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Open Access Publications from the University of California

Scholarly Works (10 results)

  • Article
  • Peer Reviewed
UC Irvine Previously Published Works (2019)
The subprime mortgage crisis was a devastating financial shock for many homeowners. This research uses a probabilistic matching strategy to link foreclosure records with birth certificate records from 2006 to 2010 in California to identify birth parents who experienced a foreclosure. Among mothers who did, those issued a loan during the peak of subprime lending from 2005 to 2007 were more Hispanic and socioeconomically disadvantaged than mothers with loans originating before 2005. We use a mother fixed-effects analyses of ever-foreclosed mothers issued a loan during 2006 and 2007 and find that infants in gestation during or after the foreclosure had a lower birth weight for gestational age than those born earlier, suggesting that the foreclosure crisis was a plausible contributor to disparities in initial health endowments.
    Cover page: Subprime Babies: The Foreclosure Crisis and Initial Health Endowments
    • Thesis
    • Peer Reviewed
    UC Berkeley Electronic Theses and Dissertations (2015)

    Foreclosure rates reached unprecedented levels in the United States during the Great Recession. During 2010, one in 45 housing units nationwide received a foreclosure filing. Residents who lived near properties in foreclosure from 2007 to 2012 lost an estimated collective $2.2 trillion in property values, local governments tax base declined, and affected communities experienced an increase in crime and blight. In the aftermath of the foreclosure crisis, little is known about how the foreclosure crisis affected the health of homeowners who lost their homes to foreclosure and the health of residents living in communities hit hard by the crisis. This dissertation, made up of three papers, first explores the explicit and implicit theories evoked by the literature in this space, and then empirically tests the hypothesis that the foreclosure crisis had spillover effects on health. The first paper systematically reviews the existing, early-stage research on foreclosures and health by presenting an organizational schema based on level of analysis, type of housing distress measure, and health outcome. In addition, the review describes the specific mechanisms linking foreclosures and health, and how this field aligns and departs from the larger body of work on recessions and health. The second and third papers empirically test if the foreclosure crisis has an impact on glycemic control (hemoglobin A1c) and weight change of patients in a large clinical population of continuously insured patients with diabetes living in the Bay Area of California during 2007 to 2010. The three primary conclusions from this work are: 1) there was no evidence of a spillover effect of the foreclosure crisis on A1c or weight change among patients in a managed care system; 2) the pathways by which health is influenced by experiencing a foreclosure compared to living near a foreclosure are distinct and vary based on the manner in which the exposure and outcome are operationalized; 3) housing and labor market factors appear to have related yet discrete repercussions on health and healthcare.

