Low-Income Housing Rental Assistance, Perceptions of Neighborhood Food Environment, and Dietary Patterns among Latino Adults: the AHOME Study

Abstract

Federal rental assistance programs, in the form of the traditional public housing program and the Housing Choice Voucher Program (HCVP-formerly known as Section 8), are designed to reduce the economic rental burden for low-income residents. While residents using federal housing vouchers, which allow low-income residents in public housing to move out of public housing to rent-subsidized homes, have been found to be have better cardiovascular outcomes compared to the cardiovascular outcomes of low-income public housing residents, the mechanisms explaining these associations remains an understudied area. The aim of this study is to assess whether residents participating in HCVP or unassisted residents had greater access to healthy foods such as fruits and vegetables, and less access to unhealthy foods such as fast food and sugar sweetened beverages, when compared to residents living in public housing (referent group). The Affordable Housing as an Obesity Mediating Environment (AHOME) study is a cross-sectional study of Latinos residing in low-income housing in the Bronx, NY (n=362). Participants were interviewed to assess food patterns and perceptions of neighborhood environment. The analytic sample was primarily female (74.5%) with a mean age of 46.4years (SD=14.68). Residents participating in HCVP had similar availability of fruits and vegetables in the home compared to residents receiving no assistance or public housing residents. HCVP participants consumed more fast food (β=0.34; CI=0.10-0.58) but had similar sugar sweetened beverage consumption compared to public housing residents. Unassisted residents had more fast food consumption (β=0.25; CI=0.01-0.49) but less sugar sweetened beverage consumption (β=-0.52; CI=-0.76--0.28) than public housing residents. Perceptions of neighborhood food environment were not significantly associated with dietary patterns. This study shows variability in consumption of sugar sweetened beverage consumption and fast food consumption, but not in availability of fruits and vegetables, across residents participating in HCVP, public housing residents, and unassisted residents. Evaluating the health benefits associated with low-income housing mobility programs, such as HCVP, requires examining how housing may influence dietary patterns above and beyond an individual's socioeconomic position.