Housing Choice Voucher Research Articles

Earned Income Tax Credit Plus: A New Way to House the Working Poor

The housing affordability crisis is one of the defining features of the US today. The demand for housing subsidies outstrips supply by a factor of at least 4 to 1. Moreover, housing affordability varies greatly between and within metropolitan areas. This article proposes a new federal policy—the Earned Income Tax Credit (EITC) Plus—to decrease housing cost burdens for working households by combining aspects of two major federal programs, the EITC, a tax-based subsidy for low-income working households, and the Housing Choice Voucher, a subsidy that pays the difference between 30% of household income and rent. We propose an EITC housing supplement via the tax code for markets where income and current EITC benefits are below 30% of rent levels. It will reduce the housing affordability crisis and reduce the geographic disparities of the Housing Choice Voucher. We simulate the cost at $101 billion nationally (based on 2021 figures). Varying program rules and parameters can significantly reduce costs. Piggybacking on the EITC simplifies the proposal’s implementation and increases its political palatability.

Examining Health Differences Among Older Adults with Federal Rental Assistance in the United States.

About 1.8 million older adults receive rental assistance in the United States, but surprisingly little is known about their health, especially among the growing number of older housing choice voucher (HCV) holders. This is the first known study to use nationally representative data (2006-2018) from the National Health Interview Survey merged with Department of Housing and Urban Development (HUD) administrative data to describe the health of older HUD renters (N = 4,582) living in public housing, multifamily housing, or receiving an HCV. Logistic regression models were used to examine potential health differences by HUD program type. Contrary to expectations, the results suggest that older HCV holders were more likely to experience health challenges compared to older adults with project-based assistance. The results bring awareness to the health challenges experienced by older HCV holders and emphasize the need for future research to examine why older HCV holders are more likely to experience these health challenges. Policy makers and program administrators must consider how the HCV program has significantly aged in the past two decades and consider what program and policy changes are necessary to ensure that older adults have access to affordable housing that matches their changing needs and preferences.

“This Voicemail Box Is Full”: Landlord Perceptions of Communication Issues as a Key Challenge to Participating in the Housing Choice Voucher Program

The Housing Choice Voucher (HCV) program, which is the largest rental subsidy program in the United States, relies on the participation of landlords. Research shows, however, that not all landlords are willing to participate. The present study analyzes qualitative, semi-structured interviews conducted with landlords (N = 25) in an effort to deepen our understanding of their experiences with the HCV program, and specifically, to explore the challenges they face in communicating with the public housing authority (PHA). The sample comes from a city where the financial incentive to participate is not strong, and a lack of source of income protections makes landlord participation more voluntary. Landlords reported communication issues with the local PHA as one of the biggest challenges of working with the program—specifically, difficulty interacting with staff and accessing program information. Ultimately, these communication issues created negative experiences for landlords, characterized by frustration and feeling unsupported, which led some to reduce their participation. These findings suggest a need to improve communication between PHAs and currently participating landlords, especially in light of recent expansions in the HCV program.

Exploring the association between household compositional change and mobility of subsidized householders in the United States: A life course perspective

ABSTRACT This study examines the relationship between household compositional change and residential mobility of subsidized householders. Data from the U.S. Department of Housing and Urban Development Annual Longitudinal Files 2005–2018 is used to measure household compositional change and mobility for subsidized householders in the Public Housing and Housing Choice Voucher programs. Householders are 67% more likely to move when a change in household composition occurs. Members entering the household induce larger estimated mobility effects than members exiting the household. Although the odds that a householder move are associated with a household compositional change is greatest in the Housing Choice Voucher program for tenant-based vouchers, there is still a strong association with household compositional changes and mobility in Public Housing and for project-based voucher units where options for mobility are limited. The results have implications for future research on program design factors such as occupancy standards in subsidized housing in the United States.

