Child and Family Health in Subsidized Housing: A Randomized Experiment in NY City

DESCRIPTION (provided by applicant): From a public health perspective, moving to subsidized housing, to less poor neighborhoods, to housing developments with low rates of crime, or to more mixed income settings might reduce health disparities between children and families who have low income and those who do not. Children and young adolescents may be particularly influenced by housing given that they spend a large proportion of their time in their home neighborhood where the accessibility and quality of local amenities and institutions matter, and because they are influenced by their parents' responses to residential location. Receipt of in-place subsidized housing, the focus of our proposal, may help to improve the health and developmental trajectories of at-risk youth through multiple pathways. The proposed experimental research will utilize the NYC Department of Housing Preservation and Development's lottery system to identify treatment and control households that fit our study criteria. Group assignment will include families with children who move to a subsidized apartment in one of eleven newly constructed housing sites (treatment) and matched families who do not receive housing (control). This proposal's design improves and expands upon the design of earlier housing experiments in that it (a) compares the impact of moving to a new neighborhood versus staying in the same neighborhood among recipients of subsidized housing, (b) compares the impact of moving into mixed-income versus solely low- income buildings, (c) examines the impact of subsidized housing on near-poor families (rather than just families below the poverty threshold), (d) examines the effect of subsidized housing where the uptake of the offer is 90% (rather than less than one-half in Moving to Opportunity), and (e) examines the effect of subsidized housing where the families are likely to stay in the subsidized housing (in Moving to Opportunity, over half of those who did move ended up moving again, typically back to poor neighborhoods). Our proposed data collection strategy will include baseline data collection at time of application for housing, using a self-administered questionnaire to be completed by the primary caregiver and augmented by information obtained from the housing application itself. Follow-up assessments will include in-person interviews with the primary caregiver and detailed information on up to two co-resident children for each participating household. Our follow-up information on children will be collected by proxy for children under age eight and in-person with children ages eight to eighteen. Experimental analyses will be used to quantify the impact of moving to subsidized housing and additional exploratory analyses will be conducted to investigate the potential benefits of housing relative to neighborhoods and assess evidence of differential impacts among those receiving particular types of subsidized housing. Relationships among household, housing, and neighborhood features will be examined as potential outcomes as well as mediators of individual-level health outcomes. PUBLIC HEALTH RELEVANCE: The health of children and adults is influenced by the environments in which they live. Experimental research has shown that moving to new housing in particular kinds of neighborhoods may improve the life chances of poor families; however, previous research confounded housing- and neighborhood mobility and did not investigate the benefits of mixed-income housing developments. Our randomized experiment will address these shortcomings will NYC children and families who apply for in-place subsidized housing allocated through a housing lottery and test whether receipt of such housing improves the health and well-being of children and caregivers.