MacArthur announced five grants totaling $2.7 million for research to explore the role housing plays in the long-term health and well-being of children, families, and communities. Recipients will mine and connect existing data sets and resources – such as those from the Centers for Medicare and Medicaid, U.S. Departments of Health and Human Services and Housing and Urban Development, and school statistics – in new ways to reveal insights into the effectiveness of housing policies and related public programs.
These multi-disciplinary research grants will inform important and timely policy discussions about how stable, quality housing may help address the related challenges of scarce housing, financial security, an aging population, increasing health costs, and the achievement gap in education. Four of the five research projects seek to address how housing for older adults can be designed and supplemented with services to achieve improved health and well-being outcomes, while lowering overall health care costs. The fifth project will investigate how, when using housing vouchers, parental housing choices may or may not lead to better school quality and educational outcomes for their children.
Selected through a competitive process from a pool of 212 proposals, the projects were awarded as part of the Foundation's $25 million research initiative on How Housing Matters to Families and Communities. The initiative is exploring if and how quality, stable, affordable housing promotes positive outcomes in education, employment, and physical health, among other areas. It seeks to determine how investments in housing may help realize a greater return from other social and public investments.
This year’s How Housing Matters grant recipients are:
“In these tough economic times with a challenging housing market, these forward-thinking researchers will contribute to a body of work that will provide solid evidence on the smartest, most cost-effective ways to connect housing, health, community development, and education policy to address the needs of families and communities,” said Ianna Kachoris, housing program officer for the MacArthur Foundation.
Since December 2008, MacArthur has awarded 34 grants through the How Housing Matters initiative, totaling over $17 million. Topics include how housing matters to child development and well-being, and housing’s impact on physical and behavioral health and economic opportunity. Findings will be released over the next few years, as research projects are completed.
MacArthur is a leader in affordable housing, investing over $300 million in grants and program-related investments over the last two decades. The Foundation invests in the preservation of existing rental housing, advances knowledge about the role of housing through rigorous research, and pursues policy innovations and strategies to improve family and community outcomes through housing. View all past recipients.
Background: Research shows that lower-income older adults are likely to experience multiple chronic illnesses and deteriorating physical and cognitive functioning as they age. Left unaddressed, these physical and mental challenges compromise an older person's health, quality of life, and ability to live independently. They also contribute to higher health and long-term care costs, the bulk of which are paid for by the Medicare and Medicaid programs.
Anticipated growth in the aging population will exacerbate these challenges over the next 20 years. One promising strategy to address this increased need would bring health and long-term services and supports into publicly-assisted, congregate senior housing properties. The positive impact that supportive housing can have on the lives of other vulnerable populations, including the homeless, has already been demonstrated by prior research. These findings suggest that creating linkages between housing and services could also yield important benefits for older housing residents, housing providers, and public health care payers. Yet, few studies have examined the specific impact of housing-plus-services models on older adults.
Design: This study will provide empirical evidence about the role of publicly- assisted, service-enriched housing for older adults in allowing residents to “age in place” in a cost-effective manner. The project will build on an ongoing study, supported by the U.S. Departments of Health and Human Services (HHS) and Housing and Urban Development (HUD), to develop the first-ever dataset to link demographic, health status and health service utilization data for elderly residents of publicly-assisted housing. Major activities of this project will include:
Outcomes: This study is the first national effort to assess whether publicly-assisted, service-enriched senior housing can serve as an effective platform for meeting the health and long-term care needs of low-income older residents, while helping to reduce care costs. Study results could help inform future policy and practice discussions aimed at developing effective strategies to: (1) implement the Affordable Care Act, (2) control Medicare and Medicaid costs, (3) rebalance long-term care systems at the state level, and (4) inform HUD's commitment to pursuing housing as a platform for the provision of services.
Background: The lack of affordable housing for the elderly is a significant social problem. An important factor in private and public sector efforts to address housing needs is the strong complementarity between health and housing at older ages, suggesting housing and health issues should be considered in tandem. Unfortunately, public agencies concerned with health and housing issues are split between the state, local, and federal levels. This split is mirrored in academic research: those focusing on housing rarely consider health; those focusing on health rarely consider housing.
