Poor Health: Adding Insult to Injury for HOPE VI Families

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Abstract

At every age level, HOPE VI Panel Study respondents are much more likely than other adults overall to describe their health as fair or poor; the rates are even higher than those of black women, a group with higher-than-average rates of poor health. HOPE VI Panel Study respondents suffer many serious conditions including arthritis, asthma, depression, diabetes, hypertension, and stroke at rates twice as high as black women nationally; a significant number of HOPE VI Panel Study respondents also face the burden of multiple serious health problems. And the death rate of HOPE VI residents far exceeds the national average of black women, with the gap increasing dramatically at older ages. These findings imply an urgent need for better and more comprehensive support for families as they undergo the stress of involuntary relocation.

Introduction

Congress created the HOPE VI program in 1992 to address the myriad problems in distressed, urban public housing developments: deteriorating physical conditions; rampant drug dealing and violent crime; and a resident population with high rates of unemployment, welfare receipt, and teen pregnancy, and low levels of education and literacy (see text box on page 9). HOPE VI, now up for reauthorization, differed from earlier attempts to improve conditions in federally subsidized public housing because it explicitly included a focus on resident well-being rather than simply focusing on improving buildings. Specifically, the program sought to help residents achieve selfsufficiency—that is, to become employed and leave the welfare rolls. To help achieve this goal and provide support to residents during the revitalization process, HOPE VI mandated that sites use a portion of their grants to provide residents with what they called "community supportive services." Although there was no official requirement for what these services should consist of, generally, housing authorities chose to focus their efforts on employment- and education-related programs (Popkin et al. 2004).

But concentrating service resources on employment-related programs assumes that residents actually are able to work, particularly at the kinds of physically demanding jobs available to low-skilled workers, such as nursing assistants, housekeepers, and restaurant servers. Further, it assumes that not having a job and being self-supporting is the biggest challenge facing residents. But findings from the HOPE VI Panel Study suggest that poor health is an even more serious problem for these families than lack of employment.

Because of well-documented links between physical environment and resident well-being, the HOPE VI Panel Study has focused intensively on residents' physical and mental health since it began in 2001. As a result, the study has become the most comprehensive source of information on public housing residents' health available. The HOPE VI Panel Study tracks a sample of 887 residents from five distressed public housing developments that were slated for redevelopment in 1999 and 2000 (see text box on page 9). We surveyed residents before relocation in 2001, and again in 2003 and 2005. In each round of surveys, we asked respondents a series of questions about their overall health status.

(End of excerpt. The complete brief is available in PDF format.)

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

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