Housing Authority Research Articles

Local Housing Choice Voucher Distribution Policies Impact Healthcare Utilization: a Randomized Natural Experiment

While associations between obtaining affordable housing and improved health care are well documented, insufficient funding often forces housing authorities to prioritize limited housing vouchers to specific populations. We assessed the impact of obtaining housing on health care utilization at two urban housing authorities with different distribution policies: Housing Authority A prioritized seniors and people with disabilities, while Housing Authority B prioritized medically complex individuals and families with school-aged children. Both housing authorities used random selection to distribute vouchers, allowing us to conduct a randomized natural experiment of cases and waitlisted controls. No significant demographic differences were present between those receiving vouchers and waitlisted controls. Housing Authority A vouchers were associated with increased outpatient visits (OR = 1.19; P = 0.051). Housing Authority B vouchers decreased the likelihood of emergency department visits (OR = 0.61; P = 0.042). This study provides evidence that, while obtaining housing can result in better health care outcomes overall, local prioritization policies can influence that impact.

Towards a Smart Community Welfare as a response to the housing emergency

The implementation of a social housing network requires the adoption of welfare policies within a shared national regulatory framework, as well as new organisational, design and community models, enabled by the pervasiveness of ICT, in order to allow a paradigm shift in the dualistic structure of the real estate market. Following an analysis conducted on several levels and the involvement of local social housing authorities, we identified guidelines that are both programmatic – in the context of policies for the home – and project-related – regarding the physical and digital space, able to foster peculiar social-care relationships. In this perspective, the integration of the domains considered (smart, community, welfare) could promote an alternative social housing network.

Changes in Reported Secondhand Smoke Incursions and Smoking Behavior after Implementation of a Federal Smoke-Free Rule in New York State Federally Subsidized Public Housing.

This study assessed changes in smoking behavior and secondhand smoke (SHS) exposure after implementation of the U.S. Department of Housing and Urban Development (HUD) rule prohibiting the use of cigarettes, cigars, pipes, and waterpipes in all federally subsidized public housing, including within residential units (apartments). Using quantitative data from a repeated cross-sectional mail survey of New York State residents of five public housing authorities (N = 761 at Wave 1, N = 649 at Wave 2), we found evidence of policy compliance (99% decrease in odds of self-reported smoking in units, OR = 0.01, p < 0.01, CI: 0.00–0.16), reduced SHS incursions (77% decrease in odds of smelling smoke within developments, OR = 0.23, p < 0.01, CI: 0.13–0.44), and lower reported smoking rates in July 2018 (9.5%, down from 16.8%), 10 months after implementation of the rule. Despite evident success, one-fifth of residents reported smelling smoke inside their apartment at least a few times per week. This study provides insights into how the policy was implemented in selected New York public housing authorities, offers evidence of policy-intended effects, and highlights challenges to consistent and impactful policy implementation.

Housing Rental Scheme Based on Redactable Blockchain

With the increase of the housing population, it is very important for renters to find credible housing information through rental platforms. However, due to the imperfection of relevant laws and insufficient supervision of the housing rental market, problems have emerged one after another. In this article, we propose a housing rental scheme based on redactable blockchain, introducing a trusted third party to verify the homeowner rental listings, and fundamentally preventing false listings from flowing into the housing rental market. Specifically, a trusted third party similar to the housing authority will issue a verifiable claim for the homeowners listing, and then the accounting node of the consortium blockchain will publish the verified listing information on the blockchain so as tenants to make inquiries according to their needs. At the same time, we use the new chameleon hash to build a redactable blockchain. After the homeowner proposes to change the housing price or housing information, the content of the historical block is modified as required. Thus, to a certain extent, the changes in housing prices can be monitored to curb chaos in the housing rental market.

The Effect of Work Requirements on Mental Health of Subsidized Housing Recipients: Evidence from the Housing Authority of Champaign County, Illinois

This study examines the early effect of work requirements on mental health of subsidized housing recipients. The Housing Authority of Champaign County (HACC) enforced work requirements for working-aged and non-disabled recipients and supported their transition to work with case management services. In addition, non-compliance with work requirements might result in the loss of housing subsidy. We collected survey data 1 year prior to and 1 year following the implementation of HACC’s work requirements to compare changes in mental health measures between work-able recipients who were and were not subject to work requirements. We calculate the average treatment effects on the treated estimates obtained from difference-in-differences with propensity score matching to control potential bias stemming from unobserved time-invariant variables and support the model’s parallel trend assumption. Our main results show that, during the early phase of work requirements, impacted heads of households were predicted to increase depression scores and decrease hopefulness scores relative to changes in mental health measures of the matched control groups over the same period. Recipients’ mental health would play a critical role in the success of HACC’s self-sufficiency strategies, and therefore the housing authority may strengthen the transition of hard-to-employ recipients into the workforce by offering careful assessment and screening to identify recipients with serious mental health problems or other employment barriers and reinforcing their access to supportive health and social services.

