Date of Award

January 2024

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Danya E. Keene

Second Advisor

Andrew Fenelon

Abstract

Introduction: Crowded living conditions are associated with many negative health outcomes, with significant implications for children, as they are particularly shaped by their home environment and more likely to live in crowded conditions, given their larger household size. How rental assistance programs may shape and improve household crowding has not been previously explored. Methods: This study leveraged data from NHANES linked with HUD administrative rental assistance records. We examined changes in crowding measures in U.S. children using linear and logistic regression models stratified by different rental assistance program types. Results: There was a statistically significant 40 percentage point reduction in the odds of crowding for those currently receiving HUD assistance compared to the pseudo-waitlist or those who will receive rental assistance within two years of their NHANES interview (95% CI, 0.39 to 0.93). For public housing residents, there was a 13 percentage point decline in the percentage of households experiencing overcrowding (95% CI, -0.24 to -0.03), decreases in household size (β = -0.45; 95% CI, -0.77 to -0.14), and an increase in rooms per person (β = 0.12; 95% CI, 0.01 to 0.22). For multifamily housing residents, there was a decrease in household size (β = -0.59; 95% CI, -1.06 to -0.13) and total number of rooms (β = -0.57; 95% CI, -0.94 to -0.19]). For HCV recipients, there was an 8 percentage point reduction in the percentage of households experiencing overcrowding, an increase in the total number of rooms (β = 0.25; 95% CI, 0.03 to 0.48), and an increase in rooms per person (β = 0.12; 95% CI, 0.03 to 0.22). Conclusion: Rental assistance reduces crowding in children—both continuous and dichotomous measures show this. These reductions are found for both HCV recipients and public housing residents. For HCVs, this reduced crowding appears to reflect an increased number of rooms, whereas for public housing residents, this reduced crowding seems to reflect decreased household size. These program-specific differences illustrate that rental assistance can reduce crowding through different mechanisms, and the effects can be nuanced.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/07/2026

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