Housing Assistance and Child Health: A Systematic Review

Abstract

Context: Given a large and consistent literature revealing a link between housing and health, publicly supported housing assistance programs might play an important role in promoting the health of disadvantaged children.

Objective: To summarize and evaluate research in which authors examine housing assistance and child health.

Data sources: PubMed, Web of Science, PsycInfo, and PAIS (1990-2017).

Study selection: Eligible studies were required to contain assessments of public housing, multifamily housing, or vouchers in relation to a health outcome in children (ages 0-21); we excluded neighborhood mobility interventions.

Data extraction: Study design, sample size, age, location, health outcomes, measurement, program comparisons, analytic approach, covariates, and results.

Results: We identified 14 studies, including 4 quasi-experimental studies, in which authors examined a range of health outcomes. Across studies, the relationship between housing assistance and child health remains unclear, with ∼40% of examined outcomes revealing no association between housing assistance and health. A sizable proportion of observed relationships within the quasi-experimental and association studies were in favor of housing assistance (50.0% and 37.5%, respectively), and negative outcomes were less common and only present among association studies.

Limitations: Potential publication bias, majority of studies were cross-sectional, and substantial variation in outcomes, measurement quality, and methods to address confounding.

Conclusions: The results underscore a need for rigorous studies in which authors evaluate specific housing assistance programs in relation to child outcomes to establish what types of housing assistance, if any, serve as an effective strategy to reduce disparities and advance equity across the lifespan.

FIGURE 1

Flow diagram of study selection for the identification of peer-reviewed publications on housing assistance and child health in the United States, January 1990 to December 2017. PAIS, Public Affairs Information Service.