摘要：Objectives. We assessed the extent to which living near foreclosed properties is associated with individuals’ subsequent weight gain. Methods. We linked health and address information on 2068 Framingham Offspring Cohort members (7830 assessments) across 5 waves (1987–2008) to records of all Massachusetts foreclosures during that period. We used counts of lender-owned foreclosed properties within 100 meters of participants’ homes to predict body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) and the odds of being overweight (BMI ≥ 25), adjusted for individual and area-level covariates. Results. Mean BMI increased from 26.6 in 1987–1991 to 28.5 in 2005–2008; overweight prevalence increased from 59.0% to 71.3%. Foreclosures were within 100 meters of 159 (7.8%) participants’ homes on 187 occasions (1.8%), in 42 municipalities (21%). For each additional foreclosure, BMI increased by 0.20 units (95% confidence interval [CI] = 0.03, 0.36), and the odds ratio for being overweight associated with proximity to a foreclosure was 1.77 (95% CI = 1.02, 3.05). Conclusions. We found a robust association between living near foreclosures and BMI, suggesting that neighbors’ foreclosures may spur weight gain. More than 6 million mortgages were involved in foreclosure between 2007 and 2010, 1 and more than 1.8 million US homes (1.5% of all housing units) were subject to a foreclosure filing in 2011 alone. 2 Researchers have expressed concerns about the impact of the housing crisis on the public’s health, 3–5 identifying housing distress and many of its sequelae as health risk factors. 6–10 However, robust empirical evidence regarding the association between foreclosure and health remains sparse (Table A, available as a supplement to this article at http://www.ajph.org ). 11–18 Current studies, though useful, are limited by cross-sectional data, 11,12,18 ecologic study designs, 16 retrospective reporting, 15,17 and self-reported measures. 11–15,18 Although it is crucial that living close to foreclosed properties (i.e., homes that have been repossessed by lenders for nonpayment of mortgages) could affect the health of individuals not personally experiencing foreclosure, only 2 existing papers conceptualize foreclosure as a community-level health risk factor. 11,16 Because they are typically vacant, bank-owned foreclosures can be unsightly or dangerous if poorly maintained or unsecured. They also compete with nearby properties for sale. Both these disamenity and supply-side impacts are thought to lower nearby home values, 19–22 potentially provoking fears of reduced home equity among neighbors. Foreclosures have also been shown to encourage crime, 23 to disrupt neighborhood social networks and strain social support systems, 4 and to degrade the quality of the built environment as a form of blight. Many of these economic, social, and physical impacts are, in turn, documented health risk factors, and in some studies, associated with higher BMI. 24–29 With the Framingham Offspring Cohort data between years 1987 and 2008, and linking these to geocoded data on foreclosed properties, we tested the hypothesis that living near foreclosures is a risk factor for higher objectively measured body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) and odds of being overweight.
