Vouchers May Be Insufficient to Facilitate Upward Mobility for Families with Health Vulnerabilities without Additional Relocation Services

A study published in Housing Policy Debate, “Does Poor Health Influence Residential Selection? Understanding Mobility among Low-Income Housing Voucher Recipients in the Moving to Opportunity Study,” evaluates the association between health and the upward residential mobility of families participating in the Moving to Opportunity for Fair Housing Demonstration Project (MTO) Study. The research finds that traditional, unrestricted Section 8 voucher recipients with health vulnerabilities were less likely to experience upward mobility over time compared to healthy recipients. However, families who received Section 8 vouchers that were geographically restricted to low-poverty neighborhoods and coupled with counseling experienced greater upward mobility over time, regardless of health status.

The researchers analyzed individual- and family-level data from 3,526 families who participated in the HUD-sponsored MTO study, a randomized controlled trial involving families with children under 18 who lived in public housing in five U.S. cities (Baltimore, Boston, Chicago, Los Angeles, and New York). Participating families were assigned to one of three groups: one comprising participants who received a “traditional” (geographically unrestricted) Section 8 Housing Choice Voucher; another comprising participants who received a geographically restricted Section 8 voucher that could only be used in “low-poverty” areas with a Census Tract poverty rate below 10% and that were coupled with counseling services to help with relocation; and a control group comprising participants who remained in public housing.

The MTO study included a baseline survey at the start of the study (1994-1998) and a follow-up survey (2001-2002). The researchers classified a family as having a health vulnerability if, at baseline, the family reported that someone in the household had a disability, or if a child in the household had a health issue related to special needs, development, mental or physical health, or a learning disability. To evaluate residential upward mobility, the researchers operationalized data from the Child Opportunity Index (COI), which classifies neighborhood opportunity as “very low,” “low,” “moderate,” “high,” and “very high” based on 19 indicators related to educational, health, environmental, social, and economic conditions.

The researchers first assessed whether MTO families used their vouchers to move into higher-opportunity neighborhoods. They found that regardless of health status, MTO voucher type was the strongest indicator of neighborhood opportunity over time. When the study began, over 70% of all MTO families lived in very-low-opportunity neighborhoods. Between baseline and follow-up, all MTO families who received a voucher experienced greater gains in neighborhood opportunity than the control families who remained in public housing. However, families who received the low-poverty vouchers coupled with counseling services were significantly more likely to move to higher-opportunity neighborhoods (on average) than those who received a traditional, unrestricted voucher.

The researchers further analyzed the three-way relationship between MTO voucher type, baseline health status, and time. They found that among MTO participants who received a low-poverty voucher coupled with counseling services, healthy families initially moved to higher-opportunity neighborhoods compared to families with health vulnerabilities. Over the study period, however, these two groups ended up in neighborhoods with similar average opportunity indices, regardless of health status. Conversely, healthy traditional, unrestricted voucher recipients remained in higher-opportunity neighborhoods over time compared to the control group, whereas traditional, unrestricted voucher recipients with health vulnerabilities eventually returned to lower-opportunity neighborhoods similar to those of the control group.

The researchers conclude that families with health vulnerabilities may struggle to obtain and sustain upward mobility for myriad reasons, including social and health ties to their original communities, health-related expenses, and limited bandwidth to find and relocate to better neighborhoods. The researchers speculate that the coupling of relocation and housing counseling services provided with the low-poverty vouchers may have reduced or eliminated barriers to sustaining upward mobility for these families. They call on housing mobility programs to provide in-depth client-needs assessments and tailored housing-mobility counseling that includes addressing family health issues. 

Read the article at: https://bit.ly/3T83an8