Can Fair Share Policies Expand Neighborhood Choice? Evidence From Bypassing Exclusionary Zoning Under Massachusetts Chapter 40B

Opening up neighborhoods that offer greater opportunities for social mobility to low- and moderate-income households remains a challenge in the United States. Exclusionary zoning practices act as a barrier to current efforts by restricting the supply of affordable housing. In this paper, we examine whether fair share policies that seek to bypass these restrictive zoning practices offer one potential solution. Focusing on Massachusetts Chapter 40B, we find clear evidence that such policies build affordable housing in neighborhoods with strikingly greater opportunities for social mobility than are otherwise available to low- and moderate-income households. Leveraging novel data on 40B development addresses linked to a wide range of public and administrative records, we find that 40B produces affordable units in neighborhoods with greater economic mobility, higher performing schools, greater social capital, less pollution, better health outcomes, and lower incarceration rates than both the typical neighborhood in Massachusetts and those available to beneficiaries of the state’s Low-Income Housing Tax Credit, Housing Choice Voucher, and public housing programs. Consistent with previous research on policies that have segregated affordable housing and opportunity, we also find that neighborhoods with affordable 40B units are whiter and more affluent than average. An examination of underlying policy mechanisms suggests that 40B’s ability to bypass exclusionary zoning plays a central role in explaining differences in neighborhood characteristics between 40B and other programs. We further find little evidence to support concerns that 40B’s zoning override leads to affordable 40B units being built in the least advantaged areas of municipalities, in polluted zones, or near highways, though a non-trivial share of units are located in industrial zones. These results suggest that policies like 40B may be valuable complements to other major housing programs in the United States.

Federal Housing Assistance and Blood Lead Levels in a Nationally Representative US Sample Age 6 and Older: NHANES, 1999-2018.

Federal housing assistance is an important policy tool to ensure housing security for low-income households. Less is known about its impact on residential environmental exposures, particularly lead. We conducted a quasi-experimental study to investigate the association between federal housing assistance and blood lead levels (BLLs) in a nationally representative US sample age 6 y and older eligible for housing assistance. We used the 1999-2018 National Health and Nutrition Examination Survey (NHANES) linked with US Department of Housing and Urban Development (HUD) administrative records to assess BLLs of NHANES participants with concurrent HUD housing assistance (i.e., current recipients, ) and those receiving assistance within 2 y after the survey (i.e., pseudo-waitlist recipients, ). We estimated BLL least squares geometric means (LSGMs), odds ratio (OR) for BLL , and percent differences in LSGMs by HUD housing assistance status adjusting for age, sex, family income-to-poverty ratio, education, country of birth, race/ethnicity, region, and survey year. We also examined effect modification using interaction terms and stratified analyses by program type [i.e., public housing, multifamily, housing choice vouchers (HCV)], and race/ethnicity. Current HUD recipients had a significantly lower LSGM [; 95% confidence interval (CI): 1.02, 1.12] than pseudo-waitlist recipients (; 95% CI: 1.14, 1.28), with an adjusted OR of 0.60 (95% CI: 0.42, 0.87) for BLL . Some effect modification were observed: The protective association of HUD assistance on BLL was strongest among public housing ( LSGM; 95% CI: , ), multifamily ( LSGM; 95% CI: , ), and non-Hispanic White ( LSGM; 95% CI: , ) recipients. It was weaker to null among HCV ( LSGM; 95% CI: , 1.7%), non-Hispanic Black ( LSGM; 95% CI: , 5.4%), and Mexican American (-12.5% LSGM; 95% CI: , ) recipients. Our research underscores the importance of social-structural determinants like federal housing assistance in providing affordable, stable, and healthy housing to very low-income households. More attention is needed to ensure housing quality and racial equity across HUD's three major housing assistance programs. https://doi.org/10.1289/EHP12645.

Racial/Ethnic Disparities in Renters’ Experiences with Maintenance Delays in the United States

Structural racism and individual discrimination contribute to racial inequalities in poor housing conditions in the United States. Less is known about whether and how structural racism and individual discrimination shape a parallel, but distinct, process that is also consequential for family wellbeing: experiencing housing unit maintenance delays. Maintenance delays transform acute problems into chronic stressors and increase exposure to physical hazards over time. Using the 2013 American Housing Survey, I examine racial/ethnic disparities in maintenance delays across non-Hispanic White, Black, Hispanic, Asian, and American Indian/Alaska Native renters. Given that 2.3 million low-income households rent using Housing Choice Vouchers (HCVs), a federal housing assistance program with requirements around repair timing, I also examine how renting with a voucher shapes maintenance delays. There are three principal findings. First, White renters are more likely to report timely repairs than either Black or Hispanic renters. Second, for Black renters, both structural racism experienced in rental markets and individual discrimination drive this disparity, whereas Hispanic renters’ diverging maintenance experiences are largely explained by pathways impacted by structural racism. Third, renting with an HCV is not associated with repair timeliness for any racial/ethnic group. Taken together, the findings suggest that racial/ethnic disparities in substandard housing emerge not only through unequal exposure to housing quality problems but also through unequal responses to these issues.

