JHU Housing & Health Collaborative
Children
Receipt of Vouchers and Children’s Healthcare use
Examines whether children whose families receive housing choice vouchers have different patterns of Medicaid enrollment and health care use compared to those on the voucher waitlist.
Background
Housing vouchers, which subsidize the costs or rent and utilities and enable low-income families to rent homes on private market, are the nation’s largest housing assistance program. As policy-makers and practitioners consider ways to optimize the use of existing vouchers and seek support to expand the overall supply of affordable housing, there is a critical need for research that investigates the link between housing choice vouchers and health.
Approach
Working with two public housing authorities (Seattle Housing Authority and King County Housing Authority) and a health department (Public Health –Seattle & King County), we are investigating the association between the receipt of a housing voucher on children’s enrollment in Medicaid and patterns of health care use. The proposal uses quasi-experimental difference-in-differences methods leveraging the fact that families who receive housing assistance are randomly selected from a long waitlist and takes advantage of administrative housing linked with Medicaid data.
Team
The study team incudes Craig Pollack (PI) Matthew Eisenberg, Amanda Blackford, and Justin Rose at Johns Hopkins and Alastair Matheson and Amy Laurent at Public Health –Seattle & King County.
Funding
The project is supported by the National Institute for Nursing Research (R21HD105143).
Mobility Asthma Study (MAP)
Studies the impact of Baltimore’s housing mobility program on asthma exposures and outcomes.
Background
Children living in poor-urban neighborhoods bear a high burden of asthma morbidity, and there is strong evidence that housing-related environmental exposures such as pest allergens are a major driver of this excess asthma morbidity. Historic residential discrimination together with systemic disinvestment in neighborhoods have contributed to poor neighborhood and housing conditions, which make successful mitigation of housing-related exposures difficult, and in many cases, impossible. In contrast, housing mobility programs, where families are supported in moving to less segregated communities, may address the root- causes of the exposures that drive asthma disparities, while also serving as a tool by which we can parse the role of various housing and neighborhood exposures and understand their long-term effects on asthma.
Approach
Working with the Baltimore Regional Housing Partnership, the Mobility Asthma Project (MAP) recruited children with asthma who move from higher- to lower-poverty neighborhoods. Through home visits and surveys, the study collects information on asthma symptoms, exposures, lung function growth, and stress.
Team
The study team includes Craig Pollack, Lauren Barrow, Syed Qasim Hussaini, and Amanda Blackford at Johns Hopkins. Robin Yabroff, Leticia Nogueira, and Qinjin Fan help lead the effort from the American Cancer Society.
Funding
The project is supported by the National Institute of Environmental Health Sciences (R0 ES026170).
Raising Children with Medical Complexity, Issues of Housing and Household Expenses
Mixed methods study to explore the experience of housing and household expenses for families of children with medical complexity in Maryland.
Background
Children and Youth with Special Health Care Needs (CYSHCN) can have many home care requirements including medications, therapies, and medical equipment. Prior studies have shown that caring for CYSHCN can result in challenges with parental employment and family finances; yet, how the child’s care needs specifically impact housing adequacy or stability for families of CYSHCN has not been well-described.
Approach
In partnership with Parent’s Place of Maryland and the Coordinating Center, we recruited parents/guardians of CYSHCN in Maryland to conduct surveys and semi-structured interviews focused on housing and household expenses.
Team
The study team incudes Rebecca Seltzer, Pamela Donohue, Renee Boss, Karen Fratantoni, Kate Detweiler (Children’s National), Danielle Gaskin, Brandon Smith.
Funding
The project is supported by the Thomas Wilson Foundation.
Through the Family’s Lens: Identifying opportunities to optimize the home environment for children with medical complexity
Uses photovoice methodology to document barriers and facilitators to caring for children with medical complexity in the home environment.
Background: There is a growing population of children with medical complexity (CMC), who have serious medical needs and require hospital-like care at home. In order to stay healthy and out of the hospital, these children require a home that is safe, stable, accessible, and spacious enough to meet their intensive daily care needs. Yet, for many CMC, their current housing situation falls short and does not promote optimal quality of life and independence.
Approach: In this study, we use Photovoice methodology, a participatory research strategy combining photography, critical dialogue, and experiential knowledge of participants, to document barriers and facilitators to caring for CMC in the home and use this information to inform future family education and home-based interventions. Our goal is to understand, from the family’s lens, what barriers they experience to adequate housing and where we can begin targeting interventions to improve both the quality of life and the quality of homes for children with the greatest medical needs in Maryland.
Team: The study team includes Rebecca Seltzer, Pamela Donohue, Brandon Smith, and Mona-Esmat Jarrah.
Funding: The project is supported by the Thomas Wilson Foundation.