Boston Medical Center, Children's HealthWatch

Housing Insecurity and Health and Development of Very Young, Low-income Children


Award:
$750,000 over three years
Principal Investigator:
Deborah A. Frank (email) &
John T. Cook (email)
Website:
Children’s Health Watch

Background: Though housing is a basic necessity for all people, we lack both a clear picture of housing insecurity’s influence on young children’s health and effective policy solutions. Recent research suggests associations between housing and children’s health are complicated by multiple family hardships. This research will build on earlier studies on relationships among housing insecurity, housing subsidies, other family hardships, and health of children under age three. Our earlier research found that young children in families on waiting lists for housing assistance were more likely to be seriously underweight than children in comparable families in subsidized housing, and that housing subsidies are positively associated with housing security. It also showed that very young children in housing-insecure families have worse health and development outcomes than children in housing-secure families.

Design: Researchers will use data collected by Children’s HealthWatch over the last 12 years at clinics and emergency departments of academic medical centers serving low-income families in five cites (Boston, Baltimore, Little Rock, Minneapolis and Philadelphia). Data include cross-sectional records on 36,000 households with children under age three. The survey captures information on household characteristics and demographics, experience of homelessness, receipt of federal assistance program benefits, child hospitalization history, child and maternal health status, child and maternal height and weight, child developmental issues, maternal depression, energy insecurity, and food insecurity. These data will be used to determine how the presence of multiple family hardships and receipt of benefits from multiple assistance programs influence housing security, and child and maternal health.

Outcomes: This research will clarify relationships among housing insecurity, prior homelessness and child health, among housing insecurity and other family hardships including food and energy insecurity, and relationships between housing insecurity and affordability. Findings will have direct implications for housing policy and ways that housing policy in combination with food and energy policies can be targeted best to protect the health of very young children.

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Initiative for a Competitive Inner City

Driving Inner City Economic Growth: An Analysis of the Economic Potential of the Construction, Housing, and Real Estate Cluster


Award:
$300,000 over two years
Principal Investigator:
Teresa Lynch (email)
Website:
Initiative for a Competitive Inner City

 

Background: In the future, construction, housing, and real estate (CHRE) activity can be a critical leverage point in reversing job loss trends in the economically distressed portions of America's cities. While these "inner cities" experienced a net loss of jobs from 1998 to 2007, CHRE activity in these neighborhoods grew by more than 13% during the same period, reflecting an inherent inner city strength. In addition to improving the physical and competitive environment of local economies, CHRE activity creates jobs that are accessible to inner city residents, providing entrée into career paths that result in middle-income wages without high formal education requirements.

The principal objectives of the study are to document the contributions of the CHRE cluster to inner city, central city, and regional economies; and to identify the private sector levers and public sector policies that can translate CHRE activity into business and employment opportunities in inner city economies. In an environment in which inner city residents, like so many others, are desperately seeking employment, this study examines the opportunity for CHRE to be re-positioned as a long-term inner city wealth creator.

Design: The study is based on a two-part approach. The first part involves a detailed descriptive, analytical, and empirical treatment of the CHRE cluster, using data from ICIC's proprietary State of the Inner City Economies (SICE) database, along with national data sets, including County Business Patterns; Current Construction Reports; Economic Census; Annual Survey of Manufactures; and Bureau of Labor Statistics' data on industries, occupations, education and training. The second part of the study identifies public policy and private sector strategies for maximizing the impact of CHRE, including residential housing activity, on urban economies. This part of the study utilizes city case studies, expert roundtables, and detailed statistical analyses.

Outcomes: Project findings will be disseminated aggressively in order to help public and private sector decision-makers develop strong CHRE clusters in inner city neighborhoods, resulting in entrepreneurial and employment opportunities for residents. Among the channels that ICIC will utilize to communicate its message are its annual Inner City Economic Forum (ICEF), conference calls with key decision makers, and publication in popular, trade, and academic journals.

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Mayor's Fund to Advance New York City/Department of Housing Preservation and Development


Award:
$300,000 over two years
Principal Investigator:
Elyzabeth Gaumer (email)
Website:
New York City, Department of Housing Preservation & Development

 

Background: In order to better understand the benefits subsidized housing provides to families and communities, it is essential to undertake rigorous, high-quality studies to address several critical gaps in the knowledge about housing and neighborhood as a source of risk or resilience. First, research needs to expand beyond only households living in poverty. Second, studies are needed that address the impact of in-place subsidized housing, rather than vouchers, and assess different types of place-based housing subsidy (i.e., mixed- versus low-income sites). Third, research needs to understand how subsidized housing impacts households separately from how neighborhood location affects households. Perhaps most important, empirical studies are needed that identify the specific mechanisms through which subsidized housing contributes to well-being in both the near- and long-term. This planning grant enables the New York City Department of Housing Preservation and Development (HPD) to work with both academic (Teachers College/Columbia University, New York University, New York Academy of Medicine) and municipal (Department of Health, Department of Education) partners to develop a multi-year panel study of how subsidized rental housing affects household health and social outcomes, as well as children’s educational success and developmental progress. This builds upon pilot work previously completed by HPD.

