Care, Housing Assistance, Medicaid, and Perinatal Health Outcomes Study (CHAMPS)

Investigating the impact of housing assistance on perinatal and infant health

Background: Adverse pregnancy-related outcomes and persistent inequalities in these outcomes have worsened in recent years, alongside a growing national crisis in safe and affordable housing. Despite the strong potential for housing insecurity to impact the perinatal period, there is a paucity of evidence connecting these two areas.

Through a variety of programs, including Housing Choice Vouchers, public housing, and multifamily housing, federal housing assistance limits household spending on rent and utilities. By increasing housing affordability and stability, improving housing quality, changing neighborhood context, and connecting residents with health and social services, federal housing assistance has the potential to improve the quality of care that pregnant individuals receive and, more broadly, shed light on the intersection of pregnancy and housing.

Approach: The Care, Housing Assistance, Medicaid, and Perinatal (CHAMP) Health Outcomes Study links national Medicaid claims for the years 2016-2023 with U.S. Department of Housing and Urban Development data on the receipt of federal housing assistance. Because individuals who receive housing assistance may be fundamentally different from those who do not, the study makes use of a ‘pseudo’ waitlist control design that leverages the limited supply of housing assistance relative to demand and the random timing of the receipt of housing assistance. The first aim examines the overall relationship between receipt of federal housing assistance and pregnant and postpartum individuals (including pre- and post-natal care and morbidity) and newborns (including low birth weight, preterm birth, and neonatal intensive care admission). The second aim investigates whether these relationships vary across a range of equity and policy relevant factors including race and ethnicity, neighborhood socioeconomic context, and type of housing assistance. The final aim uses qualitative methods to elicit narratives and perspectives on how housing assistance can support perinatal and infant health through interviews with policy and program officials, practitioners, and people with lived experience.

Team: The study team is led by Craig Pollack and Alene Kennedy-Hendricks and includes Matthew Eisenberg, Amanda Blackford, and Sachini Bandara.

Funding:  The project is supported by a grant from the Eunice Kennedy Shrive National Institute of Child Health and Human Development (R01HD119282) and pilot funding from the Hopkins Population Center.