Safely disposing unused and unwanted prescription and over-the-counter medications: a public health, housing, and safety partnership in Framingham, MA

BackgroundThe improper disposal of unused drugs can harm the environment and living beings. Programs such as drug take-back bins encourage people to dispose of unused medication at designated locations have increased. Unfortunately, awareness and participation is low, especially in ethnically and culturally diverse communities. The purpose of this paper is to describe the implementation of the Knock Talk and Toss (KTT), a drug take-back program aimed at taking unused drugs out of circulation and building police-resident connections in the housing authority of Framingham, MA.MethodsMulti-lingual brochures on the dangers of unused drugs and safe disposal were distributed on residents’ doors via the police department and/or listservs to residents living in the housing authority. Awareness efforts were then followed-up by teams of individuals, including the police, going door-to-door to collect any unused drugs, no questions asked. During the visits, one team member observed resident characteristics, whether drugs were disposed, including the estimated quantity and type, and police/resident interactions. Interviews were conducted with key staff and Chi-square analyses were used to assess socio-demographic differences in proportions of individuals willing to toss drug(s).ResultsA total of 27 h were spent going door-to-door and 33 pounds of drugs were disposed. Households with observed adults aged 65 years or older and children/teenagers were twice as likely to dispose drugs compared to households, where these populations were not present.ConclusionInitiatives, such as KTT, where police go door-to-door in areas with a higher concentration of families and elderly may help take unused drugs out of circulation while also enabling the police to have a positive presence in the community.

Family Self-Sufficiency Program Outcomes for Participants Enrolling During and After the Great Recession

Utilizing administrative data from the Family Self-Sufficiency (FSS) Program operated by the Denver Housing Authority, four program outcomes, (a) savings and escrow growth, (b) credit and debt reduction, (c) employment and earnings, and (d) positive exits from subsidized housing, are examined to assess if any differences exist between participants ( n = 424) who enrolled during or after the Great Recession. Propensity score matching with replacement was employed to match FSS enrollees. Compared to post-Great Recession enrollees, results suggest that enrollees entering the program during the Great Recession were more likely to reduce their monthly contractual debt and derogatory debt, increase monthly earned income, and remain in the FSS Program longer. Findings suggest that attaining participant financial capability goals is possible during severe economic shocks and may provide vulnerable families with additional capacity to weather such shocks.

A Township Complete in Itself: The London County Council Architects and the Building of Becontree, 1919–34

ABSTRACTBetween the first and second world wars, the London County Council (LCC) provided 82,000 working-class cottages and flats, of which 25,000 were built on the vast Becontree estate in the east of the metropolis. With these immense housing operations in hand, the LCC drastically increased its technical and administrative staff, becoming one of the largest municipal housing authorities in the world. This article sheds light on the organisation and functioning of the LCC Architect’s Department through analysis of the Becontree estate. Despite the extensive literature on municipal housing in the inter-war years, the council’s own architects during this period have remained almost entirely unknown. Contrary to the widespread preconception of the ‘official architect’, the LCC Architect’s Department evaluated and revised its organisational structure and managed to maintain a remarkable variety and complexity in its urbanistic approach — despite the overarching principles of standardisation and simplification, and despite its limited influence in relation to other departments within the LCC. Analysis of archival sources reveals the identity of these official architects and questions whether the organisational structure of the LCC Architect’s Department as a bureaucracy was reflected in the character of its housing estates.

Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact.

In 2018, the U.S. Department of Housing and Urban Development required public housing authorities to implement a smoke-free housing (SFH) policy that included individual apartments. We analyzed the policy implementation process in the New York City Public Housing Authority (NYCHA). From June–November 2019, we conducted 9 focus groups with 64 NYCHA residents (smokers and nonsmokers), 8 key informant interviews with NYCHA staff and resident association leaders, and repeated surveys with a cohort of 130 nonsmoking households pre- and 12-month post policy. One year post policy implementation, participants reported widespread smoking violations and multi-level factors impeding policy implementation. These included the shared belief among residents and staff that the policy overreached by “telling people what to do in their own apartments”. This hindered compliance and enforcement efforts. Inconsistent enforcement of illegal marijuana use, staff smoking violations, and a lack of accountability for other pressing housing issues created the perception that smokers were being unfairly targeted, as did the lack of smoking cessation resources. Resident support for the policy remained unchanged but satisfaction with enforcement declined (60.1% vs. 48.8%, p = 0.047). We identified multilevel contextual factors that are influencing SFH policy implementation. Findings can inform the design of strategies to optimize policy implementation.

