New York City Housing Research Articles

Long-Term Trends in Secondhand Smoke Exposure in High-Rise Housing Serving Low-Income Residents in New York City: Three-Year Evaluation of a Federal Smoking Ban in Public Housing, 2018-2021.

In July 2018, the U.S. Department of Housing and Urban Development passed a rule requiring public housing authorities to implement smoke-free housing (SFH) policies. We measured secondhand smoke (SHS) exposure immediately before, and repeatedly up to 36 months post-SFH policy implementation in a purposeful sample of 21 New York City (NYC) high-rise buildings (>15 floors): 10 NYC Housing Authority (NYCHA) buildings subject to the policy and 11 privately managed buildings in which most residents received housing vouchers (herein "Section 8"). We invited participants from nonsmoking households (NYCHA n = 157, Section-8 n = 118) to enroll in a longitudinal air monitoring study, measuring (1) nicotine concentration with passive, bisulfate-coated filters, and (2) particulate matter (PM2.5) with low-cost particle sensors. We also measured nicotine concentrations and counted cigarette butts in common areas (n = 91 stairwells and hallways). We repeated air monitoring sessions in households and common areas every 6 months, totaling six post-policy sessions. After 3 years, we observed larger declines in nicotine concentration in NYCHA hallways than in Section-8, [difference-in-difference (DID) = -1.92 µg/m3 (95% CI -2.98, -0.87), p = .001]. In stairwells, nicotine concentration declines were larger in NYCHA buildings, but the differences were not statistically significant [DID= -1.10 µg/m3 (95% CI -2.40, 0.18), p = .089]. In households, there was no differential change in nicotine concentration (p = .093) or in PM2.5 levels (p = .385). Nicotine concentration reductions in NYCHA common areas over 3 years may be attributable to the SFH policy, reflecting its gradual implementation over this time. Continued air monitoring over multiple years has demonstrated that SHS exposure may be declining more rapidly in NYCHA common areas as a result of SFH policy adherence. This may have positive implications for improved health outcomes among those living in public housing, but additional tracking of air quality and studies of health outcomes are needed. Ongoing efforts by NYCHA to integrate the SFH policy into wider healthier-homes initiatives may increase policy compliance.

Use of environmental scan to assess density, content, and variation of predatory food and beverage marketing in New York City.

To explore the presence of predatory food and beverage marketing in different neighborhoods in New York City (NYC), this study describes the methodology of an outdoor environmental scan of the physical environment. The study was conducted in four NYC neighborhoods over a three-week period, in which pairs of trained researchers canvassed designated neighborhoods to document the presence of food and beverage marketing using photographs taken on digital smart phone devices. Commercial areas in the vicinity of NYC Public Schools and NYC Housing Authority campuses located in four neighborhoods with the highest and lowest nutrition related health indicators were studied: South Bronx, Pelham Throggs Neck, Upper West Side, Chelsea/Greenwich Village. Advertisements were coded against 50+ indicators to quantify pertinent variables including the frequency and content of food and beverages advertised and all forms of predatory marketing observed. Comparisons of prevalence and content of food and beverage advertisements and predatory marketing were made across neighborhoods with the highest and lowest health indicators, using chi-squared analysis, and a significance level of p<0.05. This article demonstrates a disproportionate presence of predatory marketing in low income NYC neighborhoods with negative health outcomes compared to wealthier neighborhoods. Further, this paper demonstrates the benefits and limitations of using an environmental scan methodology to assess predatory food and beverage marketing in a large urban area such as NYC.

Disparities in Marijuana and Tobacco Smoke Incursions Among New York City Families During Early Months of the COVID-19 Pandemic.

Objectives:Once the COVID-19 pandemic arrived in New York City (NYC), stay-at-home orders led to more time spent indoors, potentially increasing exposure to secondhand marijuana and tobacco smoke via incursions from common areas or neighbors. The objective of this study was to characterize housing-based disparities in marijuana and tobacco incursions in NYC housing during the pandemic.Design:We surveyed a random sample of families from May to July 2020 and collected sociodemographic data, housing characteristics, and the presence, frequency, and pandemic-related change in incursions.Setting:Five pediatric practices affiliated with a large NYC health care system.Participants:In total, 230 caregivers of children attending the practices.Main Outcome Measures:Prevalence and change in tobacco and marijuana smoke incursions.Results:Tobacco and marijuana smoke incursions were reported by 22.9% and 30.7%, respectively. Twenty-two percent of families received financial housing support (public housing, Section-8). Compared with families in private housing, families with financial housing support had 3.8 times the odds of tobacco incursions (95% CI, 1.4-10.1) and 3.7 times the odds of worsening incursions during pandemic (95% CI, 1.1-12.5). Families with financially supported housing had 6.9 times the odds of marijuana incursions (95% CI, 2.4-19.5) and 5 times the odds of worsening incursions during pandemic (95% CI, 1.9-12.8). Children in financially supported housing spent more time inside the home during pandemic (median 24 hours vs 21.6 hours, P = .02) and were more likely to have asthma (37% vs 12.9%, P = .001) than children in private housing.Conclusions:Incursions were higher among families with financially supported housing. Better enforcement of existing regulations (eg, Smoke-Free Public Housing Rule) and implementation of additional policies to limit secondhand tobacco and marijuana exposure in children are needed. Such actions should prioritize equitable access to cessation and mental health services and consider structural systems leading to poverty and health disparities.