The project has six specific aims:
Design: This research will use an innovative approach to the empirical economic analysis of the relationship between affordable housing and the health, medical expenditures, and living arrangements of older Americans. Detailed location-based data on subsidized and unsubsidized senior housing options as well as Medicare claims records will be merged to data on older individuals in the 1992-2012 waves of the Health and Retirement Study (HRS).
Outcomes: The project makes a number of important contributions. First, it seeks to expand empirical economic analysis about elderly housing affordability and its impact in a broad set of domains. Second, it quantifies the direct health benefits from affordable housing. Third, it directly estimates the impact on the Medicare program of elderly affordable housing and residential choices. Fourth, it helps to illuminate the short-run impact of the Great Recession on older Americans. Finally, it directly informs a number of current affordable housing and aging policy efforts at the federal and state levels: efforts to sustain federal funding for Section 202, Section 8, and the Low-Income Housing Tax Credit programs; the expansion of subsidies at the state and federal levels for home modifications to help elderly age in place; clear and cost-effective benefits to justify expanded in-home and housing related services under the Older Americans Act, currently up for reauthorization; and the potential savings to Medicare and Medicaid from bundling in-home and community-based care with affordable housing.
Background: The housing voucher program currently serves over two million households, including 2.5 million children under the age of 18. Given the scale of this program and HUD’s strategic goal of using housing as a platform to improve quality of life, it is critical that we understand how this form of federal assistance shapes opportunities and, in particular, educational opportunities for our nation’s disadvantaged youth. While the assistance provided through place-based subsidized housing is anchored to specific housing units and communities, housing vouchers give families the freedom to use their subsidies in any privately-owned housing unit that meets the program’s quality standards and rent levels. Housing Choice Vouchers therefore may enable families to move to neighborhoods and schools that are a better match for their children, which may in turn lead to improved educational outcomes. This project explores whether low-income households use vouchers to reach neighborhoods with higher performing schools, and whether children’s academic performance improves after their family receives a voucher.
Design: Relying on a new dataset, the School Attendance Boundary Information System (SABINS), the research team will start with a broad national analysis examining whether children of voucher holders live in school attendance zones with better schools than those available to comparable households. SABINS’ geo-coded attendance zones for over 200 of the largest school districts in the country allow for comparison of the quality of schools in the zones in which housing voucher holders live and the quality of schools in the zones where other assisted households live, as well as those in the zones where unassisted poor households reside. The study also examines whether voucher holders in some cities have been more successful in moving to neighborhoods with higher-performing schools, and if so, why.
A second set of analyses uses student-level data in New York City to probe more deeply into these questions. Matching longitudinal, student-level data in New York City to HUD’s assisted housing dataset, researchers will compare the characteristics of schools attended by children before and after their family receives a voucher. Finally, using this geo-coded dataset (which combines data on individual students with housing assistance over a 13-year period from 1995 to 2008), the research team will test whether a student’s outcomes improve after his or her family receives a Housing Choice Voucher. The project team will explore: whether the effects depend upon the child’s original housing circumstances (e.g., private housing versus public housing); whether they vary for families leasing up in Low Income Housing Tax Credit developments; and whether they vary across different subgroups of families and students.
Outcomes: This research will contribute to the existing literature on how housing matters for children by exploring whether housing vouchers enable recipients to move to neighborhoods with higher performing public schools, and ultimately whether they shape educational performance. Officials at HUD are increasingly interested in enhancing the educational opportunities of voucher holders. This research will provide a useful baseline that identifies the relative quality of schools available to voucher holders and how it varies across housing authorities. The research will also provide evidence about whether housing vouchers, currently the largest assisted housing program, help families move to higher opportunity schools and ultimately improve educational outcomes for poor children.