      Cover page: The Effect of the Foreclosure Crisis on Health
      • Article
      • Peer Reviewed
      Other Recent Work (2018)
        Cover page: Transgender And Cisgender US Veterans Have Few Health Differences
        • Article
        • Peer Reviewed
        UC Berkeley Previously Published Works (2017)
        The housing foreclosure crisis was harmful to the financial well-being of many households. In the present study, we investigated the health effects of the housing foreclosure crisis on glycemic control within a population of patients with diabetes. We hypothesized that an increase in the neighborhood foreclosure rate could worsen glycemic control by activating stressors such as higher neighborhood crime, lower housing prices, and erosion of neighborhood social cohesion. To test this, we linked public foreclosure records at the census-block level with clinical records from 2006 to 2009 of patients with diabetes. We specified individual fixed-effects models and controlled for individual time-invariant confounders and area-level time-varying confounders, including housing prices and unemployment rate, to estimate the effect of the foreclosure rate per census-block group on glycated hemoglobin. We found no statistically significant relationship between changes in the neighborhood foreclosure rate per block group in the prior year and changes in glycated hemoglobin. There is no evidence that increased foreclosure rates worsened glycemic control in this continuously insured population with diabetes. More research is needed to inform our knowledge of the role of insurance and health-care delivery systems in protecting the health of diabetic patients during times of economic stress.
          Cover page: Beyond the Great Recession: Was the Foreclosure Crisis Harmful to the Health of Individuals With Diabetes?
          • Article
          • Peer Reviewed
          UC Berkeley Previously Published Works (2015)
            Cover page: Cost-effectiveness of the non-pneumatic anti-shock garment (NASG): evidence from a cluster randomized controlled trial in Zambia and Zimbabwe
            • Article
            • Peer Reviewed
            UC Berkeley Previously Published Works (2016)
            The emerging body of research suggests the unprecedented increase in housing foreclosures and unemployment between 2007 and 2009 had detrimental effects on health. Using data from electronic health records of 105,919 patients with diabetes in Northern California, this study examined how increases in foreclosure rates from 2006 to 2010 affected weight change. We anticipated that two of the pathways that explain how the spike in foreclosure rates affects weight gain-increasing stress and declining salutary health behaviors- would be acute in a population with diabetes because of metabolic sensitivity to stressors and health behaviors. Controlling for unemployment, housing prices, temporal trends, and time-invariant confounders with individual fixed effects, we found no evidence of an association between the foreclosure rate in each patient's census block of residence and body mass index. Our results suggest, although more than half of the population was exposed to at least one foreclosure within their census block, the foreclosure crisis did not independently impact weight change.
              Cover page: No Spillover Effect of the Foreclosure Crisis on Weight Change: The Diabetes Study of Northern California (DISTANCE)
              • Article
              • Peer Reviewed
              UC Berkeley Previously Published Works (2013)
                Cover page: Use of the Non-Pneumatic Anti-Shock Garment (NASG) for Life-Threatening Obstetric Hemorrhage: A Cost-Effectiveness Analysis in Egypt and Nigeria
                • Article
                • Peer Reviewed
                UC Berkeley Previously Published Works (2013)
                  Cover page: Use of the Non-Pneumatic Anti-Shock Garment (NASG) for Life-Threatening Obstetric Hemorrhage: A Cost-Effectiveness Analysis in Egypt and Nigeria
                  • Article
                  • Peer Reviewed
                  UC Berkeley Previously Published Works (2017)
                  Associations between neighborhood food environment and adult body mass index (BMI; weight (kg)/height (m)2) derived using cross-sectional or longitudinal random-effects models may be biased due to unmeasured confounding and measurement and methodological limitations. In this study, we assessed the within-individual association between change in food environment from 2006 to 2011 and change in BMI among adults with type 2 diabetes using clinical data from the Kaiser Permanente Diabetes Registry collected from 2007 to 2011. Healthy food environment was measured using the kernel density of healthful food venues. Fixed-effects models with a 1-year-lagged BMI were estimated. Separate models were fitted for persons who moved and those who did not. Sensitivity analysis using different lag times and kernel density bandwidths were tested to establish the consistency of findings. On average, patients lost 1 pound (0.45 kg) for each standard-deviation improvement in their food environment. This relationship held for persons who remained in the same location throughout the 5-year study period but not among persons who moved. Proximity to food venues that promote nutritious foods alone may not translate into clinically meaningful diet-related health changes. Community-level policies for improving the food environment need multifaceted strategies to invoke clinically meaningful change in BMI among adult patients with diabetes.
                    Cover page: Food Environment and Weight Change: Does Residential Mobility Matter?: The Diabetes Study of Northern California (DISTANCE).
                    • Article
                    • Peer Reviewed
                    UC Berkeley Previously Published Works (2017)
                    We estimated associations between neighborhood supermarket gain or loss and glycemic control (assessed by glycated hemoglobin (HbA1c) values) in patients from the Kaiser Permanente Northern California Diabetes Registry (n = 434,806 person-years; 2007-2010). Annual clinical measures were linked to metrics from a geographic information system for each patient's address of longest residence. We estimated the association between change in supermarket presence (gain, loss, or no change) and change in HbA1c value, adjusting for individual- and area-level attributes and according to baseline glycemic control (near normal, <6.5%; good, 6.5%-7.9%; moderate, 8.0%-8.9%; and poor, ≥9.0%). Supermarket loss was associated with worse HbA1c trajectories for those with good, moderate, and poor glycemic control at baseline, while supermarket gain was associated with marginally better HbA1c outcomes only among patients with near normal HbA1c values at baseline. Patients with the poorest baseline HbA1c values (≥9.0%) had the worst associated changes in glycemic control following either supermarket loss or gain. Differences were not clinically meaningful relative to no change in supermarket presence. For patients with type 2 diabetes mellitus, gaining neighborhood supermarket presence did not benefit glycemic control in a substantive way. The significance of supermarket changes on health depends on a complex interaction of resident, neighborhood, and store characteristics.
                      Cover page: Association Between Neighborhood Supermarket Presence and Glycated Hemoglobin Levels Among Patients With Type 2 Diabetes Mellitus.
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