Could Receiving a Housing Voucher Reduce Hospital Stays and Spending?

Where people live is inextricably linked to their health outcomes. Less certain is the connection between neighborhood quality and long-term health care use. To fill this research gap, a recent study explored the connection between receipt of a housing voucher and hospitalization rates and spending up to 20 years after receipt of the voucher. The study’s findings add reductions in hospitalization rates and spending to the list of potential benefits from lowering children’s exposure to neighborhood poverty.

The researchers analyzed whether receipt of a housing voucher in the US Department of Housing and Urban Development’s Moving to Opportunity for Fair Housing Demonstration (MTO) program (which randomized 4,604 families with children living in public housing in the 1990s into three groups and then provided each with a different type of voucher or no voucher) was associated with lower hospitalization rates and inpatient spending in the long-term for adults and children. To understand this association, the researchers matched MTO participant data to all-payer hospital discharge data (1995 through 2014 or 2015) and Medicaid claims data (1999 through 2009). Then, researchers divided participants into two groups: one that received a voucher and one that did not. Next, they analyzed the outcomes of each group, the differences between adults and children (participants younger than 18), and the differences among children (including gender and age at receipt of the voucher).

One important study limitation is that among families who received MTO vouchers, only 53 percent relocated. It is also worth mentioning that many families who moved to high-opportunity neighborhoods did not stay long in their new neighborhoods.

The study found a significant relationship between receiving a voucher and hospitalization rates among participants who were children at the time of randomization, which has policy implications for families with kids. There were no significant relationships for adults. This finding parallels the findings in the 2016 Raj Chetty study, which found that receipt of a housing voucher had no economic impacts on adults but did have significant impacts on children who received a voucher before age 13.

Key findings

• Among participants who were adults, there was no significant difference in hospitalization rates, days in the hospital, or annual hospital spending between participants who received a voucher and those who did not.
• Among participants who were children, receipt of a housing voucher was significantly associated with lower hospitalization rates and less inpatient spending, but not with fewer hospital days.
• Among participants younger than 13, the researchers observed significantly less yearly hospital spending, as compared with children ages 13 to 17.

Policy implication

• Housing vouchers targeted at families with children younger than 13 could help decrease future hospital utilization and medical spending.

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