Design: The research design has four distinguishing features to enhance policy relevance:

  1. a lottery process for allocating units to eligible households allows randomized group assignment and experimental analyses of carefully defined treatment and control groups;
  2. a stratified treatment design in which 50 percent of households in a project will move to subsidized housing in a new neighborhood, and 50 percent will move to subsidized housing in the neighborhood they resided in at baseline, allowing the research will to disentangle housing from neighborhood effects;
  3. a study population comprised of near-poor households that largely live in private-market housing at time of application, allowing this study to assess the impact of receiving subsidies relative to a control group that does not; and
  4. a mix of study sites that vary by type (mixed- versus low-income) and neighborhood location (affluent versus poor) to facilitate comparisons among types of subsidized housing investments.

This study design enables the research team to estimate within-household changes over time, to isolate the processes by which certain housing and/or neighborhood characteristics operate, and assess whether these impacts or pathways vary across a range of income strata and outcomes.

Outcomes: This study will serve as a program evaluation for New York City’s New Housing Marketplace Plan—an $8.5 billion initiative that includes the construction of 35,000 units of affordable housing by 2014. It will directly inform local housing policies as well as provide the opportunity to demonstrate best practices for integrating research into policymaking and program design across a broad range of municipalities while also contributing to the scientific understanding of how housing matters for individuals and families. The study will compare health and social outcomes for those households that receive new construction subsidized housing to those outcomes for households that do not, as well as developmental and educational outcomes for children within our group assignments. This study aims to inform urban municipal governments as to how, where, and to whom housing subsidies should be applied to maximize health and social returns for the recipient population. The relationships among in-place subsidized affordable housing and health, social, and child outcomes that the complete study seeks to isolate and identify will inform policy decisions and justify more comprehensive and coordinated programmatic responses among local housing, health, and education agencies, both within and across, state and federal levels of government.

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Northwestern University

The Effects of Housing Vouchers on Long-Term Health Outcomes


Award:
$250,000 over two years
Principal Investigator:
Thomas McDade (email)
Website:
Institute for Policy Research

 

Background: This study examines the effects of housing vouchers on the long-term health outcomes of low-income adults, using data from a unique randomized voucher experiment known as Moving to Opportunity (MTO), involving approximately 4600 public housing households in five cities (Baltimore, Boston, Chicago, Los Angeles, and New York). This project builds on our study of MTO's medium-run outcomes (4-7 years after random assignment, collected in 2002), where we find that moving to a less disadvantaged area through either the MTO Experimental or Section 8-housing voucher only group produces a variety of benefits to program participants, including large improvements in safety and in adult mental health.

Design: We are conducting a long-term follow-up survey, 10 to 12 years after MTO random assignment, to the set of adults in MTO who were offered standard housing vouchers. These surveys include questions about health status, chronic health conditions and functional limitations, access to health services, peer associations, and involvement with health-related risk and protective behaviors. We are also measuring height, weight, waist circumference, blood pressure, and indicators of cardiovascular and metabolic disease risk in blood samples. MTO's randomized experimental design enables us to credibly estimate the causal effects of this major housing program because randomization solves the fundamental "self selection"problem that plagues most previous studies of housing vouchers and neighborhood effects.

Outcomes: From a public policy perspective, health is one of the most important outcome domains that might be affected by neighborhood environments, and hence by housing voucher programs. The size of MTO Experimental and Section 8 voucher treatments on diet, exercise and obesity measured in the interim study in 2002 are about the same size as those generated by some of the most effective lifestyle interventions that have been studied in the public health literature. Our estimates will be directly relevant to a wide range of housing policy questions, and to broader efforts to improve the health outcomes of low-income families living in some of our nation's most disadvantaged urban communities.

Publication: Neighborhood Effects on the Long-Term Well-Being of Low-Income Adults by J. Ludwig, G. Duncan, L. Gennetian, L. Katz, R. Kessler, J. Kling, and L. Sanbonmatsu. Science 21 September 2012, Vol. 337, No. 6101: pp. 1501-1510.

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University of Wisconsin-Madison

Eviction and the Reproduction of Urban Poverty


Award:
$152,000 over two years
Principal Investigator:
Matthew Desmond (email)

Background: In cities across America, thousands are evicted each year. But eviction is perhaps the most understudied process directing the lives of the urban poor. This gap in our knowledge is concerning not only because eviction has been linked to homelessness, job loss, and suicide, but also because studying eviction offers unique opportunities to gain new perspectives on the reproduction of urban poverty, racial inequality, and the low-income housing market. This study explores housing dynamics in poor communities in Milwaukee, focusing, in particular, on the causes and consequences of eviction.

Design:This study combines three methods.

  • First, the researcher conducted a yearlong ethnography of eviction, living in two poor Milwaukee neighborhoods and following families experiencing eviction as well as landlords doing the evicting.
  • Second, five year’s worth of court-ordered evictions were geocoded, merged with population estimates, and analyzed.
  • Third, a new survey—the Milwaukee Area Renters Study (MARS)—was designed and implemented.

