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González-Cabán, Armando, e José J. Sánchez. "Minority households’ willingness to pay for public and private wildfire risk reduction in Florida". International Journal of Wildland Fire 26, n.º 8 (2017): 744. http://dx.doi.org/10.1071/wf16216.
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The purpose of this work is to estimate willingness to pay (WTP) for minority (African-American and Hispanic) homeowners in Florida for private and public wildfire risk-reduction programs and also to test for differences in response between the two groups. A random parameter logit and latent class model allowed us to determine if there is a difference in wildfire mitigation program preferences, whether WTP is higher for public or private actions for wildfire risk reduction, and whether households with personal experience and who perceive that they live in higher-risk areas have significantly higher WTP. We also compare Florida minority homeowners’ WTP values with Florida original homeowners’ estimates. Results suggest that Florida minority homeowners are willing to invest in public programs, with African-Americans WTP values at a higher rate than Hispanics. In addition, the highest priority for cost-sharing funds would go to low-income homeowners, especially to cost-share private actions on their own land. These results may help fire managers optimise allocation of scarce cost-sharing funds for public v. private actions.
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Bayer, Patrick, Fernando Ferreira e Stephen L. Ross. "The Vulnerability of Minority Homeowners in the Housing Boom and Bust". American Economic Journal: Economic Policy 8, n.º 1 (1 de fevereiro de 2016): 1–27. http://dx.doi.org/10.1257/pol.20140074.
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This paper examines mortgage outcomes for a large sample of individual home purchases and refinances linked to credit scores in seven major US markets. Among those with similar credit scores and loan attributes, black and Hispanic homeowners had much higher rates of delinquency and default in the downturn. These estimated differences are especially pronounced for loans originated near the peak of the housing boom. These findings suggest that black and Hispanic homeowners drawn into the market near the peak were especially vulnerable to adverse economic shocks and raise concerns about homeownership as a mechanism for reducing racial disparities in wealth. (JEL D14, J15, R23, R31, R38)
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Wong, Edwin S., Vanessa M. Oddo e Jessica C. Jones-Smith. "Are Housing Prices Associated with Food Consumption?" International Journal of Environmental Research and Public Health 17, n.º 11 (30 de maio de 2020): 3882. http://dx.doi.org/10.3390/ijerph17113882.
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Objective: Since January 2010, the U.S. has experienced economic recovery, including a 39% increase in home prices nationally. While higher home prices represent a wealth increase for some homeowners, it may decrease real purchasing power for others. The objective of this study is to examine the relationship between local area housing values and consumption of four food categories. Design: Observational study using data from the Behavioral Risk Factor Surveillance System between 2011 and 2015. Outcomes included number of times per week food was consumed and binary measures denoting consumption ≥2 times per day for four categories: vegetables, fruit, legumes and fruit juice. The primary explanatory variables were metropolitan/micropolitan statistical area home and rental price indices from Zillow. Differential associations by home ownership, age, race/ethnicity and education were examined. Results: Overall, housing values were not associated with intake of vegetables or fruit juice. Among homeowners, a $10,000 increase in home price was associated with small, but statistically significant reductions in fruit and legume consumption. These inverse associations were pronounced among Hispanic and non-Hispanic Black adults. Conclusions: Lower fruit and legume consumption associated with greater housing values may represent one of several explanations including a decrease in purchasing power, given increases in home prices and limited wage growth since 2010.
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Singh, Gopal K., Hyunjung Lee e Lyoung Hee Kim. "Housing and Inequalities in US Life Expectancy, Child and Youth Mortality, and All-Cause and Cause-Specific Mortality, 1979-2020: Results from the National Longitudinal Mortality Study and the National Vital Statistics System". International Journal of MCH and AIDS 12 (20 de dezembro de 2023): e653. http://dx.doi.org/10.21106/ijma.653.
