Health and Health Services Access Among Adults With Disabilities Who Receive Federal Housing Assistance

Using newly available U.S. Department of Housing and Urban Development (HUD) administrative data linked with National Health Interview Survey data, this study estimates the prevalence of disability among HUD-assisted adults and examines health disparities for this population. The linked data suggest a much higher prevalence of disability among HUD-assisted adults than previously suggested by HUD administrative data. Controlling for individual characteristics and HUD program type, assisted-housing residents who have disabilities experienced higher rates of self-reported fair or poor health, asthma, diabetes, hypertension, obesity, and cigarette smoking. Adults with disabilities had more frequent use of emergency rooms and increased concerns with affording the necessary health care. HUD-assisted adult residents with disabilities were more likely than residents without disabilities to be connected to the health-care system, having higher rates of insurance coverage and more frequent contact with specialists, general doctors, and mental health-care providers. Policy implications are discussed.     

Searching for Affordability and Opportunity: A Framework for the Housing Choice Voucher Program

Abstract

Affordability, a key factor in the housing search process, becomes critical when locating rental housing in opportunity-rich areas. The Housing Choice Voucher (HCV) program accommodates low-income households searching for housing and encourages recipients to reside in low-poverty areas. Affordable neighborhoods that are accessible to public transportation are often found in distressed areas, and not all HCV recipients succeed in locating qualified housing. To address these challenges, a housing search framework is developed to assist HCV households in the housing search process. This framework builds on the methodology of the U.S. Department of Housing and Urban Development (HUD) for the Location Affordability Index and Affirmatively Furthering Fair Housing assessment tool by creating multivariate indices that incorporate housing supply, accessibility to opportunity, and neighborhood conditions. The framework serves as a foundation for an online housing search application for public housing authorities to further fair housing goals, HCV recipients to locate qualified housing units, and local governments to assess affordability and opportunity.     

Gentrification and Fair Housing: Does Gentrification Further Integration?

ABSTRACT

On the 50th anniversary of the Fair Housing Act, long-time residents of cities across the country feel increasingly anxious that they will be priced out of their homes and communities, as growing numbers of higher-income, college-educated households opt for downtown neighborhoods. These fears are particularly acute among black and Latino residents. Yet when looking through the lens of fair housing, gentrification also offers a potential opportunity, as the moves that higher-income, white households make into predominantly minority, lower-income neighborhoods are moves that help to integrate those neighborhoods, at least in the near term. We explore the long-term trajectory of predominantly minority, low-income neighborhoods that gentrified over the 1980s and 1990s. On average, these neighborhoods experienced little racial change while they gentrified, but a significant minority became racially integrated during the decade of gentrification, and over the longer term, many of these neighborhoods remained racially stable. That said, some gentrifying neighborhoods that were predominantly minority in 1980 appeared to be on the path to becoming predominantly white. Policies, such as investments in place-based, subsidized housing, are needed in many gentrifying neighborhoods to ensure racial and economic diversity over the longer term.     

Future Prospects for Public Housing in the United States: Lessons From the Rental Assistance Demonstration Program

This article provides an overview of the Rental Assistance Demonstration (RAD) program in the United States and examines its early implementation from its start in 2013 through April 6, 2016. RAD was devised to address the physical deterioration of public housing and secure a more stable funding stream. It requires public housing authorities to shift properties out of the public housing program into a different subsidy program (project-based Section 8) which enables them to obtain mortgages on more favorable terms and to secure tax-credit investment. The program is currently limited to 185,000 housing units. As of April 6th, the program was fully subscribed, and had generated more than $2 billion in new investment. Extrapolating from the early results, RAD has the potential to yield more than $15 billion for fund the redevelopment and renovation of public housing.     

Navigating Limited and Uncertain Access to Subsidized Housing After Prison

An emerging literature has documented the challenges that formerly incarcerated individuals face in securing stable housing. Given the increasingly unaffordable rental market, rental subsidies represent an important and understudied source of stable housing for this population. The existing literature has described substantial discretion and a varied policy landscape that determine former prisoners’ access to housing subsidies, or subsidized housing spaces that are leased to members of their social and family networks. Less is known about how former prisoners themselves interpret and navigate this limited and uncertain access to subsidized housing. Drawing on data from repeated qualitative interviews with 44 former prisoners, we describe the creative and often labor-intensive strategies that participants employed to navigate discretion and better position themselves for subsidized housing that was in high demand, but also largely out of reach. Our findings also illustrate the potential costs associated with these strategies for both participants and members of their social and family networks.     

