September 2006

Grant Results

SUMMARY

From 2003 to 2004, researchers from the Urban Institute, Washington, assessed the health status of residents who were relocated as part of a federal program — called HOPE VI — to demolish decaying public housing developments and replace them with mixed-income housing.

The Urban Institute is a nonprofit, nonpartisan organization that conducts research on social and economic issues affecting America's cities and urban populations.

Key Findings
Project staff reported the following findings in the 2004 report, How Are HOPE VI Families Faring? Health:

  • The overall health of those in the HOPE VI survey is significantly worse than the general population. Forty-one percent reported their health as fair or poor, a rate more than three times greater than self-reports among all adults nationally and twice that of black women nationally.
  • About one-quarter (28 percent) of adults reported at least one of the five health problems targeted in the study (obesity, hypertension, diabetes, arthritis or asthma). Forty-four percent of adults reported two or more of these chronic health conditions.
  • Nine percent of households have at least one child between ages eight and 16 in fair or poor health, a rate three times higher than the national figure.
  • Some 17 percent of respondents reported that they had experienced a major depressive episode in the previous year, a rate almost three times higher than that observed among women nationally.
  • Health problems prevented many respondents from carrying out ordinary daily physical activities. Half (51 percent) reported difficulty with physical mobility, including such activities as walking up stairs or standing for long periods. More than one-quarter said their physical health prevented them from working or attending education or training activities.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $380,261 in support of the project from January 2003 through June 2004.

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THE PROBLEM

The HOPE VI program is the major federal initiative designed to transform public housing developments nationwide. Under HOPE VI, distressed and decaying public housing developments are being demolished and residents are being relocated to new mixed-income housing.

As part of its Hope VI Panel Study, researchers from the Urban Institute have been tracking the living conditions and well-being of residents from five developments where revitalization activities began in mid-to-late 2001 (see Appendix 2 for sites).

In a 2002 survey, the researchers found that both adults and children were in poor health overall, with many respondents suffering from multiple chronic conditions that required ongoing care and created significant barriers to employment (see Appendix 3 for more detail). The baseline findings suggested that researchers needed to include more detailed and comprehensive measures of health status among adults and children during its next wave of data collection.

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RWJF STRATEGY

The project was part of RWJF's Vulnerable Populations portfolio, which supports RWJF's long-standing interest in the health and well-being of vulnerable populations. Programs and projects within the portfolio aim to promote innovative community-based solutions that, in combination with social factors, affect health and health care outcomes for society's most vulnerable people.

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THE PROJECT

The Urban Institute conducted the second wave of its longitudinal study assessing the health of families that were relocated as a result of the Hope VI program. The longitudinal study used multiple methods, including surveys with heads of households, in-depth interviews with parents and children, interviews with local housing authority staff, analysis of administrative records and comparisons with other studies.

Project staff subcontracted with Abt Associates, a government and business research and consulting firm located in Cambridge, Mass., to collect data in 2003 for the second phase of the panel study. Researchers completed data collection and analysis on 736 parent-child pairs, representing 85 percent of the adults and children from the baseline study. Health questions in the survey focused on obesity, hypertension, diabetes, arthritis and asthma.

The RWJF grant allowed the researchers to include a broader range of questions on health and risk factors than would otherwise have been possible, the researchers say. Because of differences in the way questions were asked, results from the first and second waves of the study are not comparable.

In addition to RWJF, seven other organizations supported the Hope VI Panel Study (see Appendix 3 for a list).

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FINDINGS

Project staff reported the following findings in the 2004 report, How Are HOPE VI Families Faring? Health:

  • The overall health of those in the HOPE VI survey is significantly worse than the general population. Forty-one percent reported their health as fair or poor, a rate more than three times greater than self-reports among all adults nationally and twice that of black women nationally.
  • About one-quarter (28 percent) of adults reported at least one of the five health problems targeted in the study (obesity, hypertension, diabetes, arthritis or asthma). Forty-four percent of adults reported two or more of these chronic health conditions.
    • Obesity was the most common health problem reported, with almost half (47 percent) of the respondents classified as obese.
    • Over one-third (37 percent) of the adults said they had hypertension. Younger blacks (those 18 to 44 years old) were twice as likely to have hypertension as black women nationally.
    • Fifteen percent of respondents had diabetes, a prevalence that is 30 percent higher than that for black women nationally.
    • More than one in four adults (28 percent) said they had arthritis, a rate slightly higher than that for adults nationally.
    • Nearly one-quarter (22 percent) said they had asthma, a rate twice as high as that observed nationally.
  • Nine percent of households have at least one child between ages eight and 16 in fair or poor health, a rate three times higher than the national figure.
  • Some 17 percent of respondents reported that they had experienced a major depressive episode in the previous year, a rate almost three times higher than that observed among women nationally.
  • Health problems prevented many respondents from carrying out ordinary daily physical activities. Half (51 percent) reported difficulty with physical mobility, including such activities as walking up stairs or standing for long periods. More than one-quarter said their physical health prevented them from working or attending education or training activities.

Recommendations

Project staff made the following recommendations in How Are HOPE VI Families Faring? Health:

  • To help the residents of HOPE VI cope with the stresses of relocation, assistance is critical, particularly for those with health problems. Before, during and after residents move from their original public housing development, housing authorities have the opportunity to offer them supportive services, especially those related to mental health problems.
  • HOPE VI sites need to consider the prevalence and type of health issues when planning for redevelopment. Housing authorities need to adequately assess the needs of the population eligible to live in the revitalized units to accommodate those with health problems, especially in regard to physical mobility.
  • Housing authorities need to have reasonable expectations for economic self-sufficiency among residents. Many residents have severe limitations on their ability to work, which could mean that they are ineligible to move to new HOPE VI housing units unless work requirements at the new sites allow exceptions for dealing with chronic health problems.