Homelessness And Health: Factors, Evidence, Innovations That Work, And Policy Recommendations.

On a single night in 2023, more than 653,000 people experienced homelessness in the United States. In this overview, we highlight structural and individual risk factors that can lead to homelessness, explore evidence on the relationship between homelessness and health, discuss programmatic and policy innovations, and provide policy recommendations. Health system efforts to address homelessness and improve the health of homeless populations have included interventions such as screening for social needs and medical respite programs. Initiatives using the Housing First approach to permanent supportive housing have a strong track record of success. Health care financing innovations using Medicaid Section 1115 waivers offer promising new approaches to improving health and housing for people experiencing homelessness. To substantially reduce homelessness and its many adverse health impacts, changes are needed to increase the supply of affordable housing for households with very low incomes. Health care providers and systems should leverage their political power to advocate for policies that scale durable, evidence-based solutions to reduce homelessness, including increased funding to expand housing choice vouchers and greater investment in the creation and preservation of affordable housing.

Does Poor Health Influence Residential Selection? Understanding Mobility Among Low-Income Housing Voucher Recipients in the Moving to Opportunity Study

Housing-mobility programs and housing choice vouchers provide low-income families with a potentially transformative opportunity to move to low-poverty neighborhoods. However, families often face barriers to attaining upward residential mobility; poor health may be one important barrier, although few studies have examined this hypothesis. We used the experimental Moving to Opportunity for Fair Housing Demonstration Project (MTO) Study, constructed residential trajectories, and linked neighborhood opportunity measures to over 14,000 addresses of 3526 families across 7 years. We used latent growth curve longitudinal models to test how baseline health modified effects of MTO housing voucher treatment on neighborhood opportunity trajectories. Results show that poor baseline health adversely influenced how the voucher induced upward mobility. Voucher receipt strongly promoted residential mobility if families were healthy; moreover, the low-poverty neighborhood voucher plus counseling treatment promoted higher-opportunity neighborhood attainment than controls, regardless of the baseline health of the family. However, families with health vulnerabilities did not retain the same initial neighborhood gains conferred by the housing choice voucher (HCV) treatment as families without health vulnerabilities. These results suggest that housing counseling may be one necessary element to expand neighborhood choice into higher-opportunity neighborhoods for families with health challenges. Providing housing vouchers alone is insufficient to promote low-income-family high-opportunity moves, for families who have disabilities or special needs. The implications of these results point to scaling up housing-mobility programs, to provide tailored support for low-income families to use HCVs to make high-opportunity moves, which is particularly necessary for families with health challenges.

Leveraging accessibility modeling to improve housing equity for low-income assisted renters: A case study in Bridgeport, Connecticut

The Housing Choice Voucher Program (HCVP) in the United States assists low-income households with a rent voucher to be redeemed in the private rental market. However, public housing authorities in certain states, such as Connecticut, may impose geographic restrictions that we coin as the “same-jurisdiction rule,” when implementing the HCVP. In practice, this constraint is translated to the requirement that assisted households must lease up within the same jurisdiction, which may eventually restrict access to high-quality housing or prevent relocation to higher-opportunity neighborhoods. To identify ways for policy improvement, we adopt the two-step floating catchment area method to evaluate the accessibility to HCVP-eligible housing in Bridgeport, Connecticut with and without the same-jurisdiction rule. The results indicate that when the geographic restrictions are lifted, there is a 9.23 % increase in median accessibility, and the increase is more significant in low-accessibility areas, which are often lower-opportunity neighborhoods. The results suggest that removing the same-jurisdiction rule can result in more housing options and thus improve housing equity for assisted renters. Since the HCVP and other rental assistance programs are spatial-driven, we call for establishing an operational workflow to corroborate the rigor of these programs to improve housing equity for low-income households.

