Rental Assistance Can Be a Tool for Improving Diabetes Self-Management

The US rental assistance shortage affects the health outcomes of low-income households. Emerging research shows that people waiting for rental assistance report worse health levels and more psychological distress than those living in public housing and are more likely to have unmet health care needs because of costs. There is limited research, however, on how this shortage affects individuals’ management of chronic diseases like type 2 diabetes. Caring for type 2 diabetes requires close management of blood glucose levels through medication, diet, exercise, and health care visits, and given these resource-intensive demands, social and environmental conditions are critical for adhering to recommended self-care routines.

This research brief explores how access to rental assistance affects the self-management behaviors of people with type 2 diabetes. Through semi structured interviews with 40 low-income residents of New Haven, Connecticut, diagnosed with type 2 diabetes, researchers analyzed the effects of housing stability and affordability on their self-care routines. Twenty-six people participated in follow-up interviews nine months later. The researchers also studied the experiences of 18 interviewees who lived in rent-assisted housing at the baseline and the 5 who moved into housing with rental assistance by the follow-up. Though the study is not designed to test causal effects, by capturing the experiences of people living with diabetes, this study speaks to the pathways connecting rental assistance to diabetes self-management and outcomes.

Key findings

• Homeless participants who could move into stable housing through rental assistance reported dramatic improvements in their diabetes self-management, noting access to personal storage for medication and a kitchen for cooking healthier food as critical facilitators of success.
• Some participants shared that receiving rental assistance eased their financial burden and allowed for increased investment into their diabetes-related expenses.
• Other participants noted that receiving rental assistance created new expenses as they transitioned from rent-free housing (e.g., living with friends and family or in a shelter) to subsidized housing where they were paying a share of the rent.
• Although moves associated with rental assistance temporarily disrupted diabetes routines, the participants’ narratives suggest that, in the long run, rental assistance facilitates the stability and social support that promotes healthy self-care routines.
• Though not all participants associated the receipt of rental assistance with improvements in their diabetes management, many described dramatic improvements in daily management that may decrease their risk for future complications.

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