Understanding the Structural Determinants of Population Health: Housing Assistance and Lead Exposure in the United States

Most research on housing and health focuses on housing affordability and stability, although housing quality remains an important determinant of child health disparities. Federal housing assistance programs, particularly public housing, have received recent criticism for quality concerns, especially those related to lead. We use NHANES data linked to HUD administrative records and a quasi-experimental approach to study the effects of housing assistance programs on blood lead levels. We find that current housing assistance recipients have significantly lower blood lead (1.06 µg/dL) than those who would enter within 2 years (1.21 µg/dL), a 12% reduction. This protective effect was strongest for public housing (20% reduction), and for non-Hispanic white individuals (21% reduction). These findings indicate not only that housing assistance can be a valuable means to reduce lead exposure. Additionally, public housing appears to receive a greater amount of criticism about quality concerns than may be warranted given actual quality.