Race, Space, and Take Up: Explaining housing voucher lease-up rates

While housing choice vouchers provide significant benefits to households who successfully lease homes with their vouchers, many recipients fail to do so. Understanding more about lease-up rates is critical, yet the latest national study was published over two decades ago and reported on the outcomes of only 2,600 voucher recipients across 48 housing authorities (Finkel and Buron, 2001). We use unique administrative data to estimate voucher lease-up rates and search times for about 85,000 new voucher recipients each year in 433 metropolitan housing authorities for 2015 to 2019, which allows us to explore variation over time, across housing agencies, and across individuals within housing agencies. Overall, only 60 percent of recipients successfully use their vouchers, even after waiting for two and a half years on average to receive them. Consistent with theoretical expectations, we show that lease-up rates are generally lower in markets with lower vacancy rates, more spatial variation in rent levels, and older housing, which may be less able to pass HUD’s quality standards. But we also find considerable variation across individuals within markets. Most notably, perhaps, we find that Black and Hispanic voucher recipients are less likely to lease homes than other recipients in their same markets. We explore mechanisms and find evidence that racial disparities are partly explained by differing conditions in the neighborhoods where voucher recipients start: voucher recipients are less likely to lease-up and take longer to successfully rent homes when they start in neighborhoods with older housing stocks and larger Black and Hispanic population shares. Observed and unobserved neighborhood factors explain about 40 percent of individual racial differences in lease-up rates. We also provide suggestive evidence showing that policy interventions, such as extended search times, neighborhood-based rent ceilings, and source of income discrimination laws, can help both to boost overall lease-up rates and to reduce these racial and spatial disparities.

How pervasive is source of income discrimination faced by housing choice voucher households: Lessons from a progressive Midwestern city

ABSTRACT Housing Choice Voucher (HCV) recipients encounter many types of discrimination in the housing search process. Landlords could choose not to lease a home to HCV recipients merely because they are HCV recipients. While many forms of discrimination (such as discrimination because of race or gender) are proscribed by federal and state constitutions, discrimination based on source of income (such as paying rent using an HCV) is not banned by the federal constitution or by most state or local statutes. Discrimination faced for using an HCV makes the housing search process more complicated and time-consuming for HCV recipients, often restricting their housing options and resulting in sub-optimal housing choices. We report on the findings of a study exploring the relative magnitude of discrimination for using HCV compared to other types of discrimination among HCV recipients of a Midwestern public housing authority (PHA). We also report on how this source of income discrimination varies by race and other socioeconomic and demographic factors. Information for this study was collected by surveying all HCV families of this PHA using a mail-out/mail-back questionnaire. Our findings suggest that source-of-income discrimination is perhaps more pervasive than other common discriminatory factors. We conclude the paper by describing policy responses to our findings.

Public Housing Authorities’ Housing Choice Voucher Policies Can Affect SSI Participation

Public Housing Authorities’ Housing Choice Voucher Policies Can Affect SSI Participation

Introducing the SEER-Medicare-Housing and Urban Development data linkage: A novel resource for examining the association of housing assistance and cancer care and outcomes.

200 Background: Lack of stable and affordable housing is an important social determinant of health. Federal housing assistance—through housing choice vouchers, public housing, and other programs—may buffer against housing vulnerabilities among low-income households, but research examining the association of housing assistance and cancer care has been limited. We introduce a new linkage of SEER-Medicare and Housing and Urban Development (HUD) administrative data that can be used to examine housing assistance and cancer care and patient outcomes to inform efforts to reduce inequities. Methods: Individuals enrolled in HUD programs 2006-2021 were linked with cancer diagnoses 2006-2019 identified in the SEER-Medicare data from 16 states using Match*Pro probabilistic linkage software. HUD administrative data include timing and type of housing assistance and verified household income. Medicare administrative data are available through 2020. We describe the cohort aged ≥66 years with continuous Medicare fee-for-service Parts A/B coverage surrounding diagnosis who had episodes of housing assistance: 1) at diagnosis or 2) starting within 3 years after diagnosis. Because supply of housing assistance is limited, eligible, low-income families are frequently wait-listed; individuals who receive housing assistance after diagnosis can serve as controls for individuals with housing assistance at diagnosis. Results: Among 42,197 individuals aged ≥66 years diagnosed with cancer and with housing assistance, the most common diagnoses were female breast (n=8,108), lung (n=5,400), colorectal (n=5,197), and prostate (4,548) cancers. Sociodemographic characteristics were similar among the 35,873 individuals with HUD assistance at diagnosis and 6,334 who received it later (Table). Both groups were majority female and non-Hispanic white and with median household income <$14,000. Private multifamily housing programs were the most common form of assistance, followed by housing choice vouchers, and public housing. Conclusions: This novel data linkage will be available through the National Cancer Institute and can be used to explore the ways in which housing assistance is associated with cancer diagnosis and outcomes, including the role of housing assistance in potentially reducing or contributing to inequities across racialized and ethnic groups.[Table: see text]

Impact of the monetary value of housing assistance on adult health outcomes.

