ArticlePloS one2020
Association of poor housing conditions with COVID-19 incidence and mortality across US counties.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 131 papers, 3 of them syntheses that pooled it.
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Who cites it
131 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effects of the built environment and human factors on the spread of COVID-19: A systematic literature review.The Science of the total environment · 2022Pooled it
- Housing-related challenges during COVID-19 pandemic among urban poor in low- and middle-income countries: A systematic review and gap analysis.Frontiers in public health · 2022Pooled it
- A systematic review of racial/ethnic and socioeconomic disparities in COVID-19.International journal for equity in health · 2021Pooled it
- Staying in Place, Staying Connected: Exploring Tie-Retention to Inform Network-Based Health Interventions in Public Housing Communities.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- The impact of Medicaid expansion on coverage among those lacking housing basics, 2010-2019.Health affairs scholar · 2026Article
- Spatial accessibility to healthcare facilities and the cumulative incidence of COVID-19 infection: evidence from the reasons for geographic and racial differences in stroke (REGARDS) study, United States, March 2020 to September 2021.Preventive medicine reports · 2026Article
- Gender differences and psychosocial stress in upper respiratory tract infections: insights from healthy and hematological cancer cohorts.BMC public health · 2026Article
- Article
- Equity in Wastewater Surveillance: Assessment of the National Wastewater Surveillance System for COVID-19.AJPM focus · 2026Article
- Food insecurity and COVID-19-related experiences among people with HIV: A mixed methods analysis and conceptual framework.PloS one · 2026Article
- Social vulnerability and the risk of respiratory virus infection in households: a case-ascertained study.BMC infectious diseases · 2025Article
- COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.Journal of racial and ethnic health disparities · 2025Article
- Household crowding and mortality before and during the COVID-19 pandemic among adults: Findings from longitudinal population surveillance data in rural and peri-urban settings in Limpopo, South Africa.Population health metrics · 2025Article
- Inadequate Indoor Air Quality and Household Overcrowding Predispose to Life-Threatening Pulmonary Infections: Call for Action.Community health equity research & policy · 2025Article
- Factors Associated with Housing Stability Among Individuals with Co-Occurring Serious Mental Illness and Substance Use Disorders Receiving Assertive Community Treatment Services.Community mental health journal · 2025Article
- Predictive quality of census-based socio-economic indicators on Covid-19 infection risk at a fine spatial scale in France.Scientific reports · 2025Article
- Do Rental Assistance Programs Relieve Overcrowding for Children?Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Socioeconomic Inequities in the Age-Specific Burden of Severe Respiratory Syncytial Virus in Canada, 2016-2019.The Journal of infectious diseases · 2025Article
- Influential Attributes on Medical Expense for Korean Older Adults Based on Mental Accounting: Panel Data Analysis Using Korean Longitudinal Study of Aging Data.Healthcare (Basel, Switzerland) · 2025Article
- Health Insurance Coverage Changes Under the Affordable Care Act Among High Housing Cost Households, 2010-18.Health economics · 2025Article
71 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivePoor housing conditions have been linked with worse health outcomes and infectious disease spread. Since the relationship of poor housing conditions with incidence and mortality of COVID-19 is unknown, we investigated the association between poor housing condition and COVID-19 incidence and mortality in US counties.
methodsWe conducted cross-sectional analysis of county-level data from the US Centers for Disease Control, US Census Bureau and John Hopkins Coronavirus Resource Center for 3135 US counties. The exposure of interest was percentage of households with poor housing conditions (one or greater of: overcrowding, high housing cost, incomplete kitchen facilities, or incomplete plumbing facilities). Outcomes were incidence rate ratios (IRR) and mortality rate ratios (MRR) of COVID-19 across US counties through 4/21/2020. Multilevel generalized linear modeling (with total population of each county as a denominator) was utilized to estimate relative risk of incidence and mortality related to poor housing conditions with adjustment for population density and county characteristics including demographics, income, education, prevalence of medical comorbidities, access to healthcare insurance and emergency rooms, and state-level COVID-19 test density. We report incidence rate ratios (IRRs) and mortality ratios (MRRs) for a 5% increase in prevalence in households with poor housing conditions.
resultsAcross 3135 US counties, the mean percentage of households with poor housing conditions was 14.2% (range 2.7% to 60.2%). On April 21st, the mean (SD) number of cases and deaths of COVID-19 were 255.68 (2877.03) cases and 13.90 (272.22) deaths per county, respectively. In the adjusted models standardized by county population, with each 5% increase in percent households with poor housing conditions, there was a 50% higher risk of COVID-19 incidence (IRR 1.50, 95% CI: 1.38-1.62) and a 42% higher risk of COVID-19 mortality (MRR 1.42, 95% CI: 1.25-1.61). Results remained similar using earlier timepoints (3/31/2020 and 4/10/2020). CONCLUSIONS AND RELEVANCE: Counties with a higher percentage of households with poor housing had higher incidence of, and mortality associated with, COVID-19. These findings suggest targeted health policies to support individuals living in poor housing conditions should be considered in further efforts to mitigate adverse outcomes associated with COVID-19.
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