# Exploring the Impacts of Housing Assistance on Children's Health Care Use

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2022 · $205,922

## Abstract

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.

## Key facts

- **NIH application ID:** 10476505
- **Project number:** 5R21NR020304-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Craig Evan Pollack
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $205,922
- **Award type:** 5
- **Project period:** 2021-08-31 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10476505

## Citation

> US National Institutes of Health, RePORTER application 10476505, Exploring the Impacts of Housing Assistance on Children's Health Care Use (5R21NR020304-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10476505. Licensed CC0.

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