To assess the impact of the dollar value of federal low-income housing assistance on adult health outcomes and whether this impact varies across housing assistance programs. We use the National Health Interview Survey (NHIS) from 1999 to 2016 linked with administrative records from the Department of Housing and Urban Development (HUD) tracking receipt of low-income housing assistance from 1999 to 2017. We use two approaches to assess the impact of the value of housing assistance among HUD housing assistance recipients on outcomes capturing overall health and mental health, chronic and acute health conditions, health care hardship, and food insecurity. First, we use multivariable regression models that adjust for a wide array of possible confounders. Second, we use an instrumental variable approach in which the county-level supply of HUD housing serves as an instrument for the value of housing assistance. Our sample includes all 12,031 adult HUD linkage-eligible NHIS respondents who were currently in HUD housing at the time of their NHIS interview. We find the most consistent associations between the value of housing assistance and measures of health care hardship, a relationship that is most robust for Housing Choice Voucher recipients, where we find a $100 increase in the value of housing assistance is associated with a 6.2 percentage point decrease in probability of needing but not being able to afford medical care. We find little evidence that the value of housing assistance impacts overall health or chronic health outcomes. The relationship between the value of housing assistance and health likely operates via an income effect, wherein receipt of a more valuable benefit frees up resources to spend on needed care. Policy changes to increase the value of housing assistance may have tangible health benefits for tenants receiving housing assistance.

The rise of single-family rentals and the relationship to opportunity neighbourhoods for low-income families with children

Single-family homes make up a significant portion of the rental housing market in the United States. Single-family rentals grew significantly in recent years, especially with the emergence of large-scale investors in the single-family rental market. We investigate if the rise of single-family rentals provides more housing choice for renter families with children, and if a greater number of single-family rentals provides low-income families with children with access to neighbourhoods with high- or moderate-opportunity education. We utilise the Child Opportunity Index to identify low-, moderate- and high-educational opportunity neighbourhoods and, using both binomial and multinomial logistic regression, examine the relationship between the rise in single-family rentals and neighbourhood opportunity access. We find growth in single-family rentals provides more rental alternatives for families with children but does not provide families with children in poverty access to high- or moderate-opportunity neighbourhoods in education. Growth in single-family rentals does provide access to high opportunity for near-poverty families with children (150–185% of poverty), but only when there are few of these kinds of families and when there are large increases in single-family rentals. Our findings suggest that rental burden prevents families with children in poverty from accessing high- and moderate-opportunity neighbourhoods, and the Housing Choice Vouchers programme does not help.

Hierarchies in the Decentralized Welfare State: Prioritization in the Housing Choice Voucher Program

Social provision in the United States is highly decentralized. Significant federal and state funding flows to local organizational actors, who are granted discretion over how to allocate resources to people in need. In welfare states where many programs are underfunded and decoupled from local need, how does decentralization shape who gets what? This article identifies forces that shape how local actors classify help-seekers when they ration scarce resources, focusing on the case of prioritization in the Housing Choice Voucher Program. We use network methods to represent and analyze 1,398 local prioritization policies. Our results reveal two patterns that challenge expectations from past literature. First, we observe classificatory restraint, or many organizations choosing not to draw fine distinctions between applicants to prioritize. Second, when organizations do institute priority categories, policies often advantage applicants who are formally institutionally connected to the local community. Interviews with officials, in turn, reveal how prioritization schemes reflect housing agencies’ position within a matrix of intra-organizational, inter-organizational, and vertical forces that structure the meaning and cost of classifying help-seekers. These findings illustrate how local organizations’ use of classification to solve on-the-ground organizational problems and manage scarce resources can generate additional forms of exclusion.

