Many public and subsidized housing developments in the U.S. are aging and in need of significant repairs. The Rental Assistance Demonstration (RAD) program allows housing agencies to convert their aging public housing developments to partial private ownership, allowing them to access capital for much-needed repairs. In a new article in Health Affairs, Ingrid Gould Ellen, Kacie L. Dragan, and Sherry Glied from the P4A Research Hub at New York University Robert F. Wagner Graduate School of Public Service, study the impact of a recent renovation and transfer program of public housing in New York City on the health and well-being of residents.
The research team combined 2014-2018 Medicaid claims data and information from developers about the renovation of six housing developments that had been transferred from the New York City Housing Authority to a public-private partnership. They compared the residents of these buildings to a matched sample of residents of comparable public housing to examine possible effects on five housing-sensitive conditions (asthma, anxiety or depression, injuries, hypertension, and acute respiratory infections such as cold and influenza), diagnoses, and health care use.
While renovations and ownership transfer of subsidized housing did not significantly affect individual outcomes or utilization, the treatment group consistently experienced improvement in four of the five conditions, meaning renovations may reduce aggregate disease burden over time. The study also revealed that more nuanced outcome measurement strategies, like an index of housing-sensitive conditions, can be useful when studying an intervention that is not targeted at improving one particular health condition.
Implications for Policy and Practice
This renovation and transfer program is very similar to those being adopted in public housing developments across the U.S. through the RAD program. The study findings suggest that even in the short run, investing in improvements may lead to tangible benefits for residents. However, given the multifaceted nature of the intervention, which involved broad-based renovations and a transfer to a new private manager, more research is required to pinpoint which specific elements of the treatment made a difference.