Storm surges, informational shocks, and the price of urban real estate: An application to the case of Hurricane Sandy

The impacts of a major hurricane on residential real estate can be devastating. Hurricane Sandy in New York City (NYC) is among the examples of how flooding can unexpectedly extend beyond FEMA flood zones. Such surprises or negative shocks can provide property owners—especially those not flooded—with new information about future flood risks, based on the difference of the property distance from the mapped flood zone and the distance to the actual locations of flooding. We use a difference-in-differences approach to quantify the effects of these shocks on residential property values for non-flooded NYC properties after Sandy. The short-run negative “surprise” effect was to lower NYC housing prices by about 6%–7% for each mile (or about 2% per standard deviation) difference between the property distance from the flood zone and the distance to the actual locations of flooding. The corresponding positive “surprise” effect is insignificant. The long-term surprise effects of flood risk on housing prices tend to disappear, as residents’ memories of the surprise fade and they seem to only recall the actual storm surge several years after the hurricane.

Storm Surges, Informational Shocks, and the Price of Urban Real Estate: An Application to the Case of Hurricane Sandy

The impacts of a major hurricane on residential real estate can be devastating. Hurricane Sandy in New York City (NYC) is among the examples of how flooding can unexpectedly extend beyond FEMA flood zones. Such surprises or negative shocks can provide property owners—especially those not flooded—with new information about future flood risks, based on the difference of the property distance from the flood zone and the distance to the actual locations of flooding. We use a difference-in-differences approach to quantify the effects of these shocks on residential property values for non-flooded NYC properties after Sandy. The short-run negative “surprise” effect was lower NYC housing prices by about 6%-7% for each mile (or about 2% per standard deviation) difference between the property distance from the flood zone and the distance to the actual locations of flooding. The corresponding positive “surprise” effect is insignificant. The long-term “surprise” effects of flood risk on housing prices tend to disappear, as residents’ memories of the “surprise” fade and they seem to only recall the actual storm surge several years after the hurricane.

Adapting to Extreme Heat: Social, Atmospheric, and Infrastructure Impacts of Air-Conditioning in Megacities—The Case of New York City

Abstract Extreme heat events are becoming more frequent and intense. In cities, the urban heat island (UHI) can often intensify extreme heat exposure, presenting a public health challenge across vulnerable populations without access to adaptive measures. Here, we explore the impacts of increasing residential air-conditioning (AC) adoption as one such adaptive measure to extreme heat, with New York City (NYC) as a case study. This study uses AC adoption data from NYC Housing and Vacancy Surveys to study impacts to indoor heat exposure, energy demand, and UHI. The Weather Research and Forecasting (WRF) model, coupled with a multilayer building environment parameterization and building energy model (BEP–BEM), is used to perform this analysis. The BEP–BEM schemes are modified to account for partial AC use and used to analyze current and full AC adoption scenarios. A city-scale case study is performed over the summer months of June–August 2018, which includes three different extreme heat events. Simulation results show good agreement with surface weather stations. We show that increasing AC systems to 100% usage across NYC results in a peak energy demand increase of 20%, while increasing UHI on average by 0.42 °C. Results highlight potential trade-offs in extreme heat adaptation strategies for cities, which may be necessary in the context of increasing extreme heat events.

Self-reported Secondhand Marijuana Smoke (SHMS) Exposure in Two New York City (NYC) Subsidized Housing Settings, 2018: NYC Housing Authority and Lower-Income Private Sector Buildings.