Ready to Rent: Administrative Decisions and Poverty Governance in the Housing Choice Voucher Program

Sociological studies of poverty governance investigate how state actors manage marginalized populations, regulate their participation in social institutions, and reform their behavior through systems of punishment and rewards. Research in this area considers a range of institutions involved in managing poverty, but it has largely ignored an institution omnipresent in the lives of the poor—public housing agencies (PHAs). Focusing on the Housing Choice Voucher program, the largest rental assistance program in the country, I examine discretionary choices made by PHAs that affect who gets access to rental assistance, how long clients have to wait, and what they must do to maintain their benefits. I ask how these administrative decisions create successive opportunities for state agencies to govern the poor. Drawing on interviews with agency officials, I describe a tripartite process of selecting market-ready households, engaging them in rituals of market formation, and utilizing market nudges to remind them of their responsibilities as market actors. This framework deepens sociological understandings of how local state agencies utilize discretionary choices in a resource-scarce, highly decentralized policy environment to evaluate, reform, and discipline the poor.

Race, Perceived Criminality and Housing Choice Voucher Recipients: Do Black Voucher Recipients’ Moves to the Suburbs Increase Crime Rates?

Public attention has focused on especially Black Housing Choice Voucher Recipients’ (HCVRs) residential mobility and whether and to what extent crime is influenced as a result. This paper adds to the growing empirical literature on this question by focusing on the race of HCVRs and examining whether changes in Black HCVRs presence in suburban areas over time is followed by changes in crime rates among the 100 largest metropolitan areas in the country. Multiple data sources are used to examine this question including data on voucher holders from the U.S. Department of Housing and Urban Development's (HUD) Picture of Subsidized Housing, on crime from the Uniform Crime Report (UCR) Offenses Known and Cleared by Arrest compiled by the FBI, and on important demographic data from the Census Bureau. First difference regression methods as well as lead and lag dependent (and independent) variable analysis, among other methods, are used to assess whether Black HCVRs influence crime in suburban areas. The results of the analysis indicate no support for the Black HCVRs – suburban crime hypothesis, consistent with previous research. The evidence indicates positive, statistically significant relationships between White HCVRs and suburban crime. However, lead and lag analysis suggests the relationship is not causal. If anything, the evidence points to White HCVRs moving to suburban areas where crime is increasing. Fears of increased crime resulting from increased presence of HCVRs are therefore not well supported by the studies’ results, and should allay any concerns about unintended crime costs of the HCV program.

Federally-assisted housing and blood lead levels in the United States, 1999-2016

Background/Aim: Despite declining blood lead levels (BLLs) in the US, lead exposure remains disproportionately high in older housing and for low-income and non-Hispanic Black households. Federal housing assistance is linked to lower BLLs among children, but has not been evaluated among all US residents and by program type. Methods: We used the National Health and Nutrition Examination Survey 1999-2016 data linked to the US Department of Housing and Urban Development (HUD) administrative records to identify HUD-assisted participants. We compared BLLs of those currently-assisted and those on the waitlist (will receive assistance within two years) using multivariable regressions for log-transformed and dichotomous (≥ 3 µg/dL) BLLs. We examined effect modification by program type (project-based: public and multifamily housing vs. housing choice vouchers) and race/ethnicity, and conducted subset analyses for women and children under 12. Results: Sociodemographic characteristics were similar in the currently-assisted and waitlist groups. BLL geometric means were 1.11 (SE: 1.03) and 1.41 (SE: 1.03), respectively (p<0.05). In adjusted models, HUD assistance was associated with 8% lower BLLs (95% CI: -13%, -2%). In stratified models, this association was stronger among project-based housing (-11%, 95% CI: -18%,-4%) compared to housing choice voucher (-5%, 95% CI: -12%, 2%) recipients. Non-Hispanic white participants experienced a stronger protective association (-16%, 95% CI: -25%, -6%) compared to Black participants (-3%, 95% CI: -10%, 5%) and Mexican-Americans (2%, 95% CI: -18%, 28%). The association was significant among women (-9%, 95% CI: -15%, -2%) but attenuated among children (-2%, 95% CI: -9%, 6%). Findings remained consistent for clinically-meaningful BLL cutoff ≥ 3 µg/dL. Conclusions: Housing assistance is an important social-structural determinant of health that can reduce residential environmental exposures through better quality housing, routine maintenance practices, and/or compliance with residential lead paint laws. Increasing access to affordable housing for very low-income households advances environmental health equity.