Health, Housing, and Data Matching

Health, Housing, and Data Matching

Todd M. Richardson, Acting General Deputy Assistant Secretary for Policy Development and Research.

The 1937 Housing Act recognized the linkage between health and housing, and a variety of housing programs over the years have focused on improving housing quality, improving accessibility of housing, and eliminating dangers such as lead paint. As Dr. Ben Carson has settled into the job as Secretary of HUD, his perspective as a physician has reinvigorated our thinking about this connection. As a tool to test our hypothesis about health and housing connections, we are proud of a new data linkage we have made between HUD’s administrative data on individuals who have received housing assistance over the years and two long-running health surveys administered by the National Center for Health Statistics (NCHS).

We describe this linkage in the recently released the Vital and Health Statistics Series 1 report, “Linkage of 1999–2012 National Health Interview Survey and National Health and Nutrition Examination Survey Data to U.S. Department of Housing and Urban Development Administrative Records.” Written by NCHS and HUD staff, this technical report reflects the collective subject-matter expertise and sustained effort of both HUD and NCHS research staff to provide data sources that can be used to examine the relationship between housing and health. The report summarizes data sources, methods used for the linkage, details of the resulting linked data files, linkage rates, and analytic considerations in using the linked data. This model interagency collaboration demonstrates the feasibility of linking cross-sectional population health survey data to longitudinal data from HUD’s administrative databases, and it aligns with the objectives and efforts of the recently released final report from the Commission on Evidence-Based Policymaking.

The NCHS-HUD Data Linkage enhances two population health surveys, the National Health and Nutrition Examination Survey and the National Health Interview Survey, by allowing researchers to examine the relationship between housing and health. These two surveys have already been linked to the Centers for Medicare & Medicaid Services administrative data and to mortality data from the National Death Index. This new linkage offers housing and health researchers a rich, new data source. Research proposal requests should be submitted to the NCHS Research Data Center.

Through this innovative, no-cost, win/win collaborative and strategic research partnership, new areas of research and insight are now being opened for the housing and health research community.* Using the NCHS-HUD linked data files, the analytic guidelines, and this report, analysts and researchers now have the data and documentation to effectively examine health conditions, health behaviors, access to health services, and the use of health services among those living in households that receive subsidized housing assistance.

This interagency data linkage project is a model for data sharing that aligns with U.S. Office of Management and Budget directives for sharing data across federal agencies to reduce respondent burden and improve federal programs and the health of the American people. Perhaps more important for researchers, the agencies, rather than building a one-time data linkage, are creating a sustainable linkage that will be continuously updated and enhanced. In mid-2018, NCHS and HUD will announce the release of the NCHS-HUD Data Linkage 2.0, which will update all survey and administrative data through 2016. Stay tuned for future updates on this initiative and related research activity.

* The following are some recent publications that have used the NCHS-HUD linked files.

K.A. Ahrens, B.A Haley, L.M. Rossen, P.C. Lloyd, and Y. Aoki. 2016. “Housing Assistance and Blood Lead Levels: Children in the United States, 2005–2012,” American Journal of Public Health 106(11), 2049–56.

D.L. Brucker, V. Helms, and T. Souza. 2017. “Health and Health Services Access Among Adults With Disabilities Who Receive Federal Housing Assistance,” Housing Policy Debate, 1–18.

A. Fenelon, P. Mayne, A.E. Simon, L.M. Rossen, V. Helms, P. Lloyd, J. Sperling, and B.L. Steffen. 2017. “Housing Assistance Programs and Adult Health in the United States,” American Journal of Public Health 107(4), 571–8.

V.E. Helms, B.A. King, and P.J. Ashley. 2017. “Cigarette smoking and adverse health outcomes among adults receiving federal housing assistance,” Preventive Medicine 99, 171–7.

V. Helms, B.L. Steffen, and J. Sperling. 2017. “A Health Picture of HUD-Assisted Adults: 2006–2012.”

A.E. Simon, A. Fenelon, V. Helms, P.C. Lloyd, and L.M. Rossen. 2017. “HUD Housing Assistance Associated With Lower Uninsurance Rates And Unmet Medical Need,” Health Affairs 36(6), 1016–23.