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Background: Limited research exists on the association between housing, life expectancy, and mortality disparities in the United States (US). Using longitudinal individual-level and pooled county-level mortality data from 1979 to 2020, we examine disparities in life expectancy, child and youth mortality, and all-cause and cause-specific mortality in the US by several housing variables. Methods: Using the 1979-2011 National Longitudinal Mortality Study (N=1,313,627) and the 2011-2020 linked county-level National Mortality Database and American Community Survey, we analyzed disparities in life expectancy and all-cause and cause-specific disparities by housing tenure, household crowding, and housing stability. Multivariate Cox proportional hazards regression was used to analyze individual-level mortality differentials by housing tenure. Age-adjusted mortality rates and rate ratios were used to analyze area-level disparities in mortality by housing variables. Results: US homeowners had, on average, a 3.5-year longer life expectancy at birth than renters (74.22 vs. 70.76 years), with advantages in longevity associated with homeownership being greater for males than for females; for American Indians/Alaska Natives, non-Hispanic Whites, and non-Hispanic Blacks than for Asian/Pacific islanders and Hispanics; and for the US-born than for immigrants. Compared with renters, homeowners had 22% lower risks of all-cause mortality, 15% lower child mortality, 17% lower youth mortality, and significantly lower mortality from cardiovascular diseases, all cancers combined, stomach, liver, esophageal and cervical cancer, diabetes, influenza and pneumonia, COPD, cirrhosis, kidney disease, HIV/AIDS, infectious diseases, unintentional injuries, suicide, and homicide. Conclusion and Global Health Implications: Several aspects of housing are strongly associated with life expectancy, child and youth mortality, and all-cause and cause-specific mortality in the US. Policies that aim to provide well-designed, accessible, and affordable housing to residents of both developed and developing countries are important policy options for addressing one of the most fundamental determinants of health for disadvantaged individuals and communities and for reducing health inequities globally.
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Sims, Kendra D., Mary D. Willis, Perry W. Hystad, G. David Batty, Kirsten Bibbins-Domingo, Ellen Smit e Michelle C. Odden. "Neighborhood Characteristics and Elevated Blood Pressure in Older Adults". JAMA Network Open 6, n.º 9 (25 de setembro de 2023): e2335534. http://dx.doi.org/10.1001/jamanetworkopen.2023.35534.
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ImportanceThe local environment remains an understudied contributor to elevated blood pressure among older adults. Untargeted approaches can identify neighborhood conditions interrelated with racial segregation that drive hypertension disparities.ObjectiveTo evaluate independent associations of sociodemographic, economic, and housing neighborhood factors with elevated blood pressure.Design, Setting, and ParticipantsIn this cohort study, the sample included Health and Retirement Study participants who had between 1 and 3 sets of biennial sphygmomanometer readings from 2006 to 2014 or 2008 to 2016. Statistical analyses were conducted from February 5 to November 30, 2021.ExposuresFifty-one standardized American Community Survey census tract variables (2005-2009).Main Outcomes and MeasuresElevated sphygmomanometer readings over the study period (6-year period prevalence): a value of at least 140 mm Hg for systolic blood pressure and/or at least 90 mm Hg for diastolic blood pressure. Participants were divided 50:50 into training and test data sets. Generalized estimating equations were used to summarize multivariable associations between each neighborhood variable and the period prevalence of elevated blood pressure, adjusting for individual-level covariates. Any neighborhood factor associated (Simes-adjusted for multiple comparisons P ≤ .05) with elevated blood pressure in the training data set was rerun in the test data set to gauge model performance. Lastly, in the full cohort, race- and ethnicity-stratified associations were evaluated for each identified neighborhood factor on the likelihood of elevated blood pressure.ResultsOf 12 946 participants, 4565 (35%) had elevated sphygmomanometer readings (median [IQR] age, 68 [63-73] years; 2283 [50%] male; 228 [5%] Hispanic or Latino, 502 [11%] non-Hispanic Black, and 3761 [82%] non-Hispanic White). Between 2006 and 2016, a lower likelihood of elevated blood pressure was observed (relative risk for highest vs lowest tertile, 0.91; 95% CI, 0.86-0.96) among participants residing in a neighborhood with recent (post-1999) in-migration of homeowners. This association was precise among participants with non-Hispanic White and other race and ethnicity (relative risk, 0.91; 95% CI, 0.85-0.97) but not non-Hispanic Black participants (relative risk, 0.97; 95% CI, 0.85-1.11; P = .48 for interaction) or Hispanic or Latino participants (relative risk, 0.84; 95% CI, 0.65-1.09; P = .78 for interaction).Conclusions and RelevanceIn this cohort study of older adults, recent relocation of homeowners to a neighborhood was robustly associated with reduced likelihood of elevated blood pressure among White participants but not their racially and ethnically marginalized counterparts. Our findings indicate that gentrification may influence later-life blood pressure control.
