The impact of the low-income housing tax credit on children's health and wellbeing in Georgia

Affordable Housing and Neighborhood Child Maltreatment Reports

Reports of child maltreatment vary by neighborhood characteristics, yet the influence of housing affordability is less understood. The current study examines the relationship between reports of suspected child maltreatment and the spatial distribution of affordable housing across 2,341 census tracts in Los Angeles County, California. Bayesian conditionally autoregressive model results indicate that neighborhoods where residents paid a greater share of their income in rent had fewer reports of suspected child maltreatment, while neighborhoods with a higher number of subsidized rental units had more reports. These findings suggest that higher cost neighborhoods provide supportive resources and amenities to families which may reduce risk of child maltreatment. Subsidized housing units are more likely to be located in high poverty, under resourced neighborhoods, thus undermining the benefits of these programs to families. These findings have implications for equitable housing policy that promotes inclusive communities as a primary prevention strategy for child maltreatment.

Addressing Racial Disparities in Pregnancy-Related Deaths: An Analysis of Maternal Mortality-Related Federal Legislation, 2017-2021

There has been increasing national attention to the issue of racial disparities in pregnancy-related deaths. Federal legislation can support approaches at multiple levels of intervention to improve maternal health. As part of the CDC Policy Academy, a team of CDC staff completed a policy analysis to determine the approaches addressed in federal legislation to reduce racial disparities in pregnancy-related deaths. We analyzed federal maternal mortality legislation introduced January 2017 through December 2021. Common approaches addressed by the legislation were categorized into themes and reviewed for their alignment with approaches identified in clinical and public health literature to reduce pregnancy-related deaths, with an emphasis on social determinants of health (SDOH) approaches and reducing racial disparities. Thirty-seven unduplicated bills addressed pregnancy-related deaths, including 27 House or Senate bills that were introduced but not passed, 6 resolutions highlighting the maternal health crisis, 2 bills that passed the House only, and 2 bills enacted into law (Preventing Maternal Deaths Act of 2018 and Protecting Moms Who Served Act). The most common themes mentioned in federal legislation were improving maternal health care, addressing health inequities and SDOH, enhancing data, and promoting women's health. Legislation focused on health inequities and SDOH emphasized implicit bias training and improving SDOH, including racism and other social factors. The reviewed federal legislation reflected common clinical and public health approaches to prevent pregnancy-related deaths, including a significant focus on reducing bias and improving SDOH to address racial disparities.

Examining Health Care Access And Health Of Children Living In Homes Subsidized By The Low-Income Housing Tax Credit

Although stable, high-quality housing improves children's physical and social-emotional health, little is known about the health of children living in buildings financed by the federal government's primary tool for constructing and renovating affordable rental housing: the Low-Income Housing Tax Credit (LIHTC). Using data from the National Health Interview Survey (2004-16) linked to data on LIHTC properties (1987-2016), this study provides national estimates for health care access and health status among low-income children living in LIHTC properties compared with low-income children not living in LIHTC properties. Children living in LIHTC properties were more likely to have had a well-child visit in the past twelve months and a dental visit in the past six months. These children also had a higher likelihood of chronic school absenteeism and current asthma. These exploratory findings suggest that policy makers should consider features of LIHTC policy as possible mechanisms to improve low-income children's health care access and health status while addressing the shortage of affordable housing in the US.

The Association of Low-Income Housing Tax Credit Units and Reports of Child Abuse and Neglect

INTRODUCTION

Poverty broadly and financial stress owing to housing insecurity specifically are associated with an increased risk of child maltreatment. Therefore, it is possible that a program designed to increase access to affordable housing such as the Low-Income Housing Tax Credit program could reduce child maltreatment. The purpose of this study is to examine the association of the availability of housing units through the Low-Income Housing Tax Credit Program with the rates of child maltreatment reports, including reports for physical abuse and neglect, at the state and county levels.

METHODS

Data were from the 2005‒2015 National Child Abuse and Neglect Data System and the Low-Income Housing Tax Credit Program database. Generalized estimating equations were conducted in 2021 to calculate rate ratios and 95% CIs, adjusting for relevant confounders.

RESULTS

At the state level, ≥25 compared with <25 Low-Income Housing Tax Credit Program units per 100,000 population was associated with a lower rate of overall child maltreatment (i.e., neglect and physical abuse; rate ratio=0.96, 95% CI=0.93, 0.99), neglect (rate ratio=0.96, 95% CI=0.94, 0.99), and physical abuse (rate ratio=0.96, 95% CI=0.93, 1.00) reports. Similarly, at the county level, ≥1 compared with 0 Low-Income Housing Tax Credit Program units per 100,000 population was associated with a lower rate of overall child maltreatment (rate ratio=0.94, 95% CI=0.92, 0.97), neglect (rate ratio=0.96, 95% CI=0.93, 0.98), and physical abuse (rate ratio=0.94, 95% CI=0.91, 0.98) reports.

CONCLUSIONS

Increasing access to affordable housing may be an effective strategy to reduce child maltreatment at both the state and county levels.