US housing subsidy may improve adolescent girls' binge drinking but worsen boys'

A housing subsidy treatment that enables low-income families in US cities to move from public to private housing appears to reduce adolescent girls' binge drinking but increase adolescent boys' binge drinking. The reasons for these differential gender effects are not yet clear.

Affordable housing policies are common in democratic nations, and the Housing Choice Voucher (HCV) program represents the largest federal investment in affordable housing in the US. Such policies have the potential to address inequality for low-income households by defraying rental costs and promoting housing mobility to higher opportunity areas.

The Moving to Opportunity (MTO) housing subsidy trial randomized volunteer low-income families in public housing to (1) receive rental subsidies redeemable in neighbourhoods with few residents living in poverty plus housing counselling, (2) receive unrestricted rental subsidies or (3) remain in public housing. In this secondary study, results from groups 1 and 2 were pooled to represent the treatment group.

This secondary analysis, published today by the scientific journal Addiction, examined 2829 adolescents (1950 in the treatment and 879 in the control group) for differences in binge drinking and other alcohol use outcomes 4 to 7 years after the study began, including following their family's receipt and use of a rental subsidy to move to a private rental unit if they were assigned to the treatment condition, or their assignment to the public housing control condition. The treatment-control risk difference (the excess risk than can be attributed to having moved with a subsidy vs. not) on binge drinking for girls was -0.022 (a beneficial effect of treatment) and for boys was 0.032 (a harmful effect of treatment).

Lead author Dr. Theresa Osypuk, Associate Professor at the University of Minnesota School of Public Health, says "Our research addresses a key policy question in the popular US-based HCV programme: whether or not to incorporate elements from non-housing sectors to improve outcomes for low-income children. Our findings suggest that although girls benefit from the HCV programme with respect to reducing underaged drinking, boys may need additional support to be successful.

"Although we don't know exactly why there is a gender difference in adolescent binge drinking resulting from this housing subsidy program, we suspect the MTO treatment may have influenced binge drinking via social relationship mechanisms, which are different for girls and boys. For example, girls and boys may cope with the stressors of moving differently, and/or parenting relationships affected by residential mobility may influence girls' and boys' drinking behaviours differently. Further research will uncover the exact mechanisms, but until then we need to respond to the fact that boys face increased risk of binge drinking under the current HCV programme."

Binge drinking is a pattern of excessive alcohol consumption that results in elevated blood alcohol concentration, leads to cognitive, sensory and motor impairment, and causes tissue damage in both acute and chronic use. Any alcohol use may cause some level of impairment, but binge drinking has a much higher risk for negative outcomes than measures such as life-time or past month alcohol use.