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Mehdipanah, Roshanak, Kiana Bess, Steve Tomkowiak, Audrey Richardson, Carmen Stokes, Denise White Perkins, Suzanne Cleage, Barbara A. Israel e Amy J. Schulz. "Residential Racial and Socioeconomic Segregation as Predictors of Housing Discrimination in Detroit Metropolitan Area". Sustainability 12, n.º 24 (13 de dezembro de 2020): 10429. http://dx.doi.org/10.3390/su122410429.
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This study examined neighborhood racial and socioeconomic characteristics associated with housing discrimination (HD) in the Detroit Metropolitan Area, Michigan. Using novel neighborhood level data from the Fair Housing Center of Metropolitan Detroit in combination with the American Community Survey, incidence rate ratios (IRRs) were derived to examine associations between HD cases and percentage of homeowners, non-Hispanic White (NHW) residents, and median income. Models were stratified to examine these associations for race-, disability- and rent-related HD outcomes. Between 2008–2017, 988 HD incidents were reported. Independently, neighborhood proportion NHW, income, and homeownership were inversely associated with all-types of HD. Jointly, the neighborhood predictors remained significant indicators. Similar patterns were observed in race-, disability- and rent-related HD when neighborhood predictors were examined independently. In the joint models, household income no longer predicted race-related HD, while proportion NHW no longer predicted disability- and rent-related HD. Results suggest HD may be more frequent in neighborhoods with greater proportions of NHB or Hispanic residents, those with lower incomes, and greater proportion of rental households. These findings have great social and health implications and warrant further exploration of how HD contributes to social and health inequities in lower income, predominantly NHB and Hispanic neighborhoods and those with more renters.
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Hartell, Ann M. "Location Affordability and Regional Economic Resilience: Evidence from the U.S. Foreclosure Crisis". Transportation Research Record: Journal of the Transportation Research Board 2672, n.º 3 (11 de junho de 2018): 37–45. http://dx.doi.org/10.1177/0361198118777082.
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The form and function of cities is in large part defined by the interrelationship between land development and transportation systems. This relationship has important implications for households, including how it shapes economic costs for housing and transportation. Understanding these cost burdens is relevant for transportation agencies that are developing policies, plans, and programs with the intent of improving affordability. This paper presents an analysis of the relationship between high housing cost burdens, high levels of vehicle ownership, demographic characteristics, and mortgage foreclosure. Using data from before the recent U.S. economic crisis, the analysis estimates the effects of pre-crisis characteristics of census tracts and metropolitan regions on foreclosure rates. Multi-dimensional measures of urban form are included to evaluate the effect of metro-level characteristics. The models indicate high shares of Black homeowners, high shares of Hispanic homeowners, and lower income levels are associated with increased foreclosure. Also important is the share of households with high housing cost burdens. High shares of households with high vehicle ownership levels are significantly and positively associated with default and foreclosure. This suggests the costs associated with the ownership of multiple vehicles contributed to households’ economic vulnerability, a vulnerability revealed by mortgage foreclosures. The results for the urban form factors are mixed. Although increased compactness of jobs and housing has a negative effect on foreclosure, increased development intensity across the entire metro region has a positive effect. These differential effects challenge broad-brush assertions of negative impacts of urban sprawl.