Fielded in low- and high-poverty white, black, and Hispanic neighborhoods and conducted via in-person interviews, the MARS study collected data on the causes and consequences of eviction as well as information about urban poverty, inner-city neighborhoods, the low-income housing market, and social networks.

Outcomes: This study will produce an estimate of the prevalence of eviction in poor Milwaukee neighborhoods. It also will document some major causes and consequences of eviction, analyzing how eviction affects relationships, material hardship, community stability, residential mobility, health, and overall quality of life. More broadly, this study will facilitate insights into the workings of the low-income housing market and its role in the perpetuation of urban poverty. Scholars and policymakers will be able to use this study’s findings to identify limitations in current policy and to develop more effective and fair housing initiatives.

Publication: Eviction and the Reproduction of Urban Poverty by M. Desmond. AJS July 2012, Vol. 118, No. 1: pp. 88-133.

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Wayne State University

Magnitudes and Mechanisms of Neighborhood Impacts on Children: Analyzing a Natural Experiment in Denver


Award:
$375,000 over two years
Principal Investigator:
George Galster &
Anna Maria Santiago

Background: This study aims to quantify how conditions in the surrounding neighborhood affect health, education, employment, social behaviors, marriage and childbearing, and exposure to violence outcomes for low-income black and latino children and probe for salient mechanisms generating these effects. We take advantage of a natural experiment: since 1987 the Denver Housing Authority has allocated residents to a wide variety of neighborhoods throughout Denver County using a quasi-random process.

Design: Our analyses will be based on data from:

  1. a retrospective survey of 745 black and latino current or former DHA residents whose 1,926 children lived in DHA for a significant period during childhood;
  2. U.S. census and Denver Piton Foundation administrative databases related to the characteristics of neighborhoods; and
  3. qualitative data from focus group interviews with primary caregivers and semi-structured interviews with individual youth aimed at probing how the neighborhood may affect outcomes.

Outcomes: Although there is a well-developed theoretical foundation about how neighborhood context could affect children, empirical work in this area leaves many key questions unanswered satisfactorily; this study aims at addressing these questions. This research will inform a longstanding debate about the aims and consequences of affordable housing policy for increasing opportunities for disadvantaged children. For example, if we find that neighborhood effects were trivial in magnitude for all domains of child outcomes, we would be less concerned about the location of assisted housing. However, if particular sorts of neighborhood environments had especially pernicious effects on children, it might imply that incentives to build in disadvantaged neighborhoods be more finely tailored to avoid such places, or even abandoned altogether. Similarly, if we were to find that only certain especially privileged neighborhoods produced beneficial effects, it might suggest that inclusionary zoning requirements there would be more efficacious.

Publication: The Mechanism(s) of Neighborhood Effects Theory, Evidence, and Policy Implications by G. Galster, 2010.

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Woodrow Wilson School of Public and International Affairs, Princeton University

Managing Mount Laurel


Award:
$445,000 over two years
Principal Investigator:
Doug Massey

Background: The geographic concentration of poor people in poor neighborhoods has been identified as a key nexus in the perpetuation and reproduction of poverty in the United States. One strategy for reducing the concentration of poverty and breaking the cycle of disadvantage is to provide poor families with access to affordable housing in middle class communities. However, efforts to build affordable housing projects in suburban areas typically meet with stiff resistance from local residents who fear negative consequences such as increased crime, deteriorating property values, stressed schools, higher taxes, and more traffic. Surprisingly, there is little systematic research on whether such fears are founded; neither is their conclusive research on whether relocating poor families to advantaged neighborhoods carries any real benefits. This project seeks to provide systematic data to address these issues.

Design: The project will draw on a variety of information sources to measure the costs and benefits of affordable housing for the communities that house them and for the poor families that inhabit them, focusing on a well-known project in Mount Laurel, New Jersey, a middle class suburb of Philadelphia. After a lengthy court battle the project finally opened in 2000. The study will draw on census and administrative data to undertake a time series analysis of trends in crime, property values, traffic congestion, taxes, and school performance before and after 2000, comparing trends in Mount Laurel with those in similar surrounding communities. It will also survey residents of the project to assess their personal, household, neighborhood, and school circumstances before and after relocation. Interviews will also be conducted of a matched set of people who applied to move into the project but have not yet done so to learn about their personal, household, neighborhood, and school circumstances. The resulting data offer two ways of assessing the effects of affordable housing on the social and economic well-being of residents:

  1. a before-and-after comparison done on project residents themselves; and
  2. a systematic comparison of residents with an equivalent sample of applicants matched using propensity score methods.

We will also survey the inhabitants of neighborhoods adjacent to the project to assess their perceptions about how conditions have changed since 2000. In addition, we will undertake in-depth qualitative interviews with stakeholders in Mount Laurel, including the mayor, the police chief, the school superintendent, city council members, affordable housing advocates, and principals and teachers in the schools attended by the children of project residents.

Outcomes: The project will yield reliable data to accurately measure the costs of affordable housing to surrounding communities and to assess the benefits of such housing to residents. We seek to offer a balanced appraisal of the utility of affordable housing provision and poverty de-concentration as tools for poverty alleviation and to shed light on how neighborhoods affect social and economic outcomes among poor adults and children.

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