Abraham Gutman, Katie Moran-McCabe and Scott Burris at the Temple University Center for Public Health Law Research published an article in the Northeastern University Law Review that explores 23 legal mechanisms, or levers, that may impact health equity in housing in the U.S., and reviews the evidence base evaluating each lever.
Paula Lantz and Samantha Iovan of the University of Michigan Research Hub used their innovative pay-for-success (PFS) surveillance system to identify strengths and challenges of several supportive housing interventions using PFS, and to assess whether PFS housing projects generally meet established criteria for improving social welfare.
In the U.S., the key challenge for many households is housing affordability. Households paying more than one-half of a limited total income for rent have very little left over for food, transportation, education, and other critical expenses. And these rent burdens have only been growing. In 1960, fewer than one in four renters was rent-burdened (or paid more than 30 percent of their income on rent); today that fraction is nearly half.
A growing literature has documented the detrimental effects of housing instability (often generated by evictions and foreclosures) on health. Using the RealtyTrac foreclosure dataset, which includes information on every foreclosure action in the U.S. between 2006 and 2015, the research team will match foreclosures with Medicaid address data and follow units through the foreclosure process (from initial notification that a mortgage holder is behind on their payments through repossession by the lender).
Low-income housing assistance programs represent a potentially powerful policy lever to promote population health and reduce health disparities. Yet, research on the impact of federal low-income housing programs on health outcomes remains highly limited, and no study to date has adequately explored whether the monetary value of housing assistance has an impact on health outcomes.
Using PFS to Scale Supportive Housing: Lessons Learned and New Directions
Pay for success sparks innovation in the public sector while limiting risk to taxpayers by ensuring the government only pays for services that are effective. Importantly, it can bring financing to interventions for populations that are often forgotten, neglected, or deemed less worthy of taxpayer support, including people experiencing chronic homelessness.