The percentage of adults in the United States reporting current marijuana use has more than doubled, from 4 to 9% between 2002 and 2018, suggesting that exposure to secondhand marijuana smoke (SHMS) has probably increased. Few studies have characterized the extent to which residents experience SHMS, particularly those living in multi-unit housing. It remains unknown how recently-implemented smoke-free housing policies (SFH) targeting cigarette smoke in public housing authorities (PHAs) will affect SHMS exposure. We sought to characterize prevalence of self-reported SHMS exposure among residents living in two different subsidized housing settings prior to SFH policy implementation in PHAs: New York City Housing Authority (NYCHA) buildings and private sector buildings where most residents receive Section8 subsidy vouchers (herein 'Section8' buildings). Residents were recruited from 21 purposefully-selected buildings: 10 NYCHA and 11 Section8 buildings (> 15 floors). Survey responses were collected during April-July 2018 for NYCHA residents (n = 559) and August-November 2018 for Section8 residents (n = 471). Of 4628 eligible residents, 1030 participated (response rates, 35% NYCHA, 32% Section8). Overall, two-thirds of residents reported smelling marijuana smoke (67%) in their home over the past year, higher than reports of smelling cigarette smoke (60%). Smoking status and smelling SHS were both strong predictors of smelling SHMS (p < 0.05). Nearly two thirds of residents perceived smoking marijuana and smelling SHMS as harmful to health. Our findings suggest that,immediately prior to SFH rule implementation in PHAs, SHMS was pervasive in low-income multi-unit housing, suggesting SFH policies should expand to cover marijuana use.

Secondhand smoke exposure in public and private high-rise multiunit housing serving low-income residents in New York City prior to federal smoking ban in public housing, 2018

BackgroundTobacco remains the leading cause of preventable death in the United States, with 41,000 deaths attributable to secondhand smoke (SHS) exposure. On July 30, 2018, the U.S. Department of Housing and Urban Development passed a rule requiring public housing authorities to implement smoke-free housing (SFH) policies. ObjectivesPrior to SFH policy implementation, we measured self-reported and objective SHS incursions in a purposeful sample of 21 high-rise buildings (>15 floors) in New York City (NYC): 10 public housing and 11 private sector buildings where most residents receive federal housing subsidies (herein ‘Section 8’ buildings). MethodsWe conducted a baseline telephone survey targeting all residents living on the 3rd floor or higher of selected buildings: NYC Housing Authority (NYCHA) residents were surveyed in April-July 2018 (n = 559), and residents in ‘Section 8’ buildings in August-November 2018 (n = 471). We invited non-smoking household participants to enroll into a longitudinal air monitoring study to track SHS exposure using: (1) nicotine concentration from passive, bisulfate-coated nicotine filters and (2) particulate matter (PM2.5) from low-cost particle monitors. SHS was measured for 7-days in non-smoking households (NYCHA n = 157, Section 8 n = 118 households) and in building common areas (n = 91 hallways and stairwells). ResultsSmoking prevalence among residents in the 21 buildings was 15.5%. Two-thirds of residents reported seeing people smoke in common areas in the past year (67%) and 60% reported smelling smoke in their apartments coming from elsewhere. Most stairwells (88%) and hallways (74%) had detectable nicotine levels, but nicotine was detected in only 9.9% of non-smoking apartments. Substantial variation in nicotine and PM2.5 was observed between and within buildings; on average nicotine concentrations were higher in NYCHA apartments and hallways than in Section 8 buildings (p < 0.05), and NYCHA residents reported seeing smokers in common areas more frequently. ConclusionsSFH policies may help in successfully reducing SHS exposure in public housing, but widespread pre-policy incursions suggest achieving SFH will be challenging.

A Randomized Controlled Trial of a Rapid Re-housing Intervention for Homeless Persons Living with HIV/AIDS: Impact on Housing and HIV Medical Outcomes.

We conducted a randomized controlled trial to determine whether, for homeless persons living with HIV/AIDS (PLWHA), rapid re-housing can improve housing and HIV viral suppression more than standard housing assistance. We recruited 236 PLWHA from HIV emergency housing in New York City (NYC) and randomized them to: (1) Enhanced Housing Placement Assistance (EHPA), i.e., immediate assignment to a case manager to rapidly re-house the client and provide 12months of case management or (2) usual services, i.e., referral to an NYC housing placement program for which all HIV emergency housing residents were eligible. We compared time to stable housing placement and percentage virally suppressed from baseline to 12months. EHPA clients were placed faster than usual services clients (p = 0.02;25% placed by 150days vs. 243days, respectively), more likely to be placed [adjusted hazards ratio = 1.8;95% confidence interval(CI) 1.1-2.8], and twice as likely to achieve or maintain suppression (adjusted odds ratio 2.1;95% CI 1.1-4.0).

