Exploring the Impacts of Housing Assistance on Children's Health Care Use

项目摘要 缺乏安全和负担得起的住房反映了一场国家危机。虽然研究已经记录了 住房不安全对儿童健康的影响，很少有研究探讨住房补贴可能有助于儿童健康的方式。 保护儿童的健康免受这种威胁。住房券，用于补贴房租和水电费， 使低收入家庭能够在私人市场上租到住房，是全国最大的住房援助项目 程序.然而，只有四分之一的符合条件的家庭获得租金援助。作为决策者， 从业人员考虑如何优化现有代金券的使用，并寻求支持， 由于经济适用房的供应，迫切需要进行研究，调查住房之间的联系 选择代金券和健康。与两个公共住房管理局（西雅图住房管理局和King 县住房管理局）和卫生部门（公共卫生-西雅图和金县），我们打算 调查收到儿童参加医疗补助的住房券与 卫生保健使用模式。该提案使用准实验差异的方法 利用这一事实，即接受住房援助的家庭是从一长串等待名单中随机挑选出来的， （N> 40，000），从而减少潜在的混淆。该提案扩展了一个独特的数据链接， 公共住房当局和卫生部，其中行政住房数据已 已成功与Medicaid索赔和就诊数据关联。在第一个目标中，我们将使用不同的- 差异方法，以调查是否收到住房选择券与变化有关 与候补名单上的人相比，第二个目的是研究 领取住房选择券的家庭有不同的住院、急诊模式 访问，“住房敏感”条件（包括哮喘，其他呼吸系统疾病，精神健康和伤害） 和健康儿童的就诊率相比最后的目的是检查重要的儿童因素是否 例如年龄、性别和种族/民族，改变了住房券和医疗保健之间的关联 使用.该提案将学术研究人员与公共住房和公共卫生当局聚集在一起， 将成果转化为可采取行动的政策建议和做法的巨大潜力， 改善儿童的健康和福祉。

Project Summary The lack of safe and affordable housing reflects a national crisis. While research has documented the harms of housing insecurity on children’s health, little work has examined the ways in which housing subsidies may help protect children’s health from this threat. Housing vouchers, which subsidize the costs or rent and utilities and enable low-income families to rent homes on private market, is the nation’s largest housing assistance program. However, only a quarter of eligible households receive rental assistance. As policy-makers and practitioners consider ways to optimize the use of existing vouchers and seek support to expand the overall supply of affordable housing, there is a critical need for research that investigates the link between housing choice vouchers and health. Working with two public housing authorities (Seattle Housing Authority and King County Housing Authority) and a health department (Public Health –Seattle & King County), we intend to investigate the association between the receipt of a housing voucher on children’s enrollment in Medicaid and patterns of health care use. The proposal uses quasi-experimental difference-in-differences methods leveraging the fact that families who receive housing assistance are randomly selected from a long waitlist (N>40,000), thereby reducing potential confounding. The proposal extends a unique data linkage performed by the public housing authorities and health department in which administrative housing data has been successfully linked with Medicaid claims and encounter data. In the first aim, we will use a difference-in- difference approach to investigate whether the receipt of a housing choice voucher is associated with changes in Medicaid enrollment compared to those on the waitlist. The second aim studies whether children whose families receive a housing choice voucher have different patterns of hospitalization, emergency department visits, ‘housing-sensitive’ conditions (including asthma, other respiratory conditions, mental health and injuries) and well-child visits compared to those on the waitlist. The final aim examines whether important child factors such as age, gender, and race/ethnicit modify the associations between housing vouchers and health care use. The proposal brings together academic researchers with public housing and public health authorities with the strong potential to translate the results into actionable policy recommendations and practice designed to improve children’s health and well-being.