Health and Healthcare Access Among Adults Living in Affordable Housing: National Estimates for the Low-Income Housing Tax Credit

Abstract

By merging data from the National Health Interview Survey (2004–2016) with a census of buildings financed by the Low-Income Housing Tax Credit (LIHTC), this study provides national estimates for the health status and healthcare access among low-income adults living in LIHTC-financed housing. Compared to those not living in LIHTC-financed housing, unadjusted analyses found that younger adults (age 18–64) living in LIHTC-financed housing reported worse health status, more psychological distress, and more use of emergency department care, but they were also more likely to be insured, receive a flu vaccine, and have a usual source of care. Older adults (age 65+) living in LIHTC reported more psychological distress, more need for assistance with activities of daily living, more falls in the past year, and more use of emergency department care, as well as a slightly higher likelihood of being insured. Adjusted analyses revealed that sociodemographic characteristics helped explain some but not all of these findings, suggesting a need for further investigation of the drivers of health status and healthcare access for adults living in LIHTC-financed housing.

Keywords:

• LIHTC
• housing and health
• healthcare access
• affordale housing

Disclosure statement

Dr Pollack reported stock ownership in Gilead Pharmaceuticals and that from September 2019 to July 2022, Johns Hopkins entered into a contract with the US Department of Housing and Urban Development (HUD) for him to work part-time on a temporary assignment assisting the agency on housing and health issues. The findings and conclusions in this report are those of the authors and do not necessarily represent those of HUD.

Additional information

Funding

This study was funded the National Institute of Child Health and Human Development (R03HD098411).

Notes on contributors

Sarah G. Gensheimer

Sarah G. Gensheimer is a resident physician in internal medicine at Maine Medical Center and a recent graduate of the Johns Hopkins School of Medicine and Johns Hopkins Bloomberg School of Public Health. Her research focuses on health and healthcare access for patients with complex social needs.

Matthew D. Eisenberg

Matthew D. Eisenberg is an Associate Professor and Associate Chair in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. Trained as an economist, his research focuses on analyzing how federal, local, and employer-level policies influence individuals’ health related decision making.

Albert W. Wu

Albert W. Wu is the Fred and Juliet Soper Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. He is an internal medicine physician whose research focuses on the quality and outcomes of health care and services.

Craig Evan Pollack

Craig Evan Pollack is the Katey Ayers Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. He is an internal medicine physician whose research focuses on the connection between housing, neighborhood environments, and health.