Tenant-based housing voucher programs improve health outcomes

Tenant-based housing voucher programs improve housing, health, and health-related outcomes for adults, including housing quality and security, health care utilization, and neighborhood opportunities (eg, lower neighborhood poverty rates and -high safety).

Tenant-based housing voucher programs improve housing, health, and health-related outcomes for adults, including housing quality and security, health care utilization, and neighborhood opportunities (eg, lower neighborhood poverty rates and -high safety). Children age 12 and younger whose households use vouchers show improvements in education, employment and earnings later in life. Based on this evidence from a systematic review of Community Guidance, the Community Preventive Services Task Force recommends tenant-based housing voucher programs. This paper describes evidence from the Community Guide systematic review, as well as considerations for implementing this intervention so that all members of eligible households can benefit.

Tenant-based housing voucher programs help very low-income households afford safe and sanitary housing in the private market. Vouchers are tied to households, not specific housing units, so that households can use vouchers to move to more affordable neighborhoods when units are available. Vouchers pay a significant portion of rent, which leaves households with money to cover other needs.

The U.S. Department of Housing and Urban Development (HUD) administers the Housing Choice Voucher Program, a tenant-based voucher program designed to assist very low-income households. From 1994 to 1998, HUD also sponsored the Transition to Opportunity experiment. This randomized trial evaluated the long-term effects of moving households with children from public housing in high-poverty areas to neighborhoods with greater opportunity. HUD provided households in the experimental group with pre-relocation counseling and offered them tenant-based housing vouchers that could be used to move into neighborhoods with a poverty level <10% for at least one year.

This systematic review of community leadership included evaluations of the Housing Choice Voucher Program and the Moving to Opportunity experiment. We wanted to know whether tenant-based housing voucher programs improve health and health-related outcomes for households using vouchers.

In 2020, we completed a systematic review of 7 studies described in 20 publications (search period from January 1999 to July 2019).

Key Findings:

  • Households that used vouchers reported higher housing quality and security, less poverty and food insecurity, and fewer physical and mental health problems than households that were eligible but not offered voucher assistance programs.
  • Children age 12 and younger whose households used vouchers show improvements in education, employment and earnings later in life. Teens whose families received vouchers reported fewer depressive symptoms.
  • Results for adolescents varied by gender. Females ages 10-20 whose families used renter vouchers to live in lower-poverty neighborhoods had better physical and mental health outcomes, while males of the same age had worse health outcomes. results.

Additional considerations:

Additional services that can help improve the rental process for households receiving vouchers are:

  • Increasing the time to find and rent a property,
  • Assistance in finding housing (e.g. counseling before moving),
  • Availability of short-term payments for initial costs (eg rental deposits).

Why this is important:

  • In the US, there is neither enough affordable rental housing nor vouchers available to serve very low-income households (≤50% of their area median income).
  • Tenant-based housing voucher programs give people access to better housing and neighborhood opportunities. As a result, they improve recipients’ health and health-related outcomes.
  • Because tenant-based housing voucher programs are designed for low-income households, they can increase health equity.

Read our article in Journal of Public Health Management and Practice to learn more about our review and the systematic review evidence supporting tenant-based housing vouchers:

Author profile

Karen Emmons

Karen Emmons is the TH Chan Professor of Social and Behavioral Sciences at the Harvard School of Public Health. Her work focuses on community-engaged approaches to implementing cancer prevention interventions in settings that serve historically disadvantaged communities. She is a past president of the Society for Behavioral Medicine and a member of the National Academy of Medicine. Dr. Emmons is also a member of the Community Preventive Services Task Force.

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