Project Summary

This project seeks to exploit a novel, multi-arm natural experiment of public housing redevelopment, in which subsets of public housing residents will be displaced and assigned to different environments versus remaining in-place. Using a rigorous mixed-methods design to fill critical holes in the knowledge base, we will address whether improving housing quality, limiting external displacement, and creating mixed-income communities improve the physical, mental, and behavioral health of public housing residents, including children, youth, adults, and older adults. 

Research Questions

Specifically, we ask:

• Does a transition to high quality and healthy housing improve the physical, emotional, and behavioral health of residents in comparison to disordered housing?
• Does residential stability confer advantages for the physical, emotional, and behavioral health of residents in comparison to residential displacement?
• Does residence in a mixed-income building improve resident physical, emotional, and behavioral health in comparison to residence in a concentrated poverty building?
• Do effects of housing quality/residential stability/mixed-income buildings vary across resident age, gender, or race/ethnicity?
• Are effects of housing quality/residential stability/mixed-income buildings mediated through social, environmental, or physiological mechanisms?
  

Challenges

1.2 million American households reside in public housing developments. With $7.42 billion in FY20 federal funding, public housing is a key federal investment. Yet, following decades of discriminatory policies and underinvestment in affordable housing, residents of our nation’s public housing often live in conditions of concentrated poverty and unhealthy housing and community contexts, isolated from social and economic opportunities. These social determinants of health drive substantial health disparities, with public housing residents experiencing elevated levels of mortality and morbidity across numerous health domains.

In response, current policy efforts seek to redevelop public housing into mixed-income communities in order to deconcentrate poverty, create healthier housing environments, enhance community resources, and decrease community stressors, with over $7 billion in funding for such efforts since 1990. New models further seek to limit resident displacement and quickly improve housing conditions and community safety to reduce stressors and preserve social connections among residents. Such public housing redevelopment efforts have expanded dramatically across the US without rigorous empirical study. As such, it is essential to delineate the repercussions of public housing redevelopment policies on health disparities, and to identify the specific policy levers and mechanisms which drive such effects.

Approach  

We will conduct a quasi-experimental mixed-methods longitudinal study following 1068 individuals (children, youth, adults, and older adults) in 600 households across 5 years of public housing redevelopment. We bring an interdisciplinary team uniquely qualified for this study, including developmental and clinical psychologists specializing in complex longitudinal studies of human health and well-being, social workers with extensive experience in community-based research, an engineer specializing in environmental health and exposure disparities, and a biostatistician expert in causal inference, partnered with community residents, service providers, and topical experts. We will collect four waves of surveys, combined with unique, validated direct environmental assessments, physiological stress measures, and annual in-depth qualitative interviews and geocoded administrative data.

• An interdisciplinary team led by Rebekah Levine Coley (LSOE) and Sam Teixeira (SSW) will study the impact of housing quality, stability, and economic integration on health disparities among a sample of public housing residents.
• With a 5-year grant from the National Institute of Minority Health and Health Disparities, Coley and Teixeira will partner with community agencies, residents, and housing providers to better understand the effects of housing redevelopment in South Boston.
• We will use multiple unique measures including four waves of surveys, combined with real time air quality assessments, stress measured through hair cortisol samples, and annual in-depth qualitative interviews and geocoded administrative data.