Location has an effect on older adults' health, according to a new study that found those living in public housing fare poorly and suffer more from fatigue and chronic conditions than those in other community dwellings.

The study, published in a recent issue of the journal Ethnicity & Disease, confirms that older adults living in public housing owned by government are twice as likely—57.3 percent versus 26.9 percent—to report fair or poor health compared with those with who haven't lived in public housing.

Investigators analyzed multiple, simultaneously occurring symptoms of the nation's poorest and most at-risk individuals, says lead author Pamela Parsons, of Virginia Commonwealth University. The findings are a snapshot of those in public housing, says the study's research team. Such information might aid future innovations in public housing development to meet the needs of this growing segment of society, researchers say.

In 2002, the AARP Public Policy Institute found that more than 2 million older adults live in publicly subsidized rental housing.

"The real issue is: How can we provide better care and services for these elders?" says Parsons, a nurse practitioner who focuses on frail elders in public housing.

More than 16,000 individuals age 50 and older participated in the Health and Retirement Study. They responded to interview questions on housing status, the state of their health, and their functionality—how well they performed activities of daily living and mobility. Fatigue, cardiac conditions, stroke, hypertension, diabetes, arthritis, and psychiatric problems were more prevalent among elders living in public housing.

Simply having access to more specific information ultimately could help improve necessary support mechanisms for older adults, Parsons says.

"Legislators need data to change and create policies that help people age in place," she says.

The cost of private-pay assisted living is prohibitive for some, making public housing the only viable option, Parsons says.

"Frail elderly fear moving to a higher level of care and losing independence. Many are very functionally compromised, with low health literacy," she says. "We can't eradicate chronic illness, but we can minimize symptoms and improve quality of life."

Not surprisingly, the existence of chronic, multiple symptoms is a catalyst for decline in elders' health status over time, Parsons says.

"As a society, we have difficulty determining how to deal with increased life span overall, most evident in populations that are poor and frail," says Dr. Stephen Bartels, a professor of psychiatry and of community and family medicine at Dartmouth Medical School.

The experience of aging in the community setting shouldn't include having to transfer from one facility to another, based upon the older adult's need, Bartels says.

"Those in senior housing have modest, minimal access to resources. Our current system of care is biased toward nursing homes, settings appropriate for people who need nursing," Bartels says. "But options are limited for those with chronic conditions in lower socioeconomic settings."

Ethnicity & Disease is a quarterly medical journal studying the ethnic patterns of disease. This article is courtesy of Health Behavior News Service, part of the Center for Advancing Health.