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Connor, Avonne E., Mu Jin e Kala Visvanathan. "Abstract 1289: Disparities in healthcare utilization and access among female cancer survivors in Maryland". Cancer Research 84, n.º 6_Supplement (22 de março de 2024): 1289. http://dx.doi.org/10.1158/1538-7445.am2024-1289.
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Abstract Background: Healthcare utilization can be defined as how often healthcare is used, through what venue, and if access is available. There are medically vulnerable groups of cancer survivors, such as racial/ethnic minorities and economically disadvantaged populations, that may underutilize healthcare throughout cancer survivorship compared to non-vulnerable groups. Factors associated with survivorship care access/utilization should be evaluated to identify at-risk groups and reduce risk of poor health outcomes. Among female cancer survivors in Maryland, we examined the associations between race/ethnicity, obesity, measures of economic stability, and healthcare utilization-related outcomes (including access to care providers, type of doctor provides majority of care, and unmet health care needs because of cost). Methods: Survey data were analyzed for 1,353 non-Hispanic white (NHW) and 280 non-Hispanic Black (NHB) women with a self-reported history of cancer living in Maryland who completed the Maryland Behavioral Risk Factor Surveillance Survey between 2011-2020. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for the associations between independent factors and healthcare utilization outcomes. Results: On average, survivors were 66.8 (standard deviation (SD)=12.8) years of age at time of survey and 53.5 (SD=15.6) years of age at time of cancer diagnosis. Breast cancer was the most common cancer reported (58.9%). While most women reported being retired (50.6%), 30.6% reported being employed and 10% were unemployed. Most women were homeowners (81.5%) and 40.1% had household incomes >$50,000/year. Overall, race/ethnicity was not associated with any of the outcomes. Unemployed survivors (compared to employed) were 3.90 times more likely (95% CI 1.38-11.04, p=0.01) to report not being able to see a doctor because of cost. Survivors who were not homeowners (compared to homeowners) were 0.39 times less likely (95% CI 0.22-0.67, p <0.001) to report having a general/family practitioner for majority of cancer survivorship care. Survivors with household incomes ≤$50,000/year (compared to >$50,000/year) were 2.36 times more likely (95% CI 1.20-4.65, p=0.01) to not have seen a doctor in the past year. Lastly, obese survivors, compared to non-obese, were 0.25 times less likely (95% CI 0.07-0.84, p=0.02) to not have at least one healthcare provider. Conclusions: While race/ethnicity was not associated with healthcare access/utilization, our results do demonstrate various disparities in access to care and healthcare utilization during cancer survivorship by employment status, home ownership, and income. Our findings can inform interventions in collaboration with healthcare providers caring for female cancer survivors to address challenges associated with access to survivorship care among medically underserved survivors in Maryland. Citation Format: Avonne E. Connor, Mu Jin, Kala Visvanathan. Disparities in healthcare utilization and access among female cancer survivors in Maryland [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1289.
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Fitzpatrick, Kevin M., Don E. Willis, Matthew L. Spialek e Emily English. "Food Insecurity in the Post-Hurricane Harvey Setting: Risks and Resources in the Midst of Uncertainty". International Journal of Environmental Research and Public Health 17, n.º 22 (13 de novembro de 2020): 8424. http://dx.doi.org/10.3390/ijerph17228424.
