# The effects of affordable housing access on type 2 diabetes self-management and control

> **NIH NIH R01** · YALE UNIVERSITY · 2021 · $429,329

## Abstract

Project Abstract
Low-income US renters face a severe affordable housing crisis that likely has adverse effects on population
health. The current affordable housing shortage is likely to have particularly significant implications for the
health of adults living with behaviorally managed chronic conditions such as type 2 diabetes. Type 2 diabetes
requires complex and resource intensive daily management that is highly sensitive to social conditions such as
housing. Furthermore, the rising prevalence of type 2 diabetes and diabetes related complications are
unequally borne by low-income adults and racial minorities; two populations that are at greater risk of housing
challenges. Rental assistance, provided by the US Department of Housing and Urban Development (HUD) is a
primary source of affordable housing for low-income households. However, due to supply constraints, fewer
than 1 in 4 eligible households receive this resource and waiting lists average 26 months nationally. Access to
rental assistance may improve diabetes self-management and control by reducing housing costs that can
compete with diabetes-related expenses and by providing stability that allows individuals to establish and
maintain consistent self-management routines. Furthermore, the unmet need for rental assistance creates a
unique opportunity to study the effects of affordable housing on health through rigorous approaches that
compare waitlisted and rent-assisted individuals. The primary goals of this study are to estimate the effects of
rental assistance on biological and behavioral indicators of diabetes self-management and control, and to
examine the processes through which these effects occur. Our project has three aims: 1) To estimate the
effects of rental assistance on type 2 diabetes self-management and control using a unique linkage of HUD
administrative data and a nationally representative health survey. 2) To examine how transitions from rental
assistance waiting lists into rent-assisted housing are associated with changes in diabetes self-management
and control in a longitudinal cohort of adults with type 2 diabetes 3) To examine how experiences of waiting for
and obtaining rental assistance shape diabetes behaviors and outcomes using qualitative interviews conducted
with a sub-sample of aim 2 participants. Findings will inform whether and how rental assistance and other
housing interventions can be leveraged to improve diabetes outcomes and to reduce diabetes disparities.
Furthermore, by identifying processes that connect housing to health, findings will inform clinical and
behavioral interventions to improve diabetes outcomes for inadequately housed adults, even in the absence of
expanded housing access. Beyond diabetes, findings will serve as a model for understanding relationships
between affordable housing access and chronic disease management behaviors more broadly.

## Key facts

- **NIH application ID:** 10130524
- **Project number:** 5R01DK124500-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Danya Keene
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $429,329
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10130524

## Citation

> US National Institutes of Health, RePORTER application 10130524, The effects of affordable housing access on type 2 diabetes self-management and control (5R01DK124500-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10130524. Licensed CC0.

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