Document text
Principal Investigator: BENJAMIN S ABELLA
Organization: UNIVERSITY OF PENNSYLVANIA
Fiscal Year: 2024
Award: $406,250
Funding agency: National Institute of Nursing Research
The objective of the PHLHousing+ Evaluation is to test whether unconditional, monthly cash payments made
directly to tenants increases housing security and thereby reduces health disparities for low-income renters
who, in the city of Philadelphia, are disproportionately Black. This objective is aligned with the strategic aim of
NINR to understand which pandemic-era housing policies would best be continued to advance health equity.
The PHLHousing+ Evaluation comprises three groups, all of whom earn below 50% area median income and
have at least one child under the age of 16 years living at home: 270 households who receive monthly cash
payments in lieu of a rental voucher (Cash group), 225 households who are eligible for (or currently using) a
rental voucher (Voucher group), and 789 households on the Philadelphia Housing Authority (PHA) waitlist who
will not be offered a rental voucher for the foreseeable future because of their randomized position on the
waitlist (Control group). Of the 1,284 households in the study, 82.5% are headed by single women and 82.8%
are Black. There are 2,678 children in the sample, ranging in age from 1 to 19 years (median = 10, IQR = 5-
15). Monthly cash payments range from $89 to $2079, with a median payment of $881; payments vary based
on household income, family size, and fair market rent. Households in the Cash group will receive monthly
payments for 2.5 years. All three groups are surveyed every six months for three years via an online survey;
the first wave of surveys was deployed in August 2022. Existing surveys include measures of self-reported
mental and physical health and hospital utilization for adults and children. We propose to extend these data in
three ways: (1) by extracting electronic health record (EHR) data on emergency department (ED) visits and
hospital admissions linked to our survey respondents; (2) by administering brief, monthly surveys that will
increase participant retention between biannual surveys and will measure mood and health-promoting
behaviors that might be pathways by which PHLHousing+ promotes positive health outcomes; and (3) by
linking household addresses with census-based data on neighborhood opportunity and Philadelphia Police
Department crime data. Aim 1 is to test whether rental assistance (Cash + Voucher vs. Control) or type of
assistance (Cash vs. Voucher) is associated with self-reported mental and physical health and with affective
volatility and health-promoting behaviors. Aim 2 is to test whether the availability or type of rental assistance is
associated with ED use or hospital admissions as recorded in EHR, specifically for problems that are
disproportionately associated with housing insecurity (e.g., mental health problems). Aim 3 is to test whether
availability or type of rental assistance is associated with exposure to housing problems (e.g., pests, mold),
access to neighborhood opportunity, or exposure to crime. Study findings will have immediate implications for
the City of Philadelphia's model for providing housing assistance, will inform efforts to establish similar
programs in other cities, and will inform federal approaches to rental assistance.
Terms: <0-11 years old><16 year old><16 years of age><21+ years old><Accident and Emergency department><Address><Adult><Adult Human><Affective><Age><Area><Behavior><Black><Black race><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Censuses><Child><Child Youth><Children (0-21)><Cities><Competence><Control Groups><Crime><Data><Decrease health disparities><Dimensions><Disease><Disorder><ED visit><ER visit><Economic Income><Economical Income><Economics><Education><Educational aspects><Effectiveness><Electronic Health Record><Eligibility><Eligibility Determination><Emergencies><Emergency Department><Emergency Situation><Emergency care visit><Emergency department visit><Emergency hospital visit><Emergency room><Emergency room visit><Emotional><Emotional Depression><Evaluation><Exposure to><Family Sizes><Filamentous Fungi><Future><Goals><Health><Health Promotion><Health disparity mitigation><Health disparity reduction><Home><Hospital Admission><Hospitalization><Hospitals><Household><Household Heads><Housing><Housing and Urban Development><Income><Individuals from minority><Individuals of minority><Injury><Link><Low income><Lower health disparities><Marketing><Measures><Medical><Mental Health><Mental Hygiene><Minority Groups><Minority People><Minority Population><Minority individual><Mitigate health disparities><Modeling><Molds><Moods><Neighborhoods><Neurodevelopmental Problem><Outcome><Pathway interactions><Patient Self-Report><Pennsylvania><Philadelphia><Police><Policies><Position><Positioning Attribute><Problem behavior><Property><Protocol Screening><Psyche structure><Psychological Health><Random Allocation><Random Selection><Randomized><Randomized, Controlled Trials><Reduce health disparities><Respondent><Risk><Role><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Salutogenesis><Sampling><Section 8><Secure><Security><Self-Report><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Survey Instrument><Surveys><Testing><Time><Translating><Trauma><U.S. Department of Housing and Urban Development><Waiting Lists><Woman><World Health Organization><adulthood><age 16 years><ages><alleviate symptom><ameliorating symptom><anxiety symptoms><anxious symptom><authority><behavioral problem><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><decrease symptom><depression symptom><depressive><depressive symptoms><disparity in health><economic><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><experience><experiment><experimental research><experimental study><experiments><fewer symptoms><health disparity><health equity><homes><hospital utilization><incomes><indexing><injuries><kids><mental><minority health disparity><novel><pandemic><pandemic disease><participant retention><pathway><payment><perceived stress><perception of stress><physical conditioning><physical health><programs><promoting health><randomisation><randomization><randomized control trial><randomly assigned><reduce symptoms><relieves symptoms><self-reported stress><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><sixteen year old><sixteen years of age><social health determinants><social role><socio-economic><socio-economically><socioeconomically><socioeconomics><stress perception><symptom alleviation><symptom reduction><symptom relief><voucher><waitlist><youngster>