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Why is housing tenure associated with a lower risk of admission to a nursing or residential home? Wealth, health and the incentive to keep ‘my home’
  1. Mark McCann1,
  2. Emily Grundy2,
  3. Dermot O'Reilly3
  1. 1Institute of Child Care Research, Queen's University Belfast, Belfast, UK
  2. 2Department of Population Studies, London School of Hygiene and Tropical Medicine, London, UK
  3. 3Centre for Public Health, Queen's University Belfast, Belfast, UK
  1. Correspondence to Dr Mark McCann, Institute of Child Care Research, Queen's University Belfast, 6 College Park, Belfast BT7 1LP, UK; mark.mccann{at}


Background Previous research has shown that home ownership is associated with a reduced risk of admission to institutional care. The extent to which this reflects associations between wealth and health, between wealth and ability to buy in care or increased motivation to avoid admission related to policies on charging is unclear. Taking account of the value of the home, as well as housing tenure, may provide some clarification as to the relative importance of these factors.

Aims To analyse the probability of admission to residential and nursing home care according to housing tenure and house value.

Methods Cox regression was used to examine the association between home ownership, house value and risk of care home admissions over 6 years of follow-up among a cohort of 51 619 people aged 65 years or older drawn from the Northern Ireland Longitudinal Study, a representative sample of ≈28% of the population of Northern Ireland.

Results 4% of the cohort (2138) was admitted during follow-up. Homeowners were less likely than those who rented to be admitted to care homes (HR 0.77, 95% CI 0.70 to 0.85, after adjusting for age, sex, health, living arrangement and urban/rural differences). There was a strong association between house value/tenure and health with those in the highest valued houses having the lowest odds of less than good health or limiting long-term illness. However, there was no difference in probability of admission according to house value; HRs of 0.78 (95% CI 0.67 to 0.90) and 0.81 (95% CI 0.70 to 0.95), respectively, for the lowest and highest value houses compared with renters.

Conclusions The requirement for people in the UK with capital resources to contribute to their care is a significant disincentive to institutional admission. This may place an additional burden on carers.

  • Care home admission
  • house value
  • longitudinal study

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  • The authors alone are responsible for the interpretation of the data.

  • Funding The Northern Ireland Longitudinal Study (NILS) is funded by the Health and Social Care Research and Development Division of the Public Health Agency (HSC R&D Division) and NISRA. The NILS-RSU is funded by the ESRC and the Northern Ireland government.

  • Competing interests None.

  • Ethics approval This study was approved by ORECNI.

  • Provenance and peer review Not commissioned; internally peer reviewed.