Housing Assistance Programs and Adult Health in the United States

Abstract

Objectives To examine whether access to housing assistance is associated with better health among low-income adults. Methods We used National Health Interview Survey data (1999–2012) linked to US Department of Housing and Urban Development (HUD) administrative records (1999–2014) to examine differences in reported fair or poor health and psychological distress. We used multivariable models to compare those currently receiving HUD housing assistance (public housing, housing choice vouchers, and multifamily housing) with those who will receive housing assistance within 2 years (the average duration of HUD waitlists) to account for selection into HUD assistance. Results We found reduced odds of fair or poor health for current public housing (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.57, 0.97) and multifamily housing (OR = 0.75; 95% CI = 0.60, 0.95) residents compared with future residents. Public housing residents also had reduced odds of psychological distress (OR = 0.59; 95% CI = 0.40, 0.86). These differences were not mediated by neighborhood-level characteristics, and we did not find any health benefits for current housing choice voucher recipients. Conclusions Housing assistance is associated with improved health and psychological well-being for individuals entering public housing and multifamily housing programs.

HUD Housing Assistance and Levels of Physical Activity Among Low-Income Adults

“…Additionally, receiving housing assistance in a higher-SES neighborhood might require adults to move, which disrupts important social networks that can encourage physical activity (eg, walking groups) ( 29 ). However, the lack of modification by neighborhood SES in our analysis is consistent with a study that examined the relationship between HUD housing assistance and adult health ( 3 ).…”

“…A challenge of estimating the relationship between HUD housing assistance and health behaviors is unobserved confounding (ie, factors correlated with the receipt of housing assistance and physical activity [ 3 ]). To control for unobserved differences between adults with housing assistance and adults without housing assistance, we used a “pseudo–wait-list” approach.…”

“…Wait-listed respondents likely resemble the current assistance group on numerous observed and unobserved characteristics. This pseudo–wait-list approach was used in previous studies to examine the association of housing assistance with health status and health care utilization ( 3 , 4 ). As a check on the suitability of this control group, we compared current recipients of assistance and future recipients of assistance on observed health and sociodemographic characteristics reported in NHIS.…”

“…The US Department of Housing and Urban Development (HUD) manages and oversees federal housing assistance programs, which can include the provision of housing vouchers (eg, Housing Choice Vouchers), which help people rent private homes, or the provision of public housing ( 2 ). The receipt of housing assistance is linked with better overall self-rated health, less psychological distress ( 3 ), and lower rates of uninsurance and unmet medical needs ( 4 ) among adults, as well as lower blood-lead levels in young children ( 5 ). The extent to which housing assistance may also lead to healthier behaviors, such as physical activity, is uncertain.…”

The Next Generation of Diabetes Translation: A Path to Health Equity

“…This singular approach ignores the interactive, real-world environment of the individual influenced by SDOH. Multisector partnerships are critical to translation efforts (89) by offering purposeful collaborations of various stakeholder groups (e.g., government, community, private sector) and individual sectors (e.g., health, housing, transportation, environment, and economy) who work to achieve a common outcome (52,57,77,117). These partnerships promote coordinated action across local and national sectors, which is required to design and implement interventions to eliminate the root causes of diabetes disparities (89,127).…”