Category: Neighborhood and Built Environment

11 - The National Health Interview Survey Linked with HUD Administrative Data: Examining the Unique Health Care Needs of HUD-Assisted, Elderly Adult Tenants, 2006-2012

Objective. Quantify the unique healthcare needs of HUD-assisted, elderly adults.

Background. Housing is an important social determinant of health that can serve as an intervention space to promote aging in place. The U.S. Department of Housing and Urban Development (HUD) annually provides housing rental assistance to approximately 10 million low-income individuals.  Using the HUD definition of elderly, approximately one-third (34%) of HUD-assisted households are headed by elderly adults.

Methods. Prior to a recent interagency data linkage effort, HUD could not quantify the healthcare needs of HUD-assisted seniors. In collaboration with the National Center for Health Statistics, the National Health Interview Survey (NHIS) was linked with HUD administrative data for the agency’s largest rental assistance programs: public housing, the housing choice voucher program, and multifamily housing programs. Using this data, the characteristics of 2,324 elderly adults who resided in HUD-assisted properties at the time of their health interview were examined.

Results. Almost half (46.6%) of HUD-assisted, elderly adults self-reported their health as fair or poor and most (84.1%) reported living with disability. Nearly one-fifth (17.2%) of elderly adults reported that they had visited the emergency room two or more time during the prior year. HUD-assisted, elderly adults are high utilizers of the health care system and reported high rates of visiting health professionals. Most (86.1%) elderly adults reported visiting a general doctor during the past year while almost half (40.7%) reported visiting a specialist during the prior year. The sample also reported high rates of chronic health conditions and diagnoses. For example, 15.0% had current asthma at the time of their health interview. Among those with current asthma, 39.5% reported having an asthma attack during the prior year.  Approximately one-third (31.9%) reported having ever been diagnosed with diabetes. Oral health appeared to be a primary concern for HUD-assisted, elderly adults as 41.9% reported having no natural teeth at the time of their health interview. According the body mass index calculations, most (66.4%) HUD-assisted, elderly adults were obese at the time of their health interview.

Conclusion.  Results suggest that elderly, HUD-assisted adults have unique health care needs that can be better addressed to promote aging in place. Corresponding strategies to utilize housing as a platform to improve quality of life, such as the utilization of supportive services and the development of cross-sector relationships, should be employed.


Veronica Helms

Social Science Analyst
U.S. Department of Housing and Urban Development, Office of Policy Development & Research
Washington, District of Columbia

Veronica Helms, MPH, is a Social Science Analyst with the U.S. Department of Housing and Urban Development (HUD), Office of Policy Development and Research (PD&R), Office of Research, Evaluation and Monitoring (OREM). Veronica is also a part-time doctoral candidate in Health Equity and Social Justice at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on the link between housing and health, social determinants of health, data linkage, and maternal and child health populations.