The association between government housing assistance and severe psychological distress: a cross-sectional analysis using NHIS data

This is the authors' abstract. We don't add key points for this paper.

Housing instability is a critical social determinant of health that significantly impacts mental well-being. This study examines the association between government housing assistance programs and severe psychological distress using 2021 National Health Interview Survey data. Severe psychological distress (Kessler K6 score ≥13) was analyzed in a weighted sample of 63,940,499 U.S. adults. Logistic regression models assessed this relationship while adjusting for sociodemographic factors. Results revealed higher distress prevalence among housing assistance recipients (16.4%) compared to non-recipients (7.9%) (p < .001). Adjusted analyses indicated non-recipients had significantly lower odds of distress (OR = 0.59, 95% CI [0.42, 0.82], p < .001). Poor health status (OR = 9.10, 95% CI [6.36, 13.02], p < .001) and being female (OR = 2.20, 95% CI [1.63, 2.97], p < .001) were associated with higher distress levels. These findings suggest current housing programs may inadequately address recipients’ mental health needs. Healthcare professionals including nurses, social workers, and psychologists are uniquely positioned to advocate for policy changes and integrate mental health services into housing programs. This research highlights the importance of multidisciplinary collaboration in advancing health equity and informing policy solutions.