Tenant-based Housing Voucher Programs Advance Health Equity

The Community Preventive Services Task Force (CPSTF) recommends tenant-based housing voucher programs to improve health and health-related outcomes for adults and to advance health equity. Health-related outcomes include housing quality and security, healthcare use, and neighborhood opportunities (e.g., lower poverty level, better schools).

The recommendation is based on evidence from a systematic review of 7 studies in 20 publications. Evidence showed that households who used vouchers reported greater housing quality and security, less poverty and food insecurity, and fewer physical and mental health conditions compared with households who were eligible, but not offered, assistance from voucher programs. Children ages 12 years and younger whose families used vouchers showed improvements in education, employment, and income later in life.

Outcomes for adolescents varied by gender. Females 10-20 years of age whose families use tenant-based vouchers to live in lower poverty neighborhoods experience better health outcomes while males of the same age experience worse physical and mental health outcomes. The CPSTF noted additional research is needed to better understand and address the challenges faced by adolescent males.

What are Tenant-based Housing Programs?

Tenant-based housing voucher programs help households with very low incomes afford safe and sanitary housing in the private market. Vouchers are tied to households rather than specific housing units, so that households can use vouchers to move to neighborhoods with greater opportunities. Vouchers pay a substantial portion of the rent, which leaves households with money to cover other needs.

Tenant-based housing voucher programs may vary with regard to eligibility criteria (e.g., family income level), rental process (e.g., time allowed to find and rent a property), assistance (e.g., counseling in finding rentals), relocation requirements (e.g., housing in low-poverty neighborhoods), and availability of short-term payments for initial expenses (e.g., rental deposits).

Why is this important?

Housing is an established social determinant of health.^1,2 In the United States, housing quality, housing security, and neighborhood characteristics have been associated with health and health-related outcomes.^3-5

For More Information:

• The Community Guide
  • Intervention Summary
  • One Pager – Health Equity: Tenant-Based Housing Voucher Programs
  • Health Equity topic page
• U.S. Department of Housing and Urban Development
• HUD Exchange Homelessness Assistance Programs
• U.S. Department of Veterans Affairs Housing Assistance

References

¹ Fullilove MT. Housing is health care. American Journal of Preventive Medicine 2010;39(6): 607-8.

² U.S. Department of Health and Human Services. Healthy People 2030. Bethesda (MD): 2020. Available from URL: www.health.gov/healthypeople.

³ Alley DE, Soldo BJ, Pag n JA, et al. Material resources and population health: disadvantages in health care, housing, and food among adults over 50 years of age. Am J Public Health 2009;99 (Suppl 3):S693-S701. doi:10.2105/AJPH.2009.161877.

⁴ Chetty R. The effects of exposure to better neighborhoods on children: New evidence from the Moving to Opportunity experiment. American Economic Review 2016;106(4):855-902.

⁵ Cutts DB, Meyers AF, Black MM, Casey PF, et al. US housing insecurity and the health of very young children. American Journal of Public Health 2011;101(8):1508-14.