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.

项目摘要 缺乏安全可负担的住房反映了国家危机。研究记录了 住房对儿童健康的不安全感，很少的工作检查了住房补贴可能会有所帮助的方式 保护儿童健康免受这种威胁。住房优惠券，可补贴成本或租金和公用事业 使低收入家庭能够在私人市场上租房，是美国最大的住房援助 程序。但是，只有四分之一的合格家庭获得租金援助。作为决策者和 从业者考虑优化现有凭证的使用并寻求支持以扩展整体的方法 经济适用房的供应，对研究的迫切需求可以调查住房之间的联系 选择优惠券和健康。与两个公共住房当局（西雅图住房管理局和国王 县住房管理局）和卫生部门（公共卫生 - 座位和金县），我们打算 调查收到住房凭证在儿童入学医疗补助和 医疗保健使用模式。该提案使用准实验差异差异方法 利用这一事实，即从长时间的候补名单中随机选择获得住房援助的家庭 （n> 40,000），从而减少了潜在的混杂。该提案扩展了由 公共住房当局和卫生部门已有行政住房数据 成功地与医疗补助索赔和遭遇数据联系在一起。在第一个目标中，我们将使用差异 研究收到住房选择凭证是否与更改相关的差异方法 与候补名单上的医疗补助入学率相比。第二个目的研究孩子是否 家庭获得住房选择优惠券具有不同的住院方式，急诊室 访问，“房屋敏感”条件（包括哮喘，其他呼吸系统疾病，心理健康和伤害） 与候补名单上的孩子的访问相比。最终目标检查是否重要的​​儿童因素是否 例如，年龄，性别和种族/民族修改住房凭证与医疗保健之间的关联 使用。该提案将公共住房和公共卫生部门的学术研究人员与 将结果转化为可行的政策建议和实践的强大潜力 改善儿童的健康和福祉。