Does helping housing-insecure people pay rental deposits lead to lower healthcare use?
A new study says maybe.
- 3 min. read ▪ Published
At least four states, including California, have implemented rental housing deposit support as part of Medicaid benefits.
A new paper by authors at UC Berkeley School of Public Health and elsewhere evaluates whether this type of benefit, offered as part of a Whole-Person Care pilot program in California, led to changes in hospital, emergency department, outpatient, and other health care use.
“Interventions that provide housing directly, such as permanent supportive housing or hotel placements, have been shown to reduce health spending and hospital utilization,” according to the study’s authors. “Some evidence also indicates rental assistance is associated with lower odds of poor health, less psychological distress, and fewer unmet health care needs.” However, the health benefits of rental deposit assistance had not been previously quantified.
The study compared changes in health care use among 1,690 adults in Contra Costa County between October 2018 and December 2021. Half of the adults received housing deposit support along with case management; in which a professional works with a client to identify, coordinate, and advocate for services, which may span the medical, behavioral health, and social care systems. Half received only case management during that same time period. One-time moving transition costs for those who received them averaged $1,750 per recipient.
Both cohorts were made up of those who were housing insecure.
“About half of the individuals who received a deposit felt they were at risk of losing their housing within six months,” said lead author Margae Knox, currently a postdoctoral researcher at Kaiser Permanente Northern California. Knox received her doctorate in Health Policy from UC Berkeley School of Public Health in 2023. “The comparison group—who received case management only—reported similar levels of housing insecurity.”
Looking at results for both groups, health care use declined for all services in both the deposit group and the comparison group from six months before intervention to six months post intervention. The group who received housing deposits did not show a greater decrease in health care usage.
“This is a study to build on,” said Knox. “It’s important to understand how our policies are working. It’s a starting place to figure out how to make these programs work for the people who need them.”
Indeed, Knox and her fellow researchers write that “one explanation for similarities in health care use across both groups is that both groups received case management, minimizing the observed treatment effect for housing deposits.”
“It is still possible that deposits support better health and well-being, despite no identifiable differences in health care use between the deposit and comparison groups. For example, deposit recipients who transitioned to stable housing may have gained improved rest, a cleaner environment for health maintenance, kitchen access to cook cost-effective nutritious meals, and the ability to leverage food benefits and similar supports.”
Although some may think these more innovative Medicaid programs are being led by blue states. But Arizona and Arkansas have also invested in these rental deposit assistance programs.