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Food insecurity is of heightened concern during and after natural disasters; higher prevalence is typically reported in post-disaster settings. The current study examines food insecurity prevalence and specific risk/resource variables that may act as barriers or advantages in accessing food in such a setting. Using a modified quota sample (n = 316), Hurricane Harvey survivors participated in face-to-face interviews and/or online surveys that assessed health, social and household factors, and sociodemographic characteristics. Using logistic regression analyses we find that social vulnerabilities, circumstantial risk, and social and psychological resources are important in determining the odds of food insecurity. Hispanic and/or Nonwhite survivors, renters, and those persons displaced during the natural disaster have higher food insecurity odds. Survivors with stronger social ties, higher levels of mastery, and a greater sense of connectedness to their community are found to have lower food insecurity odds. A more nuanced analysis of circumstantial risk finds that while the independent effects of displacement and home ownership are important, so too is the intersection of these two factors, with displaced-renters experiencing significantly higher odds than any other residence and displacement combinations, and particularly those who are homeowners not displaced during the disaster. Strategies for addressing differential risks, as well as practical approaches for implementation and education programming related to disaster recovery, are discussed.
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Dowling, Maritza, e Laurie Theeke. "SUBJECTIVE COGNITIVE DECLINE PHENOTYPES, SOCIAL ENGAGEMENT, AND CARDIOVASCULAR HEALTH". Innovation in Aging 7, Supplement_1 (1 de dezembro de 2023): 645–46. http://dx.doi.org/10.1093/geroni/igad104.2100.
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Abstract Epidemiological studies report subjective cognitive decline (SCD) as a risk factor for incident dementia. The co-occurrence of SCD, chronic conditions, and loneliness may contribute to functional limitations and decline. SCD etiologies are multifaceted, suggesting possible underlying phenotypes defined by clustering factors that characterize decline. Using pooled data (2015-2021) from the Behavioral Risk Factor Surveillance System (BRFSS) we investigated SCD phenotypes based on the six-item self-reported Cognitive Decline Module that measured challenges in daily life due to memory loss and confusion over the prior twelve months. We hypothesized that SCD phenotypes would be associated with socio-demographic, cardiovascular health and social engagement variables. Mixture modeling was used to determine unobserved SCD phenotypes (latent classes) based on item response patterns. Latent class membership was predicted from socio-demographic variables using multinomial logistic regression. The resulting classes predicted a six-item cardiovascular risk index (CVRI) and a measure of aloneness. SCD symptoms were reported by 65,217 (45-80+ years old). Mixture models produced four-latent SCD classes labeled as mild (43%), mild-moderate (23%), moderate (24%), and severe (10%). Mean CVRI scores were significant across classes (p < 0.001) and highest in the severe subgroup (n=6,491) which was more likely to be non-Hispanic Blacks, female, younger (45-64), low-income, non-homeowners, and report depression, and poor/fair health status. Class membership also significantly predicted aloneness. Studies are needed to examine how SCD phenotypes may be used in the design and development of interventions that are more precise to the cluster of modifiable risk factors which could, subsequently, prevent or delay dementia pathogenesis.
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Ouyang, Congrong, e Sherman D. Hanna. "The effect of racial/ethnic differences on the financial obligations ratio of renters". Financial Services Review 30, n.º 3 (30 de setembro de 2022): 165–77. http://dx.doi.org/10.61190/fsr.v30i3.3483.
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The purpose of this research was to investigate the effects of racial/ethnic status on the ratio of finan- cial obligations payments to income among U.S. renter households. The proportion of homeowner house- holds with a ratio over 40% has decreased since 2007, but the proportion of renter households with a ratio over 40% increased until 2013 and remained high in 2016. In 2016, 13% of homeowner households and 40% of renter households had a ratio over 40%. Previous research on the financial obligations burden used an arbitrary dummy variable for whether households had a high financial obligations ratio, but we used ordinary least squares (OLS) regressions on the natural log of the ratio. For renters, based on the OLS regression, households with Black, Hispanic, and Asian respondents had higher financial obligations ratios than otherwise similar households with a White respondent. Controlling for other variables, Hispanic households had a ratio about 26% higher than White households, Asian households had a ratio 16% higher than White households, and Black households had a ratio 10% higher than White households. While discrimination could be a factor in higher ratios for the groups other than Whites, immigrant status and other factors plausibly are related.
