Does HUD Assistance Affect Child Health Outcomes?

About 4 million of the 10 million Americans who receive US Department of Housing and Urban Development (HUD) assistance are children. How healthy are these children? Housing policymakers and public health professionals increasingly recognize that housing is an important social determinant of health, particularly among children, as research shows that housing can significantly shape their emotional, psychological, and behavioral health and development. To fill the gap in research that previously relied on anecdotal evidence and case studies, a recent HUD study sought to identify the prevalence of health conditions and health care use among HUD-assisted children.

The study provided prevalence estimates of the health of children ages 17 and younger in HUD-assisted households with those living in eligible but unassisted households and the general population. HUD assistance was defined as participation in one of HUD’s three primary subsidy programs: public housing, housing choice vouchers, and assisted multifamily housing. The authors linked responses from the National Health Interview Survey and the National Health and Nutrition Examination Survey over 14 years (1999–2012) to longitudinal HUD administrative data. The study explored differences in demographics, health status, health care use, and learning-related health status among the three groups, but the differences were not tested for statistical significance. The findings have important policy implications that suggest aligning housing assistance programs with health policy to potentially improve cost-effectiveness and health outcomes.

Key findings

• Most HUD-assisted children were black (52.2 percent) and lived in a single-parent, female-headed household (74.6 percent); 31.9 percent lived in large metropolitan centers.
• Although 86.8 percent of HUD-assisted children had insurance coverage through public health insurance programs, they appear to have worse health status than the general population of children.
• Most HUD-assisted children (84.4 percent) had a well-child checkup in the past year. Lower rates were reported for unassisted low-income households (80.2 percent) and the general population (76.8 percent).
• The percentage of children with unmet medical needs because of unaffordability was similar among HUD-assisted children (3.5 percent) and children in the general population (4.4 percent).
• HUD-assisted children (21.2 percent) are more likely to have asthma than children in unassisted, low-income renter households (17.7 percent).
• 5 percent of HUD-assisted children had been told by a school or health professional that they had a learning disability.

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