Association between local public housing authority policies related to criminal justice system involvement and sexually transmitted infection rates

The policies of U.S. local public housing authorities influence which populations have access to stable housing, an important resource for health. We assessed whether the restrictiveness of local public housing authority policies related to people with criminal justice histories—a population at high risk for HIV/STIs—were associated with HIV/STI rates at the local-level. An ecological analysis was conducted using data from 107 local public housing authority jurisdictions. The independent variable was a score that quantified the presence/absence of eight policies related to the ability of people with criminal justice histories to obtain and retain public housing. The dependent variables were county-level rates of HIV, gonorrhea, syphilis, and chlamydia. Ordinary least squares regression with state fixed effects was used. We find that the restrictiveness of housing authority policies towards people with criminal justice histories were significantly associated with higher HIV and gonorrhea rates, but not syphilis or chlamydia. For example, local housing authorities with a policy score more restrictive than the median score had an additional 6.05 cases of HIV per 100,000 population (32.9% increase relative to the mean rate) and 84.61 cases of newly diagnosed gonorrhea (41.3% increase). Local public housing authority policies related to people with criminal justice histories could affect HIV/STI risk at the population-level. These policies should be considered in studies and interventions at the intersection of housing, health, and justice involved populations.

Ageing well in public housing

This research examines the policy and practice issues raised by increasing demand for public housing among older Australians, and how public housing authorities can support older tenants to age well. People aged 55 years and over now comprise 35 per cent of public housing tenants nationally, in the coming years it is expected the demand on the public housing system from lower income older households will increase significantly.

Older Public Housing Tenants' Capabilities for Physical Activity Described Using Walk-Along Interviews in Montreal, Canada.

Older public housing tenants experience various factors associated with physical inactivity and are locally dependent on their environment to support their physical activity. A better understanding of the person-environment fit for physical activity could highlight avenues to improve access to physical activity for this subgroup of the population. The aim of this study was to evaluate older public housing tenants’ capabilities for physical activity in their residential environment using a socioecological approach. We conducted individual semi-structured walk-along interviews with 26 tenants (female = 18, male = 8, mean age = 71.96 years old). Living in housing developments exclusively for adults aged 60 years or over in three neighborhoods in the city of Montreal, Canada. A hybrid thematic analysis produced five capabilities for physical activity: Political, financial, social, physical, and psychological. Themes spanned across ecological levels including individual, public housing, community, and government. Tenant committees appear important to physical activity promotion. Participants called for psychosocial interventions to boost their capability for physical activity as well as greater implication from the housing authority and from government. Results further support a call for intersectoral action to improve access to physical activity for less affluent subgroups of the population such as older public housing tenants.

Redevelopment of Huai Khwang Housing Project Responsive to Users’ Spatial Behaviors

Huai Khwang Housing is a public residential project, developed since 1972 in a fringe area of Bangkok at that time. The city has been gradually expanding, so now Huai Khwang Housing turns to be in the center of the city. There is a subway station 400 meters away from the site; therefore, the land value and potentials of this housing project has been increased. However, the physical conditions of the buildings are rather rundown since they have been utilizing for more than 50 years. The National Housing Authority of Thailand, the owner of this residence, has a plan to redevelop this housing project. The preliminary public hearing was set to inform the community about the future changes and intend to receive the opinions from the residents, who are elderlies residing in this community since it was built. Therefore, this paper aims to investigate the spatial behavior of elderly residents in this housing. The methods used include interviews and observations. The results show that the housing units are used in multi-functions and the spatial requirements include storage areas, a smell-locked and partitioning cooking area, a ventilating and sun-drying area for laundry, and spaces for air-conditioning units as well as satellite discs and washing machines. It is suggested that the redevelopment housing scheme should meet these requirements.

