Dataset Information

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.

SUBMITTER: Fenelon A

PROVIDER: S-EPMC5343706 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Housing Assistance Programs and Adult Health in the United States.

Fenelon Andrew A Mayne Patrick P Simon Alan E AE Rossen Lauren M LM Helms Veronica V Lloyd Patricia P Sperling Jon J Steffen Barry L BL

American journal of public health 20170216 4

<h4>Objectives</h4>To examine whether access to housing assistance is associated with better health among low-income adults.<h4>Methods</h4>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 ...[more]

PMID: 28207335

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Project description:BackgroundWhile social assistance through the U.S. federal CARES Act provided expanded unemployment insurance benefits during the COVID-19 pandemic until the summer of 2020, it is unclear whether social assistance was sufficient in subsequent months to meet everyday spending needs and to curb the adverse health-related sequelae of financial hardship.MethodsUsing multivariable Poisson log-binomial regression and repeated cross-sectional Household Pulse Survey data between September and December 2020 on 91,222 working-aged U.S. adults and 28,842 adult housing renters, this study explored the associations of financial hardship with mental health outcomes and food and housing insecurity after accounting for receipt of social assistance.ResultsFinancial hardship rose progressively from September to December 2020, and disproportionately affected Black non-Hispanic and Hispanic Americans and lower-income households. Experiencing considerable financial hardship (vs no hardship) predicted nearly 3-fold higher risks of anxiety and depressive symptoms (e.g., adjusted prevalence ratio, PR of depression = 2.75, 95% CI = 2.54-2.98, P < .001), a 23-fold higher risk of food insufficiency (PR = 22.71, 95% CI = 15.62-33.01, P < .001), and a 27-fold higher risk of a likely eviction (PR = 27.20, 95% CI = 10.63-69.59, P < .001). Across outcomes, these relationships were stronger at each successively higher level of financial hardship (all P values for linear trend <0.001), and more than offset benefits from social assistance.ConclusionsEven after accounting for social assistance receipt, working-aged adults experiencing financial hardship had markedly greater risks of anxiety and depressive symptoms, food insufficiency, and an anticipated housing eviction. These findings point to the urgent need for direct and sustained cash relief well in excess of current levels of social assistance to mitigate the pandemic's adverse impacts on the well-being of millions of Americans, including vulnerable minority and low-income populations.

Project description:BackgroundThis paper discusses the initial testing of the Housing First Training and Technical Assistance (HFTAT) Program, a multifaceted, distance-based strategy for the implementation of the Housing First (HF) supportive housing model. HF is a complex housing intervention for serving people living with serious mental illness and a substance use disorder that requires significant individual- and structural-level changes to implement. As such, the HFTAT employs a combined training and consultation approach to target different levels of the organization. Training delivered to all organizational staff focuses on building individual knowledge and uses narrative storytelling to overcome attitudinal implementation barriers. Consultation seeks to build skills through technical assistance and fidelity audit and feedback.MethodWe employed a mixed method design to understand both individual-level (e.g., satisfaction with the HFTAT, HF knowledge acquisition and retention, and HF acceptability and appropriateness) and structural-level (e.g., fidelity) outcomes. Quantitative data were collected at various time points, and qualitative data were collected at the end of HFTAT activities. Staff and administrators (n =?113) from three programs across three states participated in the study.ResultsSatisfaction with both training and consultation was high, and discussions demonstrated both activities were necessary. Flexibility of training modality and narrative storytelling were particular strengths, while digital badging and the community of practice were perceived as less valuable because of incompatibilities with the work context. HF knowledge was high post training and retained after 3-month follow-up. Participants reported training helped them better understand the model. Attitudes toward evidence-based interventions improved over 6 months, with qualitative data supporting this but demonstrating some minor concerns related to acceptability and appropriateness. Fidelity scores for all programs improved over 9 months.ConclusionThe HFTAT was a well-liked and generally useful implementation strategy. Results support prior research pointing to the value of both (a) multifaceted strategies and (b) combined training and consultation approaches. The study also provides evidence for narrative storytelling as an approach for changing attitudinal implementation barriers. The need for compatibility between specific elements of an implementation strategy and the work environment was also observed.

Dataset Information

Housing Assistance Programs and Adult Health in the United States.

Publications

Housing Assistance Programs and Adult Health in the United States.

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