Improving Health Through HUD Housing Assistance for Chronic Disease Care - Housing is closely linked to health outcomes, and stable housing is essential for overall health and wellbeing. Housing provides continuity in home environments, access to social support, reduced family stress, and improved long-term outcomes. For adults with chronic health conditions, housing stability is even more crucial due to heightened need for consistent access to services and support. Few studies have examined how housing influences access to appropriate care for people with chronic health conditions. Federal housing assistance from the US Department of Housing and Urban Development (HUD) plays a vital role in providing affordable housing options for families with limited financial means, including a subset of the 150 million Americans who live with at least one chronic health condition. HUD assistance includes programs like housing choice vouchers, multi-family housing, and public housing. Yet there is limited understanding of how newly receiving HUD assistance as an intervention to address housing instability impacts access to and utilization of appropriate treatment regimens for adults with chronic health conditions. Factors such as housing and economic stability, insurance enrollment factors, community characteristics, and individual attributes may further influence appropriate care for chronic health conditions and outcomes for these adults. Medicaid, as the largest public insurer in the US, and HUD, as the primary housing assistance provider, both play critical roles in serving impoverished adults with chronic health conditions. However, little national data exists on the connection between the two programs, making it difficult to identify ways to improve efficiency and effectiveness. The proposed research aims to address this gap by linking Medicaid and HUD datasets to each other and to additional sources of data on community factors, to examine the relationship between newly gained housing assistance and appropriate health service use and outcomes for a large national cohort of adults with chronic health conditions. This study will be the first to examine appropriate health care and housing outcomes of adults with key chronic conditions (including asthma, coronary heart disease, depression, and diabetes) who newly receive HUD assistance and how individual and community factors influence these outcomes. In addition to quantitative analyses, qualitative interviews with policymakers and advocates working in Medicaid, housing, and health will help illuminate connections between housing and appropriate health care. By producing a robust evidence base that highlights both the impact of housing assistance and mechanisms through which it can be optimized, this study will inform policy and public health strategies to improve housing stability and health care access for people with chronic health conditions and lay the groundwork for coordinated, systems-level interventions that are immediately actionable, to foster improved health outcomes for adults with chronic conditions.