Public Housing Participation in Superstorm Sandy Recovery: Living in a Differentiated State in Rockaway, Queens

Recovery experiences of public housing residents in the Rockaways, Queens (New York City (NYC)), after Superstorm Sandy suggest that living in NYC Housing Authority (NYCHA) properties creates circumscribed opportunities for local political participation, what I call a “differentiated state.” This differentiated state is constructed from four interconnected sociospatial features: (1) tenants’ stigmatized identities, (2) U.S. Department of Housing and Urban Development (HUD) regulations, (3) NYCHA’s “para-governmental” status, and (4) spatial concentration of the developments. I empirically demonstrate this “differentiated state” based on a grounded case study of disparities in disaster recovery participation in Rockaway. This analysis offers a new spatial lens to the scholarship on policy feedbacks and delivers a new synthesis of the limits to tenants’ political participation in conventional public housing developments in the United States, home to more than two million people.

Reducing Childhood Asthma Triggers in Public Housing: Implementation and Outcomes from an East Harlem Community Health Worker Program

There are significant disparities in asthma prevalence and management in New York City (NYC). Children living in the low income, largely minority neighborhood of East Harlem are almost 13 times more likely to have an asthma related emergency department visit compared to children on the Upper East Side, an adjacent high income neighborhood. The disparities in asthma prevalence and control are in part attributable to environmental conditions, including housing, which in low-income communities is often poorly maintained, resulting in mold, pests, and other asthma triggers. Controlling Asthma through Home Remediation (CAHR), a program of LSA Family Health Service (LSAFHS), offers remediation and repair, training, and comprehensive case management to East Harlem families that have children with severe and/or persistent asthma and live in NYC Housing Authority (NYCHA) public housing. Preliminary findings, based on pre-post assessments of 60 CAHR children, include statistically significant reductions in nighttime awakenings, emergency department visits, and rescue medication use. There were reductions in daytime asthma symptoms and improvements in household conditions; however, they were not statistically significant. Recognizing the limited reach of individual level services, LSAFHS also advocates for system-wide changes across NYCHA. Citing the Americans with Disabilities Act and its relevance to individuals with asthma, LSAFHS, in partnership with other community-based organizations and public interest attorneys, reached a settlement with NYCHA in 2013 that resulted in policy changes mandating expedited repairs of leaks, mold, and related issues. Monitoring the impact of these changes is ongoing. A hope is for replication of advocacy efforts in other cities.

Government Public Housing Health Needs Assessment: Focus on Race, Ethnicity, and the Older Adult: Background, Methods, and Demographics

St. Vincent's Catholic Medical Centers of New York initiated a study in 2009 to assess the health needs of residents of New York City (NYC) municipal housing at the Robert Fulton public housing complex in Manhattan. The aim of this project was to provide valid data on perceived health services needs of the residents of a NYC housing project. These data may also be used to support hospital and community collaborative strategic decisions for developing resident-appropriate health and social services and would be valuable for use in formulating policies and programs by other interested nonprofit health and social services organizations and government. We designed a 28-item instrument and pilot tested it with our research team and members of the population under study. The English and Spanish surveys were designed as an in-person surveyor-administered instruments addressing four domains: demographics, access and barriers to health care services, risk behaviors, and perceived health needs. The sampling was an apartment-level stratified random sampling. A 20%, 188 apartment sample was drawn from the population of 944 housing units. Our response rate was 92% (173/188 apartments). Background methods, and demographic results are reported in this article. A second article will report on the needs assessment results.

Health of Older Adults in New York City Public Housing: Part 1, Findings From the New York City Housing Authority Senior Survey

