The Relationship Between Rental Assistance, Health Care Access, and Health-Related Quality of Life

In three papers this dissertation examines the relationship between rental assistance receipt and two domains of health outcomes: health care access and utilization and health-related quality of life. Using an individual-level linkage between the National Health Interview Survey and U.S. Department of Housing and Urban Development administrative rental assistance data, this dissertation examined the following aims addressed in three papers. In Paper 1, Aim 1 evaluates how rental assistance receipt is associated with a range of health care access outcomes (reporting a usual source of care, receiving in-home health care, health care office visits, hospitalizations, and emergency room visits). In Paper 2, Aim 2 engages in mediation analysis to evaluate one potential mechanism linking rental assistance receipt with health care access and utilization: unmet health care needs due to cost. In Paper 3, Aim 3 evaluates the relationship between rental assistance receipt, three aspects of HRQoL (self-rated health, psychological distress, and sleep), and chronic health conditions using moderation and subgroup analysis. Results in Paper 1 found that people receiving rental assistance have a higher likelihood of reporting a usual source of health care than those without rental assistance. Results in Paper 2 did not find statistical evidence that unmet health care needs due to cost mediate the relationship between rental assistance receipt and health care access and utilization. Moderation results in Paper 3 found that people without chronic health conditions with rental assistance report more hours of sleep than those without rental assistance, but people with chronic health conditions report similar hours of sleep between people with and without rental assistance. This dissertation examines foundational relationships between rental assistance and health care access and utilization and HRQoL outcomes. Implications for this research include informing current and future research, practice, and policies aimed at addressing social determinants of health and health-related social needs.