WASHINGTON, D.C., October 5, 2004—Residents of distressed public housing suffer from alarmingly high rates of many chronic health problems, new Urban Institute research shows.
The prevalence of health maladies in households in the federal HOPE VI program—headed mostly by poor African-American women—is significantly higher than national rates and those for all black women. The study of residents from five HOPE VI developments found
- 47 percent of adults are obese, compared with 33 percent of black women nationally;
- 37 percent have hypertension, versus 21 percent of all African-American women;
- 15 percent are diabetic, 7 percentage points above the figure for U.S. black women; and
- 22 percent have asthma, versus 11 percent for black women across the country.
Forty-one percent of HOPE VI respondents reported being in fair or poor health. That is more than three times the rate reported by all adults and about twice that of black women nationally. Apart from adults' own health concerns, 9 percent of households have at least one child in fair or poor health and 25 percent of children have asthma, about double the national estimate for all children.
"The geographic concentration of this population with severe health problems is an opportunity for health programs to serve this group efficiently," researchers Laura Harris and Deborah Kaye note in their health brief. But "whatever their underlying cause, these problems are not likely to dissipate quickly, or perhaps ever, after moving from the distressed HOPE VI development. These health problems will affect many residents' ability to relocate and achieve economic self-sufficiency."
The Urban Institute is tracking the well-being of residents from the Ida B. Wells Homes in Chicago; Shore Park Terrace in Atlantic City, New Jersey; Easter Hill in Richmond, California; East Capitol Dwellings in Washington, D.C.; and Few Gardens in Durham, North Carolina. Residents, 61 percent of whom moved to new homes, were surveyed in 2001, when revitalization began at the sites, and again in 2003. Additional surveys are planned.
Income and Employment
While the primary goal of HOPE VI is improving the living environment of public housing residents, it also aims to help them move toward self-sufficiency through new or better jobs.
However, employment rates barely budged, Diane Levy and Deborah Kaye point out in their income and employment analysis, registering 45 percent in 2001 and 46 percent in 2003.
For those working, the share reporting income above $15,000 rose from 32 percent to 42 percent. But the situation for those not working deteriorated: 86 percent in 2001 and 92 percent in 2003 reported income below $15,000.
Poor health and the need to care for young children were the most significant job barriers. Thirty percent of those in poor health were employed in 2003, compared with 46 percent of all adult respondents. Of the unemployed with children under age 6, 34 percent reported that child care problems affected their ability to take or keep a job, compared with 14 percent of similar employed respondents.
How Are the Children Doing?
Children who moved from a HOPE VI site, Susan Popkin, Michael Eiseman, and Elizabeth Cove conclude, generally live in better housing in safer neighborhoods and attend schools that are less poor and higher quality. Parents who used vouchers to secure private-market housing were less likely than other movers to report problems with local schools and more likely to perceive their children's schools as safe.
Relocation did not necessarily ameliorate children's emotional circumstances. In 2001, 54 percent of children had two or more behavior problems, a rate about 10 percentage points higher than that of poor children nationally. Two years later, the figure was unchanged. Parents who stayed put or who relocated with vouchers reported some improvements in their children's behavior, but parents who moved to other public housing reported increases in their children's behavior problems.
Parents who attend school meetings and after-school activities and those who have graduated from high school or acquired a GED were more likely to report that their children were highly engaged in school, less likely to report that their children had been held back in school, and less likely to report behavior problems.
Policy Implications: Putting It All Together
The research suggests many ways housing authorities can assist residents seeking to return to HOPE VI sites, boost their employment, improve their health, and develop their financial self-sufficiency. These include the following:
- When planning redevelopment, account for households with health problems, particularly those that limit physical mobility.
- Assess health barriers to employment and provide access to care.
- Make occupancy criteria flexible, since tenancy guidelines that require employment would bar over half of HOPE VI residents from returning to revitalized sites.
- Offer safe and affordable child care in residents' neighborhoods.
- Encourage families with children to choose vouchers and offer them ongoing supportive services to help them adjust to their new communities.
- Do not ask participating families to move during the school year.
The HOPE VI Panel Study
In summer 2001, the Urban Institute conducted a baseline survey of 887 heads of households. A second wave, involving 736 households, was undertaken in 2003. "How Are HOPE VI Families Faring? Income and Employment," by Diane Levy and Deborah Kaye, is the fourth brief from the HOPE VI Panel Study. It is available at http://urban.org/url.cfm?ID=311072. "How Are HOPE VI Families Faring? Health," by Laura Harris and Deborah Kaye, can be found at http://urban.org/url.cfm?ID=311073. "How Are HOPE VI Families Faring? Children," by Susan Popkin, Michael Eiseman, and Elizabeth Cove, is at http://urban.org/url.cfm?ID=311074.
The U.S. Department of Housing and Urban Development, the John D. and Catherine T. MacArthur Foundation, the Annie E. Casey Foundation, the Rockefeller Foundation, the Robert Wood Johnson Foundation, the Fannie Mae Foundation, the Ford Foundation, and the Chicago Community Trust have provided funding for the HOPE VI Panel Study.
The Urban Institute is a nonprofit, nonpartisan policy research and educational organization that examines the social, economic, and governance challenges facing the nation.
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