Creating Healthier, More Equitable Communities

Low-income housing assistance programs represent a potentially powerful policy lever to promote population health and reduce health disparities. Yet, research on the impact of federal low-income housing programs on health outcomes remains highly limited, and no study to date has adequately explored whether the monetary value of housing assistance has an impact on health outcomes.

Prior research suggests that universal pre-kindergarten programs can generate lifetime benefits, but the mechanisms generating these effects are not well understood. In 2014, New York City made all 4-year-old children eligible for universal pre-k programs that emphasized developmental and health screening. We examine the effect of this program on health outcomes.

High-quality, early childhood education (ECE) boosts early-life skills in disadvantaged individuals. These skills translate into better outcomes later in life, in areas like employment, education, income, and criminal activity. But ECE is also costly, and as such, it is important to have a complete picture of the social returns throughout life. In particular, it is not known whether ECE can improve health over the course of a lifetime.

Does enrollment in the Supplemental Nutrition Assistance Program (SNAP) encourage families to purchase healthier foods and thereby increase the nutrition of those families enrolled in the program?

To answer this central question, this study will use an event-study design coupled with new, high-scale commercial transaction data from a grocery retailer to provide precise evidence on the effect of SNAP receipt on the amount and composition of food purchases. The study will generate evidence on the effects of SNAP enrollment from early childhood through adulthood.

The built environment and housing have pronounced effects on community health. This study will look at the reach of Low-Income Housing Tax Credit (LIHTC) programs and their potential to produce healthier rental housing that serves low-income and vulnerable populations. The research will focus on four research questions:

The U.S. lags far behind other countries in public policies that support parents in the crucial first days, weeks, and months of a child's life. Most notably, the U.S. is the only developed country that does not guarantee a period of paid and job-protected leave for new parents. As a result, paid family leave coverage is both limited and highly unequal. This situation, however, is beginning to change, as California, New Jersey, New York, and Rhode Island and a handful of U.S. cities now have paid family leave (PFL) programs.

Children who grow up in poverty are exposed to many risk factors that adversely impact their health trajectories, resulting in poorer health into and throughout adulthood. This project will use a simulation approach to test the long-term impact of early childhood income supplements on health and educational attainment. Income supplement policies (e.g., child benefits, guaranteed minimum income, earned income tax credit, or welfare) may provide parents the opportunity to make healthier choices for their children.

In late 2015, the Vancouver Housing Authority (VHA) initiated a new policy experiment for distributing Section 8 housing vouchers. Rather than using basic income eligibility requirements, vouchers would be deliberately deployed to maximize their impact on community health by targeting those with complex medical needs and homeless families with school-age children. The central question this study seeks to answer is whether targeting specific subpopulations to prioritize Section 8 housing vouchers can increase the total impact of those vouchers on key community health indicators.

Due to budget shortfalls, many states and school districts are implementing pay-to-play policies that allow collection of fees for participation in extracurricular activities such as school sports. The number of school districts with these policies has grown over the last decade, with some states reporting a two-fold increase. Although the extent of these policies and the amount of the fees for participation vary greatly, it seems likely that the overall effects of pay-to-pay policies may disproportionally affect low-income students.

In April 2016, the U.S. Department of Agriculture (USDA) issued updated standards governing the meal pattern requirements for the Child and Adult Care Food Programs (CACFP), effective October 1, 2017. The updated standards will require participating providers to serve more whole grains, a greater variety of fruits and vegetables, and reduce the amount of solid fats and added sugars (SOFAS) in meals.

Law stands as a significant influence on health equity, and an essential means of advancing a Culture of Health characterized by an equitable distribution of well-being. This project combines applied research and translation activities to answer a series of questions designed to improve our understanding and implementation of law and policy to address health inequity through housing

Surprisingly little is known about how housing policy and neighborhood features impact health. This project will examine several housing policies in New York City­ that may affect health, and develop a measure to understand the real-time impact of housing policy on health outcomes.