Housing Assistance Significantly Reduces Housing Cost Burdens but Has Less Meaningful Impact on Health and Housing Quality Concerns for Renter Households with Disabilities

By Mackenzie Pish, NLIHC Research Analyst 

Research published in the Disability and Health Journal, “Federal rental assistance and housing outcomes among disability households: Cost burden relief without health or housing quality gains,” found that renter households who include at least one person with disabilities were more likely than non-disabled households to report poor health, housing quality issues, and affordability challenges. While federal housing assistance relieved affordability-related disparities for households with disabilities, it did not meaningfully relieve most health or housing quality disparities. 

The authors relied on 2023 American Housing Survey (AHS) data on renter households. In addition to providing data on housing assistance, disability status, housing quality, and costs, the 2023 AHS included a special topical module that collected data on household health and housing insecurity. The authors examined the association between disability status and federal housing assistance with four health indicators (overall health, sleep, drinking water, and air quality), six housing quality indicators (up-keep problems, pests, mold, water leakage, and uncomfortably hot or cold temperatures), and two housing affordability indicators (difficulty affording rent and severe cost burden).  
 
Disability households experienced higher rates of negative health, housing quality, and housing affordability indicators compared to non-disability households. The authors found that disability status was significantly associated with higher odds of a household experiencing any of the 12 negative indicators of health, housing quality, and housing affordability. Compared to non-disability households, disability households were 5.8 times more likely to report poor or fair health, 3.3 times more likely to report upkeep problems, 2.7 times more likely to report mold, and more than twice as likely to report poor sleep and uncomfortable temperatures (both hot and cold).  

The authors also examined whether housing assistance reduced the disparity between disability and non-disability households’ likelihood of experiencing each health, housing quality, and housing affordability outcome. The analyses indicated that housing assistance significantly reduced housing affordability disparities between disability and non-disability households, but had less impact, if any, on health and housing quality disparities. 

Considering only unassisted households by disability status, disability households were 8.6 percentage points more likely to experience severe cost burdens than non-disability households (27.2% versus 18.6%). But considering assisted households by disability status, disability households were 12.5 percentage points less likely to experience severe cost burdens than non-disability households (12.3% versus 24.8%). Among non-disability households, assisted households may have higher rates of severe cost burden compared to unassisted households due to how households with the highest needs and lowest incomes are prioritized in federal housing assistance programs. Similarly, unassisted disability households were 7.7 percentage points more likely than unassisted non-disability households to struggle to afford rent (44.7% versus 37.0%), while assisted disability households were 1.5 percentage points less likely than assisted non-disability households to struggle to afford rent (34.6% versus 36.1%).  

In comparison, housing assistance was not associated with meaningful improvements to most health and housing quality concerns for disability households. For example, unassisted disability households were 31.3 percentage points more likely than unassisted non-disability households to report poor or fair health (39.2% versus 7.9%), while assisted disability households were 26.5 percentage points more likely than assisted non-disability households to struggle to afford rent (48.9% versus 24.2%). Thus, housing assistance was associated with a reduction in the disparity between disability and non-disability households’ likelihood of experiencing poor or fair health but assisted disability households were still the most likely to experience poor or fair health. Both assisted disability households and assisted non-disability households may have higher rates of poor health than unassisted households due to how households are prioritized for housing assistance.  

The authors suggest that households with disabilities and particularly those who receive housing assistance may have worst-case health and housing needs that housing assistance alone cannot address, and call for more comprehensive, person-centered approaches to addressing these needs. 

Read the report here.