Is Housing Assistance Associated With Mental Health?

Abstract

Problem, research strategy, and findings

It is often suggested that housing assistance helps adults overcome mental health challenges, yet researchers have long struggled to unravel the complex psychological pathways that explain whether and how housing assistance affects mental health. We advance the literature by testing for a direct association between housing assistance and two mental health outcomes: depression and anxiety. We also tested for indirect associations, focusing on whether housing assistance affected mental health by affecting psychological stress, sense of control over life circumstances (i.e., mastery), and exposure to discrimination. We found that housing assistance was directly associated with reduced anxiety, but no direct association was found for depression. We also found that housing assistance was associated with variables believed to indirectly influence mental health, including mastery and psychological stress. However, neither of these variables was associated with depression or anxiety.

Takeaway for practice

Although our findings show some positive relationships, receipt of housing assistance alone was only modestly associated with anxiety, and there was no association for depression. Our findings therefore suggest that mental health services should be made available to program participants because housing assistance alone may not promote better mental health. Supportive housing programs provide a promising model for delivering mental health services to program participants. However, housing planners and policymakers will need to develop new areas of expertise and new strategic priorities to ensure the effective expansion, implementation, and administration of such programs.

Keywords:

• affordable housing
• housing assistance
• mental health
• theory

ACKNOWLEDGEMENTS

We thank Michael Webb, Jon Hussey, Tim Monbureau, and the Add Health research team for helping to create the data used for this study. We also thank Mai Thi Nguyen, Danielle Spurlock, and Roberto Quercia for their invaluable feedback on early drafts of this article.

DATA AVAILABILITY STATEMENT

All data used for this study are publicly available through the Carolina Population Center. For details about how to access these data, please visit the National Longitudinal Study for Adolescent to Adult Health website (https://addhealth.cpc.unc.edu/).

SUPPLEMENTAL MATERIAL

Supplemental data for this article can be accessed online at https://doi.org/10.1080/01944363.2022.2156380.

Notes

1 The benefit of our discrimination measure is that it uses recommended survey language for asking about discrimination and has been widely used in past studies (Boutwell et al., 2017; Everett, 2015; Everett et al., 2016). The drawback of this measure is that it does not ask about the type of discrimination experienced. Add Health does provide a follow-up survey question that asks about type of discrimination experienced, but nearly all Add Health respondents (75%) skipped this question. It was therefore necessary to rely on the general discrimination measure.

2 To create this variable, Add Health:

computed tract deciles based on the full set of tracts from which Add Health participants were sampled at Wave 4. We then scored each tract on a scale of 1-10 corresponding to the Wave 4 decile containing the tract’s value on the variable. We calculated neighborhood deprivation as the sum of decile scores across the five measures resulting in a score ranging from 0 to 50. Values were Z-transformed to have M = 0 SD = 1 for analysis. [Belsky et al., 2020, p. 2]

3 As a robustness check, we re-estimated our mediation models after including two of the few housing market attribute variables—census tract homeownership rate and vacancy rate—provided by Add Health. These variables were highly insignificant and reduced model data fit. Moreover, the inclusion of these variables did not alter our main results. Thus, we opted to exclude these variables because they did not enhance the validity of our analysis or alter our results.

Additional information

Notes on contributors

Atticus Jaramillo

ATTICUS JARAMILLO ([email protected]) is a visiting assistant professor in the Department of Urban Planning at the University of Wisconsin–Milwaukee.

William M. Rohe

WILLIAM M. ROHE ([email protected]) is a research professor in the Department of City and Regional Planning at the University of North Carolina at Chapel Hill.