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

探讨住房援助对儿童医疗保健使用的影响

• 批准号: 10303291
• 负责人: Craig Evan Pollack
• 金额: $ 24.76万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-31 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10303291
• 关键词: Address; Age; Area; Asthma; Child; Child Development; Child Health; Child health care; Control Groups; County; Cross-Sectional Studies; Data; Data Linkages; Development; Economic Factors; Emergency department visit; Emotional; Enrollment; Environmental Risk Factor; Ethnic Origin; Family; Gender; Health; Health Care Sector; Health Services; Health Status; Healthcare; High Prevalence; Home; Hospitalization; Household; Housing; Income; Injury; Insurance Carriers; Link; Longevity; Low income; Lung diseases; Measures; Medicaid; Mental Health; Methods; National Institute of Child Health and Human Development; Neighborhoods; Outcome; Outcome Study; Patient Self-Report; Pattern; Personal Satisfaction; Policies; Policy Maker; Privatization; Public Health; Public Housing; Quasi-experiment; Race; Recommendation; Research; Research Design; Research Personnel; Resources; Risk; Role; Security; Social Work; Subgroup; System; Testing; Translating; United States; Waiting Lists; Well Child Visits; Work; authority; comparison group; cost; design; disparity reduction; experimental study; food insecurity; improved; innovation; lower income families; metropolitan; programs; respiratory; screening; social; social determinants; social health determinants; voucher

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.

项目概要 缺乏安全和负担得起的住房反映了一场国家危机，而研究已经记录了其危害。 住房不安全对儿童健康的影响，很少有人研究过住房补贴如何提供帮助 保护儿童的健康免受这种威胁。住房券可以补贴费用或租金和水电费， 使低收入家庭能够在私人市场上租房，是全国最大的住房援助 然而，只有四分之一的符合条件的家庭作为政策制定者和参与者获得租金援助。 护士考虑如何优化现有优惠券的使用，并寻求支持以扩大整体范围 经济适用住房的供应，迫切需要开展研究来调查住房之间的联系 与两个公共住房管理局（西雅图住房管理局和 King）合作。 县住房管理局）和卫生部门（公共卫生部门 - 西雅图和金县），我们打算 调查收到住房券与儿童加入医疗补助和 该提案使用准实验双重差分法。 利用接受住房援助的家庭是从长长的候补名单中随机选择的事实 (N>40,000)，从而减少潜在的混淆，该提案扩展了由执行的唯一数据链接。 公共住房当局和卫生部门，其中行政住房数据已被收集 成功地与医疗补助索赔和遭遇数据联系起来 在第一个目标中，我们将使用差异 - 差异法调查住房选择券的收到是否与变化相关 与候补名单上的儿童相比，医疗补助入学率的变化第二个目标是研究是否有以下情况的儿童。 收到住房选择券的家庭有不同的住院、急诊模式 探访、“住房敏感”状况（包括哮喘、其他呼吸系统疾病、心理健康和伤害） 以及与候补名单上的儿童就诊次数相比，最终目的是检查儿童因素是否重要。 年龄、性别和种族/族裔等因素改变了住房券和医疗保健之间的关联 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。 将结果转化为可操作的政策建议和实践的巨大潜力，旨在 改善儿童的健康和福祉。