Association for Public Policy Analysis & Management

Panel: The Impacts of Housing Assistance on Health: Actionable Evidence for Effective Policy

(Housing, Community Development, and Urban Policy)

Housing can affect health in a number of different ways. However, the ability of policymakers to tailor and develop low-income housing assistance programs to promote health has been hampered by a lack of rigorous research. Funded by the Robert Wood Johnson Foundation’s Policies for Action research program and representing research across sectors and from multiple disciplines, the four studies in this panel each examine the relationship between housing assistance and health, with the ultimate aim of informing health-promoting policies. Collectively, the papers consider various dimensions of housing assistance. Each relies on experimental designs or other rigorous methods as well as high quality administrative data to help generate a body of actionable evidence for policymakers.

The first paper (Austensen et al.) examines the quality of housing, taking advantage of a natural experiment (and linkages to hospital, emergency room, and ambulatory care records, Medicaid claims data, and school records) to understand whether improvements in the quality of six housing developments in New York City were associated with improved health for residents. The study also investigates whether any improvements to health are due to reductions in crime, using data on the location and type of crimes committed during the study period.  The second paper (Cohen-Cline et al.) explores the effect of prioritizing the receipt of vouchers from the United States Department of Housing and Urban Development’s (HUD) Housing Choice Voucher Program (HCV). Relying on the HCV programs of two cities, which randomly distribute vouchers each year only to medically complex individuals or to seniors or people with disabilities, the study estimates whether the impact of these programs vary with respect to the utilization, cost, and quality of health care as well as self-reported health and socioeconomic outcomes.

The third and fourth papers (Dubay et al.; Miller et al.) both leverage a newly available data source that links nationally representative data from the National Health Interview Survey (NHIS) to administrative records from HUD. The paper by Dubay and colleagues investigates whether receipt and duration of housing assistance is associated with health, food insecurity, and unmet healthcare needs. Using information on the rent of assisted households, prevailing market rents, and household income, Miller et al., estimate whether the dollar value of housing assistance is associated with health outcomes, adjusting this measure of value by geographic variation in the cost of living using the Census’ Supplemental Poverty Measure. Both papers compare current recipients of assistance to future recipients and implement propensity score matching or instrumental variables analysis to bolster the validity of their findings.   

Collectively, the papers in this panel make important contributions to our knowledge about how housing assistance can be used to promote health. Two discussants, one an academic researcher, the other a senior program office for the Robert Wood Johnson Foundation will provide critical feedback on the research and consider implications for policy.