# Targeting Health Disparities through Housing Redevelopment: A Natural Experiment of Housing Quality, Stability, and Economic Integration

> **NIH NIH R01** · BOSTON COLLEGE · 2022 · $650,106

## Abstract

PROJECT SUMMARY/ABSTRACT
Following decades of discriminatory policies and underinvestment in affordable housing, the 1.2 million
households residing in our nation’s public housing (PH) developments often live in conditions of concentrated
poverty, unhealthy and unstable housing and community contexts, and constrained social and economic
opportunity. These social determinants of health drive substantial health disparities, with PH residents
experiencing elevated levels of mortality and morbidity across numerous health domains. In response, current
policy efforts seek to redevelop PH into mixed-income communities in order to deconcentrate poverty, create
healthier housing environments, decrease community stressors, and enhance community resources. It is
essential to delineate the repercussions of such policies on health disparities and to understand the
mechanisms underlying effects.
This project seeks to exploit a multi-arm natural experiment of PH redevelopment to evaluate whether
improving housing quality, limiting external displacement, and creating mixed-income communities improve the
physical, mental, and behavioral health of PH residents, including children, adults, and older adults. We will
further assess the social, environmental, and physiological mechanisms underlying such effects. Finally, we
will address whether effects vary across resident age, gender, and race/ethnicity.
The study will employ a rigorous mixed-methods design to follow 1068 individuals from 600 households in a
Boston PH community undergoing redevelopment. The redevelopment plan will move quasi-randomly selected
subsets of residents into new high quality PH, or displace them offsite followed by a return into new high quality
mixed-income housing. We will compare these residents to a matched control group who will remain in place.
Our interdisciplinary team will collect four waves of in-person surveys, direct environmental assessments, and
direct physiological stress measurements, as well as annual geocoded administrative data and intensive
qualitative interviews with a subset of respondents. This innovative combination of sources will provide data on
resident physical, mental and behavioral health; physiological stress; social connections and collective efficacy;
housing quality and disorder; and neighborhood crime, pollution, social problems and resources.
Intent-to-treat, difference-in-differences, and average treatment effect models will provide rigorous evidence of
how housing quality, residential displacement, and residence in mixed-income housing affect resident health.
Structural equation models and qualitative analyses will identify mechanisms underlying housing effects. Our
results, unearthing causal and dynamic processes underlying health disparities, will provide innovative new
data on social determinants of health to inform models of housing and community redevelopment in the context
of concentrated poverty.

## Key facts

- **NIH application ID:** 10458753
- **Project number:** 5R01MD015729-02
- **Recipient organization:** BOSTON COLLEGE
- **Principal Investigator:** REBEKAH Levine COLEY
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $650,106
- **Award type:** 5
- **Project period:** 2021-08-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10458753

## Citation

> US National Institutes of Health, RePORTER application 10458753, Targeting Health Disparities through Housing Redevelopment: A Natural Experiment of Housing Quality, Stability, and Economic Integration (5R01MD015729-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10458753. Licensed CC0.

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