Designated housing regulations and health: Implications for low-income disabled and elderly americans

Recently, there have been transformational changes in the infrastructures and systems that provide long-term care and supportive services to elderly and disabled Americans, driven by efforts to provide these services in home- and community-based settings rather than institutions. Subsidized rental housing tied to supportive services has been viewed as a potential platform for successful community integration and the opportunity to “age in place”.

Stemming from work through the National Prevention Council, and in conversation with the U.S. Department of Housing and Urban Development, we conducted a health impact assessment (HIA) of how changes to existing regulations permitting the designation of public rental housing as elderly, disabled, or a mix thereof could affect the health of low-income, eligible populations. Our assessment approach included a systematic literature review of the evidence base linking supportive housing and health, quantitative analyses of housing administrative data sets, and stakeholder engagement including an Advisory Committee, public housing resident focus groups, and key informant interviews with Public Housing Agencies (PHAs).

Synthesizing qualitative and quantitative data, we will present findings on the potential impact of a rule change on the alignment of public housing stock with population need among low-income elderly or disabled individuals, and associated health outcomes (e.g., chronic diseases, mental health, injury) or healthcare costs of service provision outside of institutions. We will also discuss the possible implications for local PHA allocation planning, administration or housing management, and the possible linkage to community health and social service supports for designated housing populations, particularly disabled individuals.