Walking Away From The Wire: Housing Mobility and Neighborhood Opportunity in Baltimore

Families using the Housing Choice Voucher Program rarely experience large gains in neighborhood or school quality when compared with unassisted poor renters. Research on housing mobility programs has reached mixed conclusions about whether vouchers can improve neighborhood and school quality, especially in the long term. We revisit these findings using new data from the partial remedy to the Thompson v. HUD desegregation case in Baltimore, known as the Baltimore Housing Mobility Program (BHMP). Through targeted vouchers, intensive counseling and innovative policy features, the BHMP helped families move to low-poverty, nonsegregated neighborhoods with higher performing school districts. We examine residential outcomes for the first 1,800 families that moved through the program for a period of up to 9 years. We find that BHMP families moved to more integrated and affluent neighborhoods, in school districts with more qualified teachers and fewer poor students—and most families stayed in these neighborhoods beyond their initial lease-up period. Eventually, a small proportion of families moved to neighborhoods that are less white, but still significantly less poor and less segregated than their original communities. We interpret these findings in light of past mobility programs and discuss policy implications for the Housing Choice Voucher Program.     

Rental Housing Assistance and Health: Evidence From the Survey of Income and Program Participation

Interest in the health impacts of renter housing assistance has grown in the wake of heated national discussions on health care and social welfare spending. Assistance may improve renters’ health by offering (a) low, fixed housing costs; (b) protection against eviction; and (c) access to better homes and neighborhoods. Using data from the Survey of Income and Program Participation and econometric analysis, I estimate the effect of receiving assistance from the public housing or Section 8 voucher programs on low-income renters’ reported health status and spending. Assisted renters spent less on health care over the year than unassisted low-income renters did, after controlling for other characteristics. This finding suggests that assisted housing leads to health benefits that may reduce low-income renters’ need to purchase health services. Voucher holders’ lower expenditures are influenced by their low, fixed housing costs, but public housing residents’ lower expenditures are not explained by existing theory.     

Collective Action for Smallholder Market Access: Evidence and Implications for Africa

It is widely acknowledged that the involvement of small farmers into markets can contribute to higher productivity and income growth, which in turn can enhance food security, poverty reduction efforts, and overall economic growth. In Africa, as in other parts of the developing world, agricultural production systems and their participants face significant challenges as a result of changing economic, environmental, and sociopolitical context. New dynamics in the global agricultural economy, such as the growth of supermarkets, are providing smallholders with both the new opportunities and new constraints to participate in and benefit from market exchanges. Collective action in the form of producer groups can enable African smallholders to take advantage of the new value chains and deal with existing market imperfections. However, certain conditions must be in place to create and sustain incentives for farmers to organize around marketing. Experiences from collective action in natural resource management (NRM) have shown that the types of markets and products, characteristics of user groups, institutional arrangements, and external environment need to be considered in order to determine the effectiveness and sustainability of collective marketing for smallholders. This paper applies the lessons from collective action in NRM to marketing, using existing case studies of producer groups in Africa, and offers policy recommendations on the factors that contribute to the success of collective marketing efforts.     

The Fair Housing Act Today: Current Context and Challenges at 50

ABSTRACT

As is true for most legislation, the Fair Housing Act (FHA) was a product of its time; the legislation’s content, and even passage, was formed by dominant issues in housing markets and the country at that time. The context shaped the goals of the FHA and the strategies and tools employed under its auspices. Fifty years after the passage of the FHA, much of that context has changed. This commentary argues that changes in the context not only raise new fair housing challenges and create new gaps in our knowledge, but also may necessitate a fresh look at fair housing strategies and tools if they are to be effective at achieving the goals of the act. This commentary begins with a brief background on the FHA itself, the social context at the time of its writing, and its main goals. Next it lays out a few key changes in housing markets relevant for fair housing, highlighting challenges they may create and where research could be of greatest value. It then considers challenges arising from threats to two specific U.S. Department of Housing and Urban Development (HUD) fair housing rules seen by many as critical fair housing tools. The commentary ends with two examples of a “refresh,” where current context has shaped, or reshaped, a strategy to address today’s fair housing challenges.     

Transportation Access,Rental Vouchers,and Neighborhood Satisfaction: Evidence From the Moving to Opportunity Experiment

The Housing Choice Voucher (HCV) program is designed in part to expand the neighborhood choices of assisted households, thereby enabling assisted households to find a living environment that simultaneously meets their housing and neighborhood preferences. While several studies have examined the impact of rental subsidies on neighborhood satisfaction, few have examined whether access to adequate transportation enables HCV recipients to locate housing in more desirable locations. This article relies on data from the Moving to Opportunity experiment to examine the impact of transportation access, rental housing vouchers, and geographic constraints on neighborhood satisfaction. We find that access to both vehicles and public transit positively influences neighborhood satisfaction, and the influence of vehicle access varies with transit proximity. These findings point to the importance of transportation in helping low-income assisted renter households locate housing in more desirable neighborhoods.     

