Identifying and Addressing Housing Insecurity in Older Patients: Trends, Referrals, and Inequities in a California...

Area of Science:

• Geriatric Medicine
• Public Health
• Health Services Research

Background:

• Housing insecurity is a growing concern for older adults, disproportionately affecting racial minorities.
• Healthcare institutions' capacity to address this challenge remains under-evaluated.
• Existing research has not sufficiently explored screening and referral processes within healthcare systems.

Purpose of the Study:

• To assess the rate of housing insecurity identification among older patients in a large California medical system.
• To examine the frequency of social service referrals for identified housing-insecure older adults.
• To investigate racial inequities in screening and referral processes.

Main Methods:

• Analysis of electronic health records (2013-2022) for over 119,000 older adults (55+).
• Utilized natural language processing (NLP) and structured data to identify housing insecurity and social service referrals.
• Employed logistic regression to evaluate racial disparities in referral rates.

Main Results:

• 0.6% of patient encounters indicated housing insecurity, with screening trends mirroring regional eviction rates.
• Only 7% of housing-insecure patients received a social service referral; referrals were more common in primary care than emergency settings.
• Asian patients demonstrated lower odds of referral compared to non-Hispanic White patients.

Conclusions:

• Significant unmet needs for housing interventions exist among older patients.
• Healthcare systems require enhanced strategies for screening and connecting older adults, especially racial minorities, to housing services.
• Addressing housing insecurity is critical for improving health outcomes in aging populations.