HUD Rental Assistance Programs May Reduce Overcrowded Living Conditions for Children
May 27, 2025
A recent article published in the Journal of Urban Health, titled “Do Rental Assistance Programs Relieve Overcrowding for Children?” examined how rental assistance programs impact overcrowding in households with children. As of 2022, nearly 4.5 million U.S. households were considered overcrowded – defined as having more than one person per room (PPR). Low-income renters are particularly vulnerable to overcrowding, often because they are forced to rent units too small for their household size or because they must “double up” with others to afford a place to live. The authors found that children in households receiving rental assistance were significantly less likely to live in overcrowded conditions relative to households that received rental assistance two years later, indicating that expanding access to rental assistance through increased funding could help alleviate crowding for families with children.
Researchers analyzed data from children under 18 whose households participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. About two-thirds (2,560) of the children lived in households receiving rent subsidies from the U.S. Department of Housing and Urban Development (HUD) at the time of their participation in NHANES, while the remainder (1,167 children) lived in households that were not subsidized at the time but received HUD assistance within two years. The authors considered the latter group a proxy for households waitlisted for HUD assistance and referred to them as a “pseudo waitlist” group. The NHANES data were combined with HUD administrative records documenting the type of assistance households received – i.e., public housing, Housing Choice Vouchers (HCV), and multifamily housing – and when they entered or exited the program.
The study found significant differences in occupancy conditions for children living in HUD-assisted households relative to pseudo-waitlisted households. “Waitlisted” households experienced significantly higher rates of crowding, with 25.7% having one or more residents per room compared to just 17.5% of assisted households. Regression models that controlled for factors like age, race, and family-income-to-poverty-ratio were used to predict the effect of rental assistance on occupancy conditions and suggested that children receiving HUD assistance were 8% less likely to live in a crowded household than those not receiving assistance. The authors found no significant differences in household size or the total number of rooms in the household between those receiving assistance and those “waitlisted.”
The authors also examined differences by program type, considering “waitlisted” households under the program through which they would later receive assistance. Among households receiving HCV, they found an 8% reduction in the group experiencing crowding relative to “waitlisted” households, which they attributed to a significant increase in the total number of rooms in the housing unit without a change in household size. Among households in public housing, there was a reduction in the group experiencing crowding of 13% relative to “waitlisted” households. In contrast to HCV households, this may be a result of a significant decrease in household sizes; the authors explain that families in doubled-up living situations may have moved into their own public housing unit, decreasing household size. No significant differences were found between households in multifamily housing and “waitlisted” households.
Overall, the study indicates that rental assistance may reduce crowding in households with children. Specifically, the findings suggest that HCVs may help families obtain rental units with more living space, while public housing may allow families to leave doubled-up living situations. The authors recommend that more research be conducted into why multifamily housing assistance does not reduce crowding, as this has important implications for HUD’s Rental Assistance Demonstration (RAD) program, which aids the conversion of public housing to multifamily housing. The authors conclude that increasing funding and capacity of HUD’s rental assistance programs could meaningfully reduce crowding and the associated negative impacts to children’s health and well-being.
Read the full report at: https://bit.ly/4kufadG.