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Lee, Jim, Hua Zhang e Yuxia Huang. "Toward a more socially equitable stormwater management fee: The case of Corpus Christi in Texas, USA". Environment and Planning B: Urban Analytics and City Science, 18 de outubro de 2023. http://dx.doi.org/10.1177/23998083231207535.
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This study evaluates a popular approach to assessing stormwater utility fees in the context of social equity. Analyses are based on comparing single-family land parcels in different neighborhoods of Corpus Christi, a U.S. city in the state of Texas that recently introduced a stormwater fee program. The stormwater fees are based on the same stormwater runoff factor for all single-family residential land parcels. We instead derive stormwater runoff estimates from parcel-scale impervious area measurements through the application of a machine-learning model to high-resolution remote sensing data. The difference between the official runoff factor and our estimate tends to be larger among land parcels in census tracts with proportionally more low-income and Hispanic households. This finding at odds with the ability-to-pay principle is attributable to the association of different neighborhoods’ sociodemographic compositions with their housing development patterns. Our work not only contributes to the design of a stormwater fee program that better characterizes the generation of stormwater runoff but it also helps city officials alleviate social inequity for homeowners in economically disadvantaged communities.
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Cantu, Phillip A., Jiwon Kim, Mariana López-Ortega, Sunshine Rote, Silvia Mejia-Arango e Jacqueline L. Angel. "Living arrangements and dementia among the oldest old: A comparison of Mexicans and Mexican Americans". Innovation in Aging, 17 de março de 2022. http://dx.doi.org/10.1093/geroni/igac014.
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Abstract Background and Objectives The growing population of adults surviving past age 85 in the U.S. and Mexico raises questions about the living arrangements of the oldest old and those living with dementia. This study compares Mexican and Mexican American individuals aged 85 and older to identify associations with cognitive status and living arrangements in Mexico and the United States (U.S.). Research Design and Methods This study includes 419 Mexican Americans in five southwestern states (Hispanic Established Population for the Epidemiologic Studies of the Elderly [H-EPESE]) and 687 Mexicans from a nationally representative sample (Mexican Health and Aging Study [MHAS]). It examines characteristics associated with living alone using logistic regression and describes the living arrangements of older adults with probable dementia in each country. Results Older adults with dementia were significantly less likely to live alone than with others in the U.S. while there were no relationships between dementia and living arrangements in Mexico. However, a substantial proportion of older adults with dementia lived alone in both nations: 22% in the U.S. and 21% in Mexico. Among Mexican Americans with dementia, those living alone were more likely to be women, childless, reside in assisted living facilities, and less likely to own their homes. Similarly, Mexican individuals with dementia who lived alone were also less likely to be homeowners than those living with others. Discussion and Implications Contextual differences in living arrangements and housing between the U.S. and Mexico pose different challenges for aging populations with a high prevalence of dementia.
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Nicklett, Emily Joy, Greta Jianjia Cheng e Zachary A. Morris. "Predictors of food insecurity among older adults before and during COVID-19 in the United States". Frontiers in Public Health 11 (12 de maio de 2023). http://dx.doi.org/10.3389/fpubh.2023.1112575.
