Long-term impact of Moving To Opportunity

Linking the Moving To Opportunity demonstration with administrative health data

Background: The Moving To Opportunity for Fair Housing Demonstration Program (MTO) was a randomized controlled trial run by the U.S. Department of Housing and Urban Development designed to uncover the impact of housing mobility programs. Research showed the beneficial impact of housing mobility on health, including obesity and diabetes risk.

Approach: We linked data on participants in MTO with administrative health records including state all-payer data from California, New York, and Massachusetts and Medicaid claims data for California, Illinois, Maryland, and New York. The resulting dataset enabled the study team to observe health care use for participants up to 21 years after their household was randomized.

Findings: Children whose families received a voucher had significantly lower rates of hospitalization and yearly hospital spending over the subsequent years compared to children whose families were in the control group.  Rates of hospital admissions among children for asthma and mental health were particularly lower for those that received vouchers. In contrast, we did not find differences in rates of emergency room use among children or for hospitalization or emergency room use among adults.  Main findings examining overall rates of hospitalization were published in JAMA and investigating emergency department use were published in Health Affairs. The report delving into the reasons for hospitalization were published in Housing Policy Debate and was awarded the journal’s 2023 Paper of the Year. 

Study team: The study team was led by Craig Pollack and included Bradley Herring, Stefanie DeLuca, Rachel Thornton, Amanda Blackford, Debra Bozzi, and Shawn Du.

Funding:  The research was supported by a grant from the Robert Wood Johnson Foundation.