The cost-effectiveness of limiting federal housing vouchers to use in low-poverty neighborhoods in the United States.

Clicks: 297
ID: 91727
2020
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Abstract
Residents of low-income neighborhoods are exposed to relatively higher rates of crime, fewer opportunities to exercise, poorer schools, and few opportunities to eat healthy foods than residents of middle-class neighborhoods. Policies that influence neighborhood context could therefore serve as health interventions. We seek to inform the policy debate over the wisdom of spending health dollars on non-health sectors of the economy by defining the opportunity cost of doing so.Cost-effectiveness analysis with Markov model and Monte Carlo simulation.We assess the long-term health and economic benefits of Moving to Opportunity-type housing vouchers vs traditional public housing. Our Markov model draws heavily from decades of follow-up data from a large randomized-controlled trial, from which we make projections about health outcomes and costs.Restricted housing vouchers cost less over the lifetime of recipients than traditional vouchers ($186,629 [95% credible interval: $148,856-$229,235] vs $194,077 [$153,831-$240,904]), while improving health and longevity (19.39 quality-adjusted life years [15.83-21.35] vs 19.16 [15.65-21.03]). Over 99% of the model simulations favored restricted housing vouchers over traditional public housing or non-restrictive vouchers.Restrictive vouchers appear to improve population health, save money, and save lives.
Reference Key
zafari2020thepublic Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Zafari, Z;Muennig, P;
Journal Public health
Year 2020
DOI
S0033-3506(19)30276-8
URL
Keywords
cost-effectiveness analysis income and health

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