# Housing tenure and early-life acute lower respiratory tract infection admissions in two national Scottish birth cohorts

## TL;DR

Children in rented housing in Scotland are more likely to be hospitalized for early-life respiratory infections compared to those in owned housing.

## Contribution

This study is the first to explore the link between housing tenure and early-life respiratory infection hospitalizations in Scottish birth cohorts.

## Key findings

- Children in social rented housing had a 40% higher odds of LRTI admission compared to those in owned housing.
- Private rented housing was associated with a 24% increased odds of LRTI hospitalization in the first cohort.
- Rent-free housing showed the highest odds of LRTI admission in the first cohort, though the effect was less consistent in the second.

## Abstract

Early-life acute lower respiratory tract infections (LRTIs) have been associated with subsequent wheezing, asthma and mortality. Despite infants and young children spending much of their time at home, the association of housing circumstances, including housing ownership status, on acute LRTI hospital admissions is not well explored.

To assess the association between housing tenure and the odds of hospital admission for acute LRTIs in children aged <2 years in Scotland.

Scottish birth records were linked to maternal census data (2001 and 2011) to construct two birth cohorts: cohort 1 (C1; born 2000–2002) and cohort 2 (C2; 2010–2012). Linkage to hospital records provided information on acute LRTI admissions. Using multivariable logistic regression models, we estimated the association of housing tenure with the odds of ≥1 hospital admission for LRTI before the second birthday with adjustment for area of residence (urban/rural), maternal highest qualification level and maternal age.

There were 14 833 LRTI admissions in 12 527 children across both cohorts. 4.0% and 5.3% children in C1 and C2, respectively, had ≥1 LRTI admission. Compared with living in owned housing, the odds of LRTI admission were higher in children living in social rented housing (C1: OR 1.40, 95% CI 1.31 to 1.49; C2: 1.23, 1.16 to 1.31), private rented (C1: 1.24, 1.11 to 1.39; C2: 1.14, 1.06 to 1.21) and rent-free housing (C1: 1.53, 1.35 to 1.74; C2: 1.04, 0.80 to 1.36).

Children living in rented housing had higher odds of early-childhood LRTI admission compared with those living in owned housing in Scotland. Further linkage to residential-level data could inform the design of LRTI prevention policies.