Predictors of senior center use among older adults in New York City public housing.

Despite agreement among stakeholders that senior centers can promote physical and mental health, research on senior center use in urban populations is limited. Our objective was to describe demographic and health factors associated with senior center use among urban, low-income older adults in order to inform programming and outreach efforts. We used data from a 2009 telephone survey of 1036 adults randomly selected from rosters of New York City public housing residents aged 65 and older. We analyzed senior center use by race/ethnicity, age, gender, health, housing type, and income, and used a forward selection approach to build best-fit models predicting senior center use. Older adults of all ages and of both genders reported substantial use of senior centers, with nearly one third (31.3%) reporting use. Older adults living alone, at risk of depression, or living in specialized senior housing had the greatest use of centers. Senior center use varied by race/ethnicity, and English-speaking Hispanics had a higher prevalence of use than Spanish-speaking Hispanics (adjusted prevalence ratio [PR]=1.69, 95% CI: 1.11-2.59). Spanish-speaking communities and older adults living in non-senior congregate housing are appropriate targets for increased senior center outreach efforts.

Bedbug complaints among public housing residents-New York City, 2010-2011.

Few studies have evaluated population-level risk factors for having a bedbug infestation. We describe characteristics associated with bedbug complaints among New York City Housing Authority (NYCHA) residents. Unique households receiving bedbug extermination services in response to a complaint during January 1, 2010 to December 31, 2011 were identified from NYCHA's central facilities work order database. We examined associations between household characteristics and having a bedbug complaint using a generalized estimating equation Poisson regression model, accounting for clustering by housing development. Of the 176,327 NYCHA households, 11,660 (6.6 %) registered a bedbug complaint during 2010-2011. Bedbug complaints were independently associated with households having five or more children versus no children (prevalence ratio [PR] = 2.0), five or more adults versus one adult (PR = 1.6), a head of household (HOH) with impaired mobility (PR = 1.3), a household member receiving public assistance (PR = 1.2), a household income below poverty level (PR = 1.1), and a female HOH (PR = 1.1). Infestations were less likely to be reported by households with employed members (PR = 0.9), and an HOH aged 30-44 years (PR = 0.9) or 45-61 years (PR = 0.9), compared with an HOH aged 18-29 years. These results indicate that bedbug control efforts in public housing should be targeted toward households with low income and high occupancy.

Multiple chronic conditions and limitations in activities of daily living in a community-based sample of older adults in New York City, 2009.

INTRODUCTION: Nationally, 60% to 75% of older adults have multiple (2 or more) chronic conditions (MCCs), and the burden is even higher among low-income, racial/ethnic minority populations. MCCs limit activities of daily living (ADLs), yet this association is not well characterized outside of clinical populations. We examined the association of MCCs with ADLs in a racially/ethnically diverse population of low-income older adults living in New York City public housing. METHODS: A representative sample of 1,036 New York City Housing Authority residents aged 65 or older completed a telephone survey in June 2009. We examined the association of up to 5 chronic conditions with basic ADL (BADL) limitations, adjusting for potential confounders by using logistic regression. RESULTS: Of respondents, 28.7% had at least 1 BADL limitation; 92.9% had at least 1 chronic condition, and 79.0% had MCCs. We observed a graded association between at least 1 BADL limitation and number of chronic conditions (using 0 or 1 condition as the reference group): adjusted odds ratio (AOR) for 3 conditions was 2.2 (95% confidence interval [CI], 1.3-3.9); AOR for 4 conditions, 4.3 (95% CI, 2.5-7.6); and AOR for 5 conditions, 9.2 (95% CI, 4.3-19.5). CONCLUSION: Prevalence of BADL limitations is high among low-income older adults and increases with number of chronic conditions. Initiating prevention of additional conditions and treating disease constellations earlier to decrease BADL limitations may improve aging outcomes in this population.

Self-reported bed bug infestation among New York City residents: prevalence and risk factors.

Bed bug infestations have risen precipitously in urban areas. Little is known about risk factors for infestations or health outcomes resulting from these infestations. In the 2009 Community Health Survey, which is a representative population-based survey, 9,934 noninstitutionalized adults in New York City reported on bed bug infestations requiring an exterminator in the past year. The authors estimated infestation prevalence and explored predictors of infestation and associations between infestations and health outcomes using logistic regression. Seven percent of adults in New York City reported bed bug infestations. Significant individual and household risk factors were younger age, increased household poverty, and having three or more adults in the household. Environmental risk factors included living in high poverty neighborhoods and in buildings with more housing units, suggesting apartment-to-apartment transmission. Bed bug infestations were not associated with stress-related outcomes of alcohol consumption or recent depression, and, unlike cockroach infestation, were not associated with recent asthma episodes caused by allergens or contaminants.

Extermination strategies reported in the NYC Health and Nutrition Examination Survey, 2004: prevalence and predictors.

It is likely that household extermination is a major source of pesticide exposure for urban residents. Little is known about the predictors of residential pest control strategies in urban areas, and greater knowledge of these may help identify who is at risk for higher pesticide exposure. Study data is from the 2004 NYC Health and Nutrition Examination Surveys, a cross-sectional, population-based study using a three-stage sampling scheme. Logistic regression was used to identify predictors of pesticide use overall, and of application strategy: (1) consumer-applied pesticides only, (2) use of a professional exterminator only, or (3) use of both. Consumer-applied extermination was more prevalent than professional or both professional and consumer (39.9% versus 27.8% and 15.9%, respectively, and non-exclusively). In multivariate models among those who used any extermination, consumer application was associated with age 60 years+, being black or Asian, and being widowed, divorced, or single. Lower income households were more likely to use both strategies, and less likely to use professional extermination only. Urban residents may benefit from targeted education on how and when to self-apply pesticides, and on best-practice pest control to avoid unnecessary pesticide exposure. Higher prevalence of consumer-applied and conjoint consumer and professionally applied extermination in low-income households may reflect both economic determinants of first recourse and higher neighborhood infestation levels.