Communications

Project staff disseminated two policy briefs, HOPE VI Panel Study: Baseline Report (published in 2002, before the grant) and How Are HOPE VI Families Faring? Health (2004) to about 1,000 researchers, practitioners, housing authorities, policy-makers and members of Congress on their mailing lists. The project director made several presentations at the annual meetings of the Urban Affairs Association and the National Low Income Housing Coalition Housing Policy Conference. Project staff conducted forums at several of the foundations that funded the study. At the invitation of HUD, project staff held a meeting in Atlantic City for 12 regional housing authorities charged with implementing supportive services to HOPE VI residents. See details of publications in the Bibliography.

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LESSONS LEARNED

  1. There are special challenges in tracking and interviewing public housing residents. Tracking residents for the second phase of the study entailed searching public databases, requesting periodic updates from housing authorities, using data from the federal Department of Housing and Urban Development (HUD) and mailing postcards to residents quarterly. In the field, interviewers were selected because they were comfortable working in low-income communities and were demographically similar to respondents. Some public housing residents have worked successfully as interviewers. (Project Director)

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AFTER THE GRANT

The HOPE VI Panel Study is a longitudinal study planned to extend through 2006. The third wave of data collection is expected to begin in spring 2005.

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GRANT DETAILS & CONTACT INFORMATION

Project

Longitudinal Examination of Public Housing Transformation on the Health of Poor Families

Grantee

Urban Institute (Washington,  DC)

  • Amount: $ 380,261
    Dates: January 2003 to June 2004
    ID#:  047047

Contact

Susan J. Popkin
(202) 261-5751
SPopkin@ui.urban.org

Web Site

http://www.urban.org

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Funders of the HOPE VI Panel Study

  • Annie E. Casey Foundation, $600,000, 2001–2004
  • Chicago Community Trust, $141,000, 2002–2003
  • Fannie Mae Foundation, $95,962, 2002–2004
  • Ford Foundation, $505,000, 2002–2004
  • John D. and Catherine T. MacArthur Foundation, $854,500, 2000–2005
  • Robert Wood Johnson Foundation, $380,261
  • Rockefeller Foundation, $295,692, 2002–2004
  • U.S. Department of Housing and Urban Development, $1.2M awarded in 2000


Appendix 2

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Study Sites

  • Shore Park/Shore Terrace, Atlantic City, N.J.
  • Ida B. Wells Homes/Wells Extension/Madden Park Homes, Chicago, Ill.
  • Few Gardens, Durham, N.C.
  • Easter Hill, Richmond, Calif.
  • East Capitol Dwellings, Washington, D.C.


Appendix 3

Highlights of Baseline Study on Health

According to the HOPE VI Panel Study: Baseline Report published in 2002:

  • Adult respondents reported dramatically lower overall health status than national averages.
  • More than one-third of adult respondents reported having a chronic illness or health condition such as high blood pressure, diabetes or arthritis.
  • Asthma is a serious problem for the respondents, with more than one in five adults having been diagnosed with asthma.
  • Poor mental health among adults is a widespread problem. Nearly one-third of the respondents (29 percent) reported poor mental health, a level that is almost 50 percent higher than the national average. Further, nearly one in six adult respondents had experienced a major depressive episode within the past 12 months.
  • Children in the HOPE VI Panel Study are in worse health than other children their age. Their parents reported substantially lower health ratings than for children in national samples. Asthma is a serious problem. One in five children between the ages of 6 and 14 had been diagnosed with asthma; the figure for younger children is one in four, more than three times the national average.
  • Parental reports about children's behavior suggest that mental health is also an issue. About two-thirds of the older children (age 6 to 14) have one or more reported behavior problems; about half have two or more. Further, a quarter of the older children have been suspended or expelled from school.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Book Chapters

Popkin SJ and Cunningham MK. "Demolition and Struggle: Public Housing Transformation in Chicago and the Challenges for Residents." In Housing Race and Regionalism: Re-thinking the Geography of Race in America, Xavier De Souza Briggs (ed.). Unpublished.

Popkin SJ. "The HOPE VI Program: What Has Happened to the Residents?" In Where are Poor People to Live: Transforming Public Housing Communities (Cities and Contermporary Society). Bennett L, Smith JL and Wright PA (eds.). New York: M.E. Sharpe, Inc., 2006.

Articles

Popkin SJ. "Beyond Crime Prevention: How the Transformation of Public Housing Has Changed the Policy Equation. Criminology & Public Policy, 3(1): 45–52, 2003.

Popkin SJ, Levy DK, Harris LE, Comey J, Cunningham MK and Buron LB. "The HOPE VI Program: What About the Residents?" Housing Policy Debate, 15(2): 385–414, 2004.

Turner MA and Popkin SJ. "A Housing Voucher Block Grant is a Bad Idea." Housing Policy Debate, 14(3): 271–281. 2003. (Comment on Jill Khadduri's "Should the Housing Voucher Program Become a State-Administered Block Grant?").

Reports

Popkin SJ, Levy DK, Harris LE, Comey J, Cunningham MK and Buron LB. HOPE VI Panel Study: Baseline Report. Washington: The Urban Institute, 2002. Also available online.

Harris LE and Kaye DR. How Are HOPE VI Families Faring? Health.. Washington: Urban Institute, 2004. Also appears online.

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Report prepared by: Nanci Healy
Reviewed by: Richard Camer
Reviewed by: Molly McKaughan
Program Officer: Pamela G. Russo