You Can’t Get There from Here: Mobility Networks and the Housing Choice Voucher Program

The Housing Choice Voucher (HCV) program represents the largest subsidized housing program in the United States. While families with vouchers can, in theory, lease any housing of reasonable quality renting below a rent ceiling, the empirical evidence suggests that they rarely use their vouchers to move to lower poverty neighborhoods. This paper examines the question of how spatial boundaries impact the residential possibilities of HCV subsidized families, both the visible boundaries of Public Housing Authority (PHA) catchment areas and the invisible boundaries of racial and economic segregation. I use administrative data supplied by the Department of Housing and Urban Development, which includes all moves by HCV families between 2005 and 2015 in the Baltimore, MD, Cleveland, OH, and Dallas, TX, metropolitan areas. Using a Louvain method of network cluster detection, I subdivide each metro into distinct mobility clusters—sets of census tracts within which voucher holders move but between which they rarely do. I find that the empirical mobility clusters at the metropolitan level are highly defined by PHA’s catchment areas. Even though families are technically allowed to “port” their voucher from one PHA catchment area to another, such behavior is rare. Within the PHA catchment areas, HCV mobility clusters are defined by patterns of race, income, and history. These findings suggest that patterns of racial and economic segregation seem to partially define the mobility clusters within PHA catchment areas, but not across them.

Four-pronged decision support framework for implementing industrialized construction projects

PurposeIndustrialized construction (IC) is promoted to address some of the ills associated with the processes and products of the traditional construction approach. With several successful projects, IC is progressively becoming a preferred alternative construction approach and spurred the interest of contractors, developers and housing authorities in the technology. Increasingly, these stakeholders are keen to ascertain the compatibility and feasibility of using IC in their projects. This paper aims to develop a knowledge-based decision support framework for implementing industrialized construction projects (ICPs) that can facilitate better and informed decision-making when deciding to implement ICPs.Design/methodology/approachA comprehensive literature review was implemented to recruit 40 decision support factors (DSFs) and grouped into project requirements, location and site attribute, labour considerations and organizational factors. A 3-member expert panel validated the relevance of 35 DSFs, which became candidates for a structured questionnaire survey of experts in 18 countries. Statistical techniques are used to evaluate and prioritize the DSFs, leading to the development of a conceptual framework.FindingsStatistical analysis revealed 33 significant DSFs. The top five most significant factors that could influence the decision to implement IC in a project include a stringent requirement for project quality control, suitability of the design for IC, organizational readiness and competencies in ICPs, client receptivity to IC and the need to minimize field construction time. A framework of project requirements, location and site attributes, labour considerations and organizational factors was proposed as decision support.Practical implicationsThe proposed framework may help to inform decision-making regarding the implementation of IC in a project. It has wider applicability because it includes technical, managerial and operational aspects of and the required competencies for IC, which are shared between project types and territories. The prioritized DSFs could be used as a guide when implementing IC, especially in countries where bespoke decision support systems cannot be developed.Originality/valueThe paper delineated the most important DSFs that are shared between IC project types and territories and can be used to investigate the compatibility of using IC in a proposed project. This research constitutes the first exclusive attempt at delineating, quantifying and ranking the sets of decision-making factors, drawing on international data set and contributes to the empirical checklist of DSFs for ICPs.

Smoking cessation intentions and attempts one year after the federally mandated smoke-free housing rule

The present study examines public housing residents’ smoking cessation intentions, expectancies, and attempts one year after implementation of the Department of Housing and Urban Development’s mandatory smoke-free rule in public housing. The sample includes 233 cigarette smokers, ages 18–80, who reside in the District of Columbia Housing Authority. Data collection occurred between March and August 2019. Descriptive statistics, chi-square, and Wilcoxon two-sample test analyses assessed smoking cessation intentions, expectancies, and attempts across resident demographics and characteristics. Findings showed 17.2% of residents reported not thinking about quitting, 39.1% reported thinking about quitting, and 48.6% reported thinking about quitting specifically because of the rule. Residents ages 60–80 were more likely to consider quitting because of the rule, compared to residents ages 18–59. Of those thinking of quitting, 58.6% were sure they could quit if they tried. Those thinking of quitting due to the rule (62.0%) were more likely to have made at least one quit attempt in the past 3 months than those i not attributinging thinking of quitting to the rule. Res Residents trying to quit reported an average of 2.7 attempts in the last 3 months;; most perceived evidence-based cessation supports as not helpful. A A majority reported thinking about quitting and attempting to quit but continuing to smoke, indicating a significant gap between intent to quit and successfully quitting. Results suggest that the rule positively influenced smoking behaviors. However, additional interventions are needed to assist public housing residents with successfully quitting smoking.

Lessons Learned: Social Determinants of Health Screening Pilot in 2 Urology Clinics.

