Addressing Housing Disrepair to Improve Equity in Functional Disability and Caregiver Burden
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PROJECT SUMMARY More than 15 million older adults have difficulty carrying out self-care, household and/or mobility activities, referred to as a functional disability —with significant inequities by socioeconomic status. The experience of having a functional disability frequently results in high healthcare spending and lower quality of life. Furthermore, functional disability is associated with greater emotional, physical, and financial difficulties or burden in family caregivers who support older adults with everyday tasks. Home environments are recognized as a key factor in disability; however, the role of housing disrepair—including, for example, damage to one’s roof or walls, problems with heating or plumbing— has rarely been studied for how it may contribute to disproportionate rates of functional disability among low-income older adults and impact caregiver well-being. Housing disrepair can be addressed, and therefore it is a potential target for interventions to improve function and slow disability among older adults, potentially reducing caregiver burden and narrowing inequities by socioeconomic status. The specific aims of this explanatory sequential mixed methods research study are to: 1) characterize housing disrepair among U.S. older adults and its associations with (a) functional disability among low-income older adults, and (b) caregiving burden (emotional, physical, and financial); and 2) characterize experiences of daily functioning of low-income older adults and their family caregivers in the presence of housing disrepair, and identify barriers to making home repairs and preferences for addressing disrepair. This study will generate foundational knowledge and an understanding of possible modifiable factors and mechanisms (NIH Stage Model 0) from which to develop an intervention. The candidate, Dr. Okoye, is an Assistant Professor at Drexel University’s College of Nursing & Health Professions and School of Public Health, with clinical experience as a nurse practitioner. With a rigorous training plan including methodological training in mixed methods research and intervention development and content expertise in family caregiving and research team leadership, and with strong, committed mentorship, Dr. Okoye will become a grant-funded independent investigator dedicated to improving health and well-being for socioeconomically disadvantaged older adults and their families. This project is well-aligned with the strategic objectives of the NIA to understand environmental factors that create and sustain health disparities among older adults, and reduce caregiver stress.