Older adults are an important and growing part of the social fabric of New York City (NYC). As people age, they face health concerns that can affect their ability to live comfortable, independent lives. Recent national surveys have found that more than 60% of older Americans have multiple chronic conditions and 20% have a physical disability.1,2 The quality of life older adults experience can be greatly improved by living in supportive physical and social environments and having routine access to high-quality health care services. More than 61,500 New Yorkers aged 65 and older live in New York City Housing Authority (NYCHA) public housing developments. 3 Age group projections suggest that the growth of this group will outpace that of NYC's older adult population,4 as NYCHA residents are more likely to stay in their residences instead of moving into assisted living facilities or out of the City. The large and growing number of older NYCHA residents also presents tremendous opportunities to target health, social, and financial services towards older adults in NYC. Despite the critical financial relief provided by subsidized housing, poverty remains a critical challenge for many. Almost half of older NYCHA residents live with incomes below the federal poverty level. In general, lowincome adults have higher rates of chronic illnesses, have worse access to health care services, and receive poorer quality of care than higher-income adults.5-7 In 2007, NYCHA convened a multidisciplinary task force to develop a strategy and recommend actions to address the needs of its large and expanding older population. The same year, the Age-friendly New York City initiative was launched by the NYC Mayor's Office and City Council with the New York Academy of Medicine.8 Following these efforts, NYCHA collaborated with the New York City Departments of Health and Mental Hygiene (DOHMH) and for the Aging (DFTA), as well as with the City University of New York (CUNY) School of Public Health, to conduct a survey among NYCHA residents aged 65 and older to examine health status and barriers to care in the context of nearuniversal Medicare coverage. This report summarizes our survey findings, makes recommendations to improve physical and mental health outcomes among older public housing residents in NYC, and aims to promote a more informed dialogue among residents, community-based organizations, and City agencies on how best to improve quality of life for older New Yorkers living in NYCHA housing. About the Data More than 1,000 randomly selected adults aged 65 and older living in NYCHA housing were interviewed by telephone in June 2009 for the NYCHA Senior Survey. Participants' demographic information was obtained from the NYCHA Tenant Data System. Analyses presented in this report were statistically weighted to be representative of all older NYCHA adults, and all comparisons discussed in the text are statistically significant. Additional data sources were used to draw comparisons between the demographics and health of older NYCHA adults and those of older adults in NYC and the US. Qualitative feedback was gathered from meetings with resident leaders across the five boroughs and a variety of NYCHA officials and development-based staff. OVERVIEW OF THE NEW YORK CITY HOUSING AUTHORITY (NYCHA) NYCHA is the largest public housing authority in North America, comprising more than 178,000 apartments in 334 developments with 2,602 residential buildings throughout the five boroughs of NYC. Nearly 404,000 individuals officially reside in NYCHA's public housing developments. The first senior development exclusively for residents aged 62 and older, Gaylord White Houses in Manhattan, was completed in 1964. Since then, the number of senior developments has grown to 42, and 14 mixed family developments include designated buildings for older adults. In total, 10,000 apartments in NYCHA's public housing portfolio are reserved for older adults. …

What explains the association between neighborhood-level income inequality and the risk of fatal overdose in New York City?

Accidental drug overdose is a substantial cause of mortality for drug users. Using a multilevel case-control study we previously have shown that neighborhood-level income inequality may be an important determinant of overdose death independent of individual-level factors. Here we hypothesized that the level of environmental disorder, the level of police activity, and the quality of the built environment in a neighborhood mediate this association. Data from the New York City (NYC) Mayor's Management Report, the NYC Police Department, and the NYC Housing and Vacancy Survey were used to define constructs for the level of environmental disorder, the level of police activity and the quality of the built environment, respectively. In multivariable models the odds of death due to drug overdose in neighborhoods in the top decile of income inequality compared to the most equitable neighborhoods decreased from 1.63 to 1.12 when adjusting for the three potential mediators. Path analyses show that the association between income inequality and the rate of drug overdose mortality was primarily explained by an indirect effect through the level of environmental disorder and the quality of the built environment in a neighborhood. Implications of these findings for the reduction of drug overdose mortality associated with the distribution of income are discussed.

The effects of selective decontrol in the NYC rental housing market

During the past decade, over 200 cities in the United States have imposed rent control [Baird, t980, pp. 54-7]. Although most likely a response to the accelerating inflation of the 1970's, this second generation of rent control has been justified on the grounds of the existence of a housing crisis. In different locales the crises are described variously as arising from a housing shortage, low vacancy rates, rent increases, tenant hardship, housing deterioration, lack of new construction, or environmental necessity [Baar and Keating, 1975, p. 490]. Invariably, newly enacted rent control ordinances are presented as temporary measures. Presumably, policymakers view the imposition of rent control and its concomitant effects as reversible after the housing crisis, however defined, has passed. But is this assumption correct? Does decontrol restore market rents, maintenance levels, optimal crowding, and tenant mobility? Or are housing units permanently altered by virtue of their having been under rent controls? These are important issues in evaluating rent control as a feature of local housing policy. Surprisingly little empirical work has been done on the relationship between rent control and housing quality, crowding, and tenant turnover. Furthermore, the authors have found no empirical studies dealing with decontrol. The purpose of this paper is to make a modest contribution to understanding the efficacy of decontrol by exploring the effects of selective decontrol in New York City (NYC). The data used in this study are taken from the 1968 Special NYC Housing