Unmet social needs lead to adverse health outcomes and contribute to health inequities. Efforts to screen for social determinants of health (SDOH) have occurred primarily within primary care. Here, we describe the feasibility of implementing a workflow for SDOH screening within 2 urology clinics in Charlotte, North Carolina. Our pilot was adapted from the WE CARE Model, which integrates a referral to community resources for patients identified with social needs and an optional followup with a navigator for additional assistance. Patients were screened with the validated Healthy Opportunities SDOH tool to assess food, housing, utilities, transportation and physical safety needs; 40 patients were screened at 2 urology clinics, totaling 80 patients. Surveys were sent to 16 clinicians and staff who participated in the pilot to assess feasibility of implementation. In all, 24/80 patients (30%) were screened for 1 or more social needs, with food and housing being the most frequent; 20/24 patients with social need (83%) successfully received a community resource guide, and 13 of those patients also requested a referral. All survey respondents either agreed or strongly agreed that screening was valuable and allowed them to better understand the needs of their patients. They also felt that understanding SDOH aligns with departmental goals and mission. Our results suggest that SDOH screening within a urological setting is feasible, and dedicated support staff should be available to ensure adequate followup for patients with unmet needs. Future work is needed to expand resources for patients and optimize workflow for clinicians.

A Qualitative Study of Unfairness and Distrust in Smoke-free Housing.

Objectives: Whereas smoke-free housing (SFH) has the potential to protect residents from tobacco smoke, evidence suggests that SFH could lead to increased indoor smoking. In this study, we examine how perceptions of a residential smoking ban could be related to non-compliance. Methods: We conducted 8 focus group interviews of low-income housing residents living in Norfolk, Virginia (N=53). Interviews were semi-structured and based on a list of guided questions related to SFH compliance, developed in partnership with a standing community advisory board comprised of low-income housing residents. Results: Several themes emerged, including pervasive non-compliance, perceived unfairness and shame, barriers to compliance, and distrust of the housing authority. Smokers reported behavior primarily motivated by punishment avoidance, rather than out of any perceived obligation to comply with the ban. Conclusions: Results led us to consider Procedural Justice Theory as a conceptual framework, in which compliance is directly related to perceptions about the legitimacy of a rule or authority. When compliance is low due to a lack of perceived legitimacy, SFH should be adapted to promote changes in smoking behavior. We offer specific theory-supported adaptations to SFH focused on trust-building and improving perceived fairness.

Changes in health and health care utilization following eviction from public housing.

This study sought to (1) determine the number of persons evicted from the Durham Housing Authority (DHA) over a 5-year period, (2) explore changes in the number of persons with various medical diagnoses and health care utilization patterns before and after eviction, and (3) examine how many persons evicted from DHA became literally homeless. This was a pre/post cross-sectional quantitative study. Heads of households evicted from DHA properties from January 1, 2013 through December 31, 2017 were included in the study. We matched people evicted by the DHA in a university health system electronic health record system to determine changes in diagnoses and health care utilization before and after eviction. We also matched the cohort in the homeless management information system to determine how many persons evicted became literally homeless. Findings indicate statistically significant increases in persons with medical diagnoses in five of ten categories, total hospital admissions, and emergency department visits after eviction. Of the 152 people included in the study, 34 (22%) became literally homeless. Health and health care utilization patterns were different before and after eviction. Implications for clinicians are explored.

The right to comfort in the century of the self

After the war, the world was divided between two main powers, a Western capitalist bloc led by the USA, and an Eastern communist bloc, driven by the USSR. From Japan to Mexico, the post-war years were ones of prosperous economic growth and profound social transformation. It was the time of re-housing families split apart and of rebuilding destroyed cities, but it was also the time of democratic rebirth, the definition of individual and collective freedoms and rights, and of belief in the open society envisaged by Karl Popper. Simultaneously, it was the time of the biggest migrations from the countryside, revealing a large faith in the city, and of baby booms, revealing a new hope in humanity. (...) Whether through welfare state systems, as mainly evidenced in Western Europe, under the prospects launched by the Plan Marshall (1947), or through the establishment of local housing authorities funded or semi-funded by the government, or through the support of private companies, civil organizations or associations, the time had come for the large-scale application of the principles of modern architecture and engineering developed before the war. From the Spanish polígonos residenciales to the German großsiedlungen, ambitious housing programs were established in order to improve the citizens’ living conditions and health standards, as an answer to the housing shortage, and as a symbol of a new egalitarian society: comfort would no longer only be found in bourgeois houses.