Evaluating the potential of a natural experiment to provide unbiased evidence of neighborhood effects on health

Benefit-Cost Analysis of an Innovative Program for Self-Sufficiency and Homeownership

BACKGROUND

Federal policy has increasingly sought to build financial capability, earnings, and assets of subsidized housing recipients.

OBJECTIVE

We conduct a benefit-cost analysis of the Denver Housing Authority's (DHA) innovative Home Ownership Program (HOP), which incentivizes participants to increase earnings, build wealth, and purchase homes.

RESEARCH DESIGN, SUBJECTS, AND MEASURES

In assessing HOP participant benefits (earnings, home-buying, and positive exits from DHA), we use parameter estimates from quasi-experimental methods (i.e., propensity score matching) that permit drawing causal inferences of program impacts. Impact estimates are robust to alternate model specification and mostly insensitive to omitted variable bias found in the social sciences. We deploy a comprehensive accounting framework, distinguishing benefits and costs accruing to program participants, nonparticipants (other citizens, taxpayers, and governments), and society as a whole. We use Monte Carlo simulation techniques to approximate distributions of benefit and cost parameters, thereby ascertaining how reliably participation in HOP yielded net benefits compared to if families had continued to receive housing assistance during the same period.

RESULTS

We estimate a net social benefit from HOP of US$6,015 per participant. The simulated standard deviation was only a third of this value and 99.9% of simulations returned positive net social benefits.

CONCLUSION

We conclude with a high degree of statistical confidence that HOP produced substantial net benefits to society as a whole, program participants, and nonparticipants alike. HOP offers strong potential for poverty alleviation among housing subsidy recipients and should be replicated.

The Use of Geographic Data to Improve Asthma Care Delivery and Population Health

The authors examine uses of geographic data to improve asthma care delivery and population health and describe potential practice changes and areas for future research.

A review of neighborhood effects and early child development: How, where, and for whom, do neighborhoods matter?

This paper describes a scoping review of 42 studies of neighborhood effects on developmental health for children ages 0-6, published between 2009 and 2014. It focuses on three themes: (1) theoretical mechanisms that drive early childhood development, i.e. how neighborhoods matter for early childhood development; (2) dependence of such mechanisms on place-based characteristics i.e. where neighborhood effects occur; (3) dependence of such mechanisms on child characteristics, i.e. for whom is development most affected. Given that ecological systems theories postulate diverse mechanisms via which neighborhood characteristics affect early child development, we specifically examine evidence on mediation and/or moderation effects. We conclude by discussing future challenges, and proposing recommendations for analyses that utilize ecological longitudinal population-based databases.