Project Funder: U.S. Department of Housing and Urban Development (HUD)
Project Partners: University of Illinois at Chicago (UIC) School of Public Health; Brinshore Development; Center for Neighborhood Technology; National Center for Healthy Housing
Project Contact: David E. Jacobs, djacobs@nchh.org, 443.539.4157
Project Description: This study examined the health and monetary benefits that may be realized when low-income residents move from stressed unhealthy housing into green affordable healthy housing. The researchers made two comparisons: (1) health status of people before the move compared to the health status of the same people after the move; and (2) health status of people who moved compared to a control group who did not move. The control group received traditional housing rehabilitation, and the study group moved into new green healthy housing. Comparisons were made for self-reported health, visual assessment of housing condition, air quality measurements, and Medicaid expenditures.
The study hypothesis was that moving into modern low-income green healthy housing is associated with improved self-reported health, housing condition, air quality, and savings in Medicaid expenditures.
Results: The participants consisted of 803 individuals from 325 public housing and low-income subsidized apartment households in Chicago. There were 562 adults and children in the study group and 231 in the control group.
We found that housing conditions and self-reported physical and mental health improved significantly in the green healthy housing study group compared to both the control group and the dilapidated public housing from which the residents moved, as did hay fever, headaches, sinusitis, angina, and respiratory allergy. Asthma severity was measured by self-reported lost school/work days and disturbed sleep, and symptoms improved significantly, as did sadness, nervousness, restlessness, and child behavior. Medicaid data in this exploratory study were inconclusive and inconsistent with self-reported health outcomes and visual assessment data on housing quality but hold promise for future investigation. Possible sources of bias in the Medicaid data include older age in the study group, changes in Medicaid eligibility over time, controlling for Medicaid costs in an urban area, and the increased stress associated with moving, even if the move is into better housing.
Conclusion: The mixed method approach employed here describes the complex relationships among self-reported health, housing conditions, environmental measures, and clinical data. Housing conditions and self-reported physical and mental health improved in green healthy housing. Health care cost savings in Medicaid due to improved housing could not be quantified here but hold promise for future investigations with larger cohorts over a longer follow-up period.
Learn More: A peer-reviewed article on this study was published in the January, 2014 issue of the Journal of Public Health Management and Practice. It is available online at http://www.ncbi.nlm.nih.gov/pubmed/24378632.