Search

BACKGROUND: Federal housing assistance is an important policy tool to ensure housing security for low-income households. Less is known about its impact on residential environmental exposures, particularly lead. OBJECTIVES: We conducted a quasi-experimental study to investigate the association between federal housing assistance and blood lead levels (BLLs) in a nationally representative US sample age 6 y and older eligible for housing assistance. METHODS: We used the 1999-2018 National Health and Nutrition Examination Survey (NHANES) linked with US Department of Housing and Urban Development (HUD) administrative records to assess BLLs of NHANES participants with concurrent HUD housing assistance (i.e., current recipients, n = 3,071) and those receiving assistance within 2 y after the survey (i.e., pseudo-waitlist recipients, n = 1,235). We estimated BLL least squares geometric means (LSGMs), odds ratio (OR) for BLL [greater than or equal to]3.5 [micro]g/dL, and percent differences in LSGMs by HUD housing assistance status adjusting for age, sex, family income-to-poverty ratio, education, country of birth, race/ethnicity, region, and survey year. We also examined effect modification using interaction terms and stratified analyses by program type [i.e., public housing, multifamily, housing choice vouchers (HCV)], and race/ethnicity. RESULTS: Current HUD recipients had a significantly lower LSGM [1.07 [micro]g/dL; 95% confidence interval (CI): 1.02, 1.12] than pseudo-waitlist recipients (1.21 [micro]g/dL; 95% CI: 1.14, 1.28), with an adjusted OR of 0.60 (95% CI: 0.42, 0.87) for BLL [greater than or equal to]3.5 [micro]g/dL. Some effect modification were observed: The protective association of HUD assistance on BLL was strongest among public housing (-19.5% LSGM; 95% CI: -27.5%, -10.7%), multifamily (-12.5% LSGM; 95% CI: -20.7%, -3.5%), and non-Hispanic White (-20.6% LSGM; 95% CI: -29.8%, -10.3%) recipients. It was weaker to null among HCV (-5.7% LSGM; 95% CI: -12.7, 1.7%), non-Hispanic Black (-1.6% LSGM; 95% CI: -8.1%, 5.4%), and Mexican American (-12.5% LSGM; 95% CI: -31.9%, 12.5%) recipients. DISCUSSION: Our research underscores the importance of social-structural determinants like federal housing assistance in providing affordable, stable, and healthy housing to very low-income households. More attention is needed to ensure housing quality and racial equity across HUD's three major housing assistance programs. https://doi.org/10.1289/EHP12645, Introduction Lead is a ubiquitous environmental toxin with deleterious effects on the nervous, hematopoietic, endocrine, renal, and reproductive systems. Higher blood lead levels (BLLs) in adults have been consistently associated [...]

Housing policy in the United States has long been characterized by unequal investment in homeownership and low-income rental assistance, with implications for racial (and ethnic) inequality in access to stable housing. In this study, I examine socioeconomic status and neighborhood characteristics of non-Hispanic White and non-Hispanic Black adults with children receiving HUD rental assistance using a nationally representative linked survey-administrative dataset. Results show that Black and White adults who receive rental assistance tend to have similar (low) incomes, yet Black adults experience significantly higher levels of neighborhood disadvantage than White adults. Furthermore, living in poverty is a substantially stronger predictor of receiving HUD rental assistance for White than Black adults. The results support the notion that rental assistance programs are a last resort for White households, many of whom may benefit from historical federal government support for homeownership. Rental assistance serves as an important safety net for Black families but fails to provide significant improvement in the neighborhood environment. The results contribute to a comprehensive understanding of racial inequality in the impacts of U.S. rental housing policy and the historical legacy of racial exclusion in U.S. homeownership programs. [ABSTRACT FROM AUTHOR]

Project-based housing programs and tenant-based housing programs (vouchers) may have differential effects on neighborhood outcomes for residents. Theoretically, vouchers should enhance access to low-poverty neighborhoods for low-income families thereby promoting economic mobility for children, though vouchers' success may vary by race and ethnicity. Drawing on a national survey-administrative data linkage and a quasi-experimental approach, we examine the impact of project-based housing and vouchers on an index of socioeconomic neighborhood disadvantage among children. We find that living in project-based housing leads to greater exposure to neighborhood disadvantage while receiving vouchers leads to reduced exposure. Reductions in neighborhood disadvantage for children receiving vouchers are found only for non-Hispanic Black and Hispanic/Latino children. For non-White families, vouchers are associated with a reduced likelihood of living in high-poverty neighborhoods and increased likelihood of living in low-poverty neighborhoods, presenting an opportunity to narrow racial and ethnic differences in children's neighborhood attainment. [ABSTRACT FROM AUTHOR]

Research on the effects of federal housing assistance programs on children's outcomes has produced mixed results. Although housing assistance programs provide a rare source of affordable and stable housing for low-income families, there remains concern that living in public housing developments increases children's risk of poor health. This paper uses a unique survey-administrative linked dataset to examine the effect of living in public housing on children's risk of health problems, including frequent diarrhea, headaches, skin allergies, asthma, and fair/poor health status. Children living in public housing have more health problems than children who do not live in public housing. However, the analysis develops several comparison groups to demonstrate that the excess health problems reflect unobserved selection into public housing. The main selection adjustment compares children living in public housing to children who enter public housing in the near future. Results indicate that public housing does not increase the risk of child health problems, and it is important to consider selection into public housing on factors that are correlated with health. The effects of public housing may be mixed, but policymakers should not confuse the economic and health challenges of public housing residents for the effects of the program itself. [ABSTRACT FROM AUTHOR]