Background: The project will provide a better understanding of whether, and under what circumstances, reverse mortgages lead to increased financial security, well-being and independence in older age. Reverse mortgages as a means of equity extraction can serve as a substantial source of supplemental income in retirement while enabling seniors to stay in their homes. However, reverse mortgages are complex and costly financial products and little is known about their appropriateness and longer term impact. The hypothesis to be tested is that the decision to obtain a reverse mortgage is influenced by a variety of factors, including individual, market and household characteristics, but also by the ability of the senior to appropriately evaluate the decision, as moderated by decision frames and access to information. Thus, reverse mortgages are expected to be empirically related to financial security and indicators of independence and well-being for a subset of seniors; however, reverse mortgages may be associated with additional financial strain for homeowners who were not a good fit for the reverse mortgage at the time of counseling.
Design: The project leverages several unique client level datasets, not otherwise publicly available, to accomplish two primary objectives:
The combination of data from multiple sources will result in a robust dataset with longitudinal observations of more than 30,000 seniors considering reverse mortgages from 2006-2013, including indicators of financial, housing and physical health and well-being both before and after the receipt of a reverse mortgage. Specifically, this project will combine administrative and credit record data on seniors receiving counseling for reverse mortgages from CredAbility, a nonprofit housing counseling organization, withclient level data from the National Council on Aging’s (NCOA) Financial Interview Tool, and loan level reverse mortgage transaction data from the U.S. Department of Housing and Urban Development (HUD). Additional information on long-term outcomes will be collected through a follow-up survey of 5,000 purposively selected seniors from the sample database. The survey provides a unique opportunity to collect self-reported indicators of independence and well-being, matched with administrative data on financial security from longitudinal credit report data. Both the propensity to receive a reverse mortgage and the impact of the reverse mortgage on longer term outcomes will be evaluated using standard econometric techniques.
Outcomes: The aging of the baby boomer generation, combined with the increasing financial insecurity of seniors facing retirement, creates a critical and timely policy need for this research. This project will directly inform current policy debates surrounding the appropriateness of reverse mortgages for seniors, and the necessary regulatory, underwriting and counseling procedures that should be in place moving forward.This research is strategically positioned to inform key policy actors including the U.S. Department of Housing and Urban Development and the new Consumer Financial Protection Agency.
Background: Rowe and Kahn's model of successful aging (1987; 1997; 1998) suggested that rather than only distinguishing between the "diseased or disabled" and the "normally" aging, recognition should be given to the heterogeneity among older adults. They proposed an additional dichotomy in defining the health status of older adults: within the “neither diseased nor disabled” category a distinction would be made between those at high risk of disease or disability and those at low or no apparent risk. The former category they called usual aging and the latter was called “successful aging.” Subsequent research indicates that it is useful to think in more quantitative terms and to distinguish degrees of success. Successful aging is of course a concept that requires definition. Rowe and Kahn developed a conceptual model based on three components: (1) Minimizing the risk of disease and disability (2) Maintaining physical and cognitive function and (3) Continuing engagement with life (including supportive social relationships and involvement in productive activity). This work was begun as part of the MacArthur Research Network on an Aging Society.
Design: Researchers and experts from the senior living industry developed a comprehensive
individual, organizational and social program, based on the successful aging concept and related research called Masterpiece Living. We will adapt the Masterpiece Living experimental intervention program---developed and successfully piloted in Continuous Care Retirement Communities---for use in affordable housing communities. Two American Baptist Homes of the West communities in the greater Los Angeles areas will be the intervention groups, with another nearby community serving as the comparison group. The study will test the effects of the Masterpiece Living program on five outcomes: quality of life, physical mobility, medical and behavioral risk factors, productive activity, and use of medical services. Outcomes for individuals in the two communities where Masterpiece Living is introduced will be compared to outcomes for individuals residing in another affordable housing retirement community where it is not introduced.
Outcomes: Our goal is to adapt the successful aging intervention program for affordable housing communities incorporating local strengths and resources, identifying limitations, creating alternative strategies. We will adapt all measures i.e. the lifestyle review, assessment of risk factors and mobility for use in affordable housing communities and prepare training manuals that can be used by others. The research results will be used to drive efforts to reform current models of service provision within the housing context and inform new legislative proposals from the Administration or members of Congress. We plan to target a range of congressional committees and federal agencies that are interested in realizing greater Medicare Medicaid savings as well as those looking to achieve improved quality of life and housing outcomes for seniors including HUD and HHS Administration on Aging, and the NIH National Institute on Aging.