Encouraging Residential Moves to Opportunity Neighborhoods: An Experiment Testing Incentives Offered to Housing Voucher Recipients

Substantial benefits can accrue from living in low-poverty neighborhoods, yet approximately 80% of the 2.2 million Housing Choice Voucher (HCV) recipients rent homes in moderate- or high-poverty census tracts. The Chicago Regional Housing Choice Initiative tested several ways to promote opportunity moves. It included the first experiment that tests whether two types of light-touch incentives induce opportunity moves for HCV recipients who had requested a moving voucher. Based on the 2,005 HCV recipients in the study, we found that neither the offer of a $500 grant nor the offer of a $500 grant coupled with free mobility counseling induced opportunity moves. The receipt of mobility counseling also did not boost opportunity moves. Regardless of the type of offer, 11%–12% of participants moved to opportunity neighborhoods. Despite requesting a moving voucher, half of the study participants remained in place, indicating significant barriers to moving. We offer potential reasons for the results and conclude with two recommended pilots to increase opportunity moves.     

Survival of the Fairest: Examining HUD Reviews of Assessments of Fair Housing

ABSTRACT

In 2015, the U.S. Department of Housing and Urban Development (HUD) issued the Affirmatively Furthering Fair Housing (AFFH) Rule, arguably the most significant federal effort in a generation to address place-based disparities in access to opportunity and to advance fair housing. In 2018, HUD suspended the rule, it said in part because of the resources it was expending to implement it and in part because of the large share of municipal plans that HUD determined had failed to meet the rule’s requirements. In this article, we present the first analysis of the fair housing plans that HUD did not accept, examining how municipalities failed to meet the rule's requirements, what those failures imply about advancing fair housing, and the extent to which HUD’s enforcement strategy was working before the suspension. Our analysis shows that HUD engaged in detailed reviews of municipalities’ Assessments of Fair Housing and provided constructive feedback. The most common issue with which municipalities struggled was setting realistic goals that would actually advance fair housing and creating measurable metrics and milestones to gauge progress. Several municipalities neglected to conduct thorough regional analyses or analyses of all relevant disparities in access to opportunity. Both shortcomings reflect broader challenges municipalities face in advancing fair housing, particularly in identifying strategies that address interconnected causes of disparities in access to opportunity and in building regional support to address those causes.     

Housing as a Social Right: Implications for Welfare State Theory

The article contributes to two central and interrelated discourses in welfare state theory and housing policy. One concerns the meaning of a 'right to housing' , and the other concerns the meaning of the dichotomy 'universal'–'selective' in housing policy . The right to housing is best seen as a political 'marker of concern' pointing out housing as an area for welfare state policy. The more precise meaning of the idea is always defined socially, in a specific national context of relations between state, citizen, and markets in housing provision. Two alternative interpretations of a right to housing are suggested, each related to a certain logic of housing provision. In a selective housing policy, the state provides a 'protected' complement to the general housing market, and the right to housing implies some legalistic minimum rights for households of lesser means. In a universal housing policy, the state provides correctives to the general housing market in order to make housing available to all types of households, and the right to housing is best seen as a social right in Marshall's meaning of an obligation of the state towards society as a whole. The concepts of 'universal' and 'selective' may be applied to either the political discourse or the social outcome of policies. Furthermore, they may refer to different political levels (e.g. welfare state level, sector level, and policy instrument level). If the dichotomy is not specified in those two respects, the distinction between a universal and a selective policy will always be seriously blurred.     

Quality of Life,Transportation Costs,and Federal Housing Assistance: Leveling the Playing Field

Abstract

Federal housing subsidies are allocated without regard to spatial differences in the cost of living or quality of life. In this article, we calculate housing subsidy payments for participants in the Housing Choice Voucher (HCV) program and demonstrate that these subsidies are significantly related to metropolitan quality-of-life differentials. We then estimate amenity-adjusted subsidies and compare these estimates with data from the U.S. Department of Housing and Urban Development’s Location Affordability Portal. Our analysis yields three insights regarding the relationship between federal housing assistance payments (HAP), metropolitan quality-of-life differentials, and transportation cost burdens. First, HCV HAP show a strong inverse correlation with household transportation expenditures, and this is particularly pronounced for low-income households. Thus, HAP do not address location affordability because those living in high-transportation cost metropolitan areas receive the lowest housing subsidies. Second, we present evidence that HAP are positively related to metropolitan quality-of-life differentials. This suggests that high-amenity metropolitan areas also tend to be the most affordable from a transportation cost perspective. Third, our proposed amenity-adjusted HAP strongly reduce the inverse relationship between HAP and transportation cost burdens.