HUD housing assistance linked to improved health care access
A new study examining the impact that access to affordable housing has on health showed that people receiving subsidized housing assistance were more likely to have medical insurance and less likely to have unmet medical need than other low income people who were on a US Department of Housing and Urban Development (HUD) wait list for the housing assistance benefit. Approximately 31 percent of the recipients of housing assistance were uninsured, as compared to about 37 percent of the future recipients.
Led by University of Maryland School of Public Health researcher Dr. Andrew Fenelon, the study analyzed data on adults ages 18-64 from the National Health Interview Survey that were linked to HUD data for the eight years from 2004-2012. The findings are published in Health Affairs, June 2017.
"We found that the benefits of giving people subsidized housing go beyond simply having access to affordable housing. Housing is good in and of itself, but even better is that with improved access to housing, you get improvements in access to health care, and ultimately better health outcomes," said Dr. Fenelon, who is an assistant professor in the UMD SPH Department of Health Services Administration. He conducted the study in collaboration with researchers from HUD, the US Department of Health and Human Services, and the National Center for Health Statistics.
Housing assistance programs funded by HUD provide low-income people with access to safe and affordable housing. People receiving public housing subsidies are often in poor health, with increased need for mental health and chronic disease care. Access to health care has been shown to improve health, and housing instability is correlated with poor access to health care. Still, there are few studies that have explored whether housing assistance programs may lead to improvements in health.
The results of this study are particularly relevant given the Trump administration's proposed $6 billion cut to the Department of Housing and Urban Development budget for 2018.
The Center on Budget and Policy Priorities, a nonpartisan research organization, estimates that the Trump proposal would result in the elimination of 250,000 rental vouchers. The center also warns that proposals in the budget would "significantly raise assisted tenants' rents and cut voucher subsidies in various ways."
Even with current funding levels, qualified individuals may wait many years to receive assistance in the form of housing choice vouchers, which may be used towards any housing arrangement.
"There are many reasons why having access to housing may enable people to obtain health insurance and access needed care," said Dr. Fenelon. "With the increased stability that comes from having a home and reduced financial burdens, and being introduced into the social service system and the access to other support services it provides, people receiving housing assistance are getting improved access to primary care health services. This is a clear demonstration that housing is one of the so-called 'social determinants' of health. The value of this program should be carefully considered in light of the far-reaching benefits it may have beyond its face value."