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BackgroundThe COVID-19 pandemic has strained the health and wellbeing of older adult populations through increased morbidity, mortality, and social exclusion. However, the impact of COVID-19 on the health of older adults through food security has received relatively little attention, despite the strong impact of diet quality on the health and longevity of older adults.ObjectiveThe objective of this study was to identify sociodemographic and socioeconomic predictors of self-reported food insecurity before and early in the COVID-19 pandemic among community-dwelling older adults in the United States.MethodsUsing longitudinal data from the Health and Retirement Study, a nationally representative sample of middle-aged and older adults in the United States, we examined the associations between sociodemographic and socioeconomic predictors of self-reported food insecurity between 2018 (N = 2,413) and June 2020 (N = 2,216) using population-weighted multivariate logistic regression models.ResultsThe prevalence of food insecurity doubled among participants from 2018 (4.83%) to June 2020 (9.54%). In 2018, non-Hispanic Black and rural residents were more likely to report food insecurity, while individuals with higher education and greater wealth were less likely to report food insecurity in adjusted models. In June 2020, those who were relatively younger, not working due to a disability, and renting were more likely to report food insecurity. Those with an increased number of functional limitations, a recent onset of a work-limiting disability, and those who were no longer homeowners experienced an elevated longitudinal risk for food insecurity.ConclusionFuture research should examine effective policies and interventions to address the disproportionate impacts of COVID-19 on populations at a heightened risk of experiencing food insecurity.
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Srivastava, Pallavi, Matthew Lacey, Javed Butler, A. Laurie Shroyer e Puja B. Parikh. "Abstract 138: Impact of Depressive Disorder on Access to Care and Quality of Care in Veterans With Cardiovascular Disease". Circulation: Cardiovascular Quality and Outcomes 10, suppl_3 (março de 2017). http://dx.doi.org/10.1161/circoutcomes.10.suppl_3.138.
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Background: Depressive disorders have been independently associated with increased morbidity and mortality in adults with cardiovascular disease (CVD). We sought to assess the association between depressive disorder and access to care and quality of care among U.S. veterans with CVD. Methods: The 2013 Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of 13,126 veterans with CVD. Presence of CVD was noted with a single affirmative response to the following questions: “Has a health care professional ever told you that you had any of the following:” (1) a heart attack or myocardial infarction, (2) angina or coronary heart disease, (3) a stroke? Access to care variables included report of financial barriers to medical care and/or prescription drug costs and report of delay in receiving medical care. Quality of care variables included annual blood cholesterol check, blood sugar testing, flu shot administration, antihypertensive use, and aspirin use. Results: Among 13,126 veterans studied, a total of 2,889 (22%) adults had a depressive disorder while 10,237 (78%) did not. Veterans with a depressive disorder tended to be younger (p<0.0001), female (7% vs 4%, p<0.0001), non-white (21% vs 14%, p<0.0001), and of Hispanic ethnicity (4.0% vs 2.2%, p<0.0001). There were less likely to be married, employed, and homeowners, and reported lower annual income. Veterans with a depressive disorder had higher rates of hypertension (78% vs 73%), hypercholesterolemia (76% vs 67%), chronic kidney disease (12% vs 8%), chronic obstructive pulmonary disease (33% vs 18%), asthma, smoking (25% vs 12%), obesity (40% vs 30%), and physical inactivity (45% vs 35%) (p<0.0001 for all). Veterans with a depressive disorder were more likely to report financial barriers to medical care (15% vs 6%, p<0.0001) and prescription drug costs (12% vs 5%, p<0.0001), and a delay in receiving medical care (24% vs 9%, p<0.0001). While no difference was noted in annual blood cholesterol check, blood sugar testing, and flu shot administration, veterans with depressive disorder reported significantly lower rates of aspirin (73% vs 78%, p=0.0003) and antihypertensive use (92% vs 94%, p<0.0001). In multivariate analysis, depressive disorder was associated with independently higher rates of reports of financial barriers to medical care (OR, 1.96; 95% CI, 1.45-2.65), financial barriers to prescription drugs (OR, 1.45; 95% CI, 1.02-2.08) and delay in receiving medical care (OR, 2.07; 95% CI, 1.65-2.60). Conclusions: Depressive disorder was associated with higher rates of financial barriers to care and prescription drugs, and patient-reported delays in medical care in U.S. veterans with CVD. Further research appears warranted to evaluate the impact of mental health disease upon cardiovascular care in veterans with CVD.