Health of Low-Income Adults in Subsidized Housing: Randomized Experiment, NY City

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DESCRIPTION (provided by applicant): From a public health perspective, moving to subsidized housing, to less poor neighborhoods, to housing developments with low rates of crime, or to more mixed income settings might reduce health disparities through multiple pathways. The proposed experimental research will utilize the NYC Department of Housing Preservation and Development's lottery system to identify treatment and control households that fit our study criteria. Group assignment will include households who move to a subsidized apartment in one of ten newly constructed housing sites (treatment) and matched households who do not receive housing (control). We estimate that our experimental sample will be comprised of about 1,300 participating treatment households and 1,690 lottery- matched controls. This proposal's design improves and expands upon the design of earlier housing experiments in that it (a) compares the impact of moving to a new neighborhood versus staying in the same neighborhood among recipients of subsidized housing, (b) compares the impact of moving into mixed-income versus solely low- income buildings, (c) examines the impact of subsidized housing on near-poor families (rather than just families below the poverty threshold), (d) examines the effect of subsidized housing where the uptake of the offer is 90% (rather than less than one-half in previous demonstrations of subsidized housing), and (e) examines the effect of subsidized housing where the families are likely to stay in the subsidized housing (compared to studies of vouchers, where over half of those who did move ended up moving again, typically back to poor neighborhoods). Our proposed data collection strategy will include baseline data collection at time of application for housing using a self-administered questionnaire to be completed by a single adult household member and augmented by information obtained from the housing application itself. Follow-up telephone interviews will take place 12-18 months after move-in, or equivalent for non-movers. A variety of information on current health status and health behaviors will be collected at baseline and follow-up to enable assessment of within-household change as well as average change between comparison groups at follow-up. Experimental analyses will be used to quantify the impact of moving to subsidized housing in a new neighborhood relative to moving to subsidized housing in the same neighborhood of residence at time of application. Exploratory analysis will compare two types of treatment: moves to mixed-income housing and exclusively low-income housing developments. Relationships among household, housing, and neighborhood features will be examined as potential outcomes as well as mediators of individual-level health outcomes. PUBLIC HEALTH RELEVANCE: Experimental research has shown that moving to new housing in particular kinds of neighborhoods may improve the life chances of poor families; however, previous research confounded housing- and neighborhood mobility and did not investigate the benefits of mixed-income housing developments. Our randomized experiment will track about 1,300 households who receive city-subsidized housing and about 1,700 matched households who do not receive housing over the first 12-18 months after move-in to assess changes in physical and mental health, and health behaviors. In addition, we will explore changes in physical, economic, and social environments that may mediate the relationship between residential context and health and well-being of low-income residents.