Paul Chung, MD, MS, Kaiser Permanente Bernard J. Tyson School of Medicine (KPSOM) Chair of Health Systems Science and Professor, is senior author of a longitudinal study published in the peer-reviewed journal Health Affairs that examines whether receiving housing assistance during childhood is associated with better health outcomes later in life. Using 52 years of nationally representative Panel Study of Income Dynamics data, a team of researchers followed individuals from preconception through middle adulthood and assessed adult obesity, diabetes, and hypertension.
The study was led by Jeffrey Colvin, MD, JD, Professor of Pediatrics, University of Missouri-Kansas City (UMKC) School of Medicine and Director of Research and General Academic Pediatrics at Children’s Mercy Kansas City. It included 588 people whose families received childhood housing assistance and 730 comparable people who did not. Propensity-score matching aligned the groups on income, demographics, neighborhood conditions, and receipt of other government benefits. Housing assistance included public housing, project-based subsidies and tenant-based vouchers, although the study could not distinguish the specific program each participant received.
"Previous research has shown that childhood is a critical period for establishing lifelong health, and that housing stability plays an important role in overall well-being,” said Chung. “Building on this evidence, we sought to better understand how childhood housing assistance may influence rates of major adult conditions."
Participants who received housing assistance for five or more years during childhood had a 69 percent lower risk of adult diabetes and a 39 percent lower risk of adult hypertension than those who never received assistance. Adjusted diabetes prevalence was 3.7 percent versus 11 percent, and adjusted hypertension prevalence was 19.6 percent versus 29.3 percent. The 9.7-point difference for diabetes was also observed for hypertension among participants whose families first received housing assistance during the preconception through infancy period.
Timing also mattered. Participants whose families first received housing assistance of any duration two years before birth through infancy had a 67 percent lower risk of diabetes and a 41 percent lower risk of hypertension in adulthood. First receipt at ages 1 through 5 was associated with a 77 percent lower risk of diabetes. First receipt at ages 6 through 17 was not significantly associated with any of the three outcomes.
No significant association was found between childhood housing assistance and adult obesity, regardless of timing or duration. This suggests that the observed diabetes and hypertension associations may operate through pathways other than lower weight, potentially including lower financial and housing-related stress, better living conditions, and improved access to health-supporting resources.
The findings support considering stable, affordable housing as a potential upstream public health strategy, particularly when assistance begins early and continues for several years. However, the study was observational and cannot establish causation. Self-reported outcomes, inability to distinguish housing-assistance types, changes in programs over time, and a relatively small sample may limit interpretation and generalizability. Despite these limitations, the findings indicate that early and sustained childhood housing assistance was associated with markedly lower adult diabetes and hypertension, but not obesity. Ultimately, the research suggests that “housing assistance deserves further consideration as a possible policy approach to address the rise of diabetes and hypertension in the U.S.”
Read the full study here .
