We purposively constructed our sample to include a range of housing experiences (subsidized, unsubsidized, homeless) and treatment regimes. We analyzed the data using grounded theory techniques of inductive coding and memo writing. Our findings suggest multiple ways that housing access can affect diabetes self-management with implications for blood glucose levels and future complications. Specifically, we describe the ways that housing access affected participants' ability to: 1) prioritize their diabetes care, 2) establish and maintain diabetes routines, and 3) afford diabetes-related expenses. Together, our findings show how housing challenges increased the cost of adherence to diabetes management regimes such that inadequately housed individuals had to both invest and sacrifice more for the same outcomes. Our findings suggest that improved affordable housing access may represent an opportunity to improve outcomes and reduce socioeconomic disparities among those living with type 2 diabetes.
Author	Murillo, Sascha Keene, Danya E. Guo, Monica
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Keywords	Housing affordability Homelessness Diabetes Health inequalities
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Snippet	Lack of affordable housing access represents a significant and growing problem for low-income households in the United States and these housing challenges may...
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SubjectTerms	Access Adult Adults Affordable housing Blood Chronic illnesses Cities Connecticut Diabetes Diabetes Mellitus, Type 2 - psychology Diabetes Mellitus, Type 2 - therapy Disease Disease management Female Glucose Grounded theory Health disparities Health inequalities Health promotion Homeless people Homelessness Households Housing - economics Housing - statistics & numerical data Housing affordability Housing costs Housing subsidies Humans Ill-Housed Persons - psychology Ill-Housed Persons - statistics & numerical data Low income groups Male Management Medical diagnosis Middle Aged Poverty Public Housing - statistics & numerical data Qualitative Research Self-Management - psychology Selfmanagement Type 2 diabetes mellitus
Title	“That wasn't really a place to worry about diabetes”: Housing access and diabetes self-management among low-income adults
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