Association for Public Policy Analysis & Management

The U.S. Department of Housing and Urban Development (HUD) provides public and assisted housing to about 5 million renter households. Since 2010, HUD’s strategic objectives have included utilizing housing as a platform to improve quality of life, with an explicit focus on tenant health. Until recently, however, no data have been available to provide nationally representative estimates of health indicators among HUD-assisted tenants. For the past several years, HUD and the National Center for Health Statistics (NCHS) have collaborated to link HUD administrative data with data from the National Health Interview Survey (NHIS, 1999-2012) and make those data available to researchers through the NCHS Research Data Center.

This exploratory study uses NCHS-HUD linked data to analyze health indicators and key characteristics among a national sample of HUD-assisted adults and low-income adults.  We examine socioeconomic, demographic, and health characteristics of HUD-assisted tenants in comparison with the general U.S. adult population and with unassisted adults in renter households below the poverty threshold. We use descriptive analysis to estimate prevalence of health indicators, as well as logistic regression to quantify the role of housing assistance. We examine two HUD-assisted adult subpopulations who were NHIS respondents: those who are concurrently HUD-assisted at the time of the NHIS interview and those who were ever HUD-assisted between June 1996 and March 2014. We also examine changes in prevalence of health characteristics of HUD-assisted renters during the past 13 years.

The Healthy People 2020 plan of the Centers for Disease Control and Prevention considers housing to be a significant social determinant of health because homes and neighborhoods represent physical and social conditions that can greatly affect individual and population health. This research represents an important step forward in understanding how HUD housing assistance is related to health of vulnerable populations, and how future policy can better align housing assistance with health services.