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Pathways Connecting Housing Assistance to Child Well-Being in Families Experiencing Homelessness

Renae Wilkinson1, Aashna Lal2, Michel H Boudreaux3

  • 1Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, 12 Arrow Street, Suite 100, Cambridge, MA, 02138, USA. rwilkinson@fas.harvard.edu.

Journal of Urban Health : Bulletin of the New York Academy of Medicine
|January 20, 2026
PubMed

Insights

Long-term rental subsidies significantly reduce child emotional-behavior problems by lowering parental stress. However, these housing interventions primarily benefit child sleep directly, not through mediating factors.

Area of Science:

  • Public Health
  • Child Psychology
  • Urban Studies

Background:

  • Family homelessness is rising, increasing children's risk for chronic health issues.
  • Long-term rental subsidies show promise in mitigating child behavioral and sleep disturbances.
  • Understanding the mechanisms behind these benefits is crucial for effective interventions.

Purpose of the Study:

  • To investigate the mediating pathways linking housing assistance interventions to improved child outcomes.
  • To analyze how factors like parental stress, violence, and food insecurity influence the effectiveness of housing subsidies.
  • To differentiate between direct and indirect effects of housing interventions on child emotional-behavioral and sleep problems.

Main Methods:

  • Utilized data from the Family Options Study (FOS), a randomized controlled trial involving ~2,300 homeless families across 12 US sites.
  • Employed mediation models to assess the indirect effects of housing interventions through candidate mediators.
  • Controlled for baseline family and child characteristics to isolate intervention impacts.

Main Results:

  • Approximately 50.7% of the positive impact of rental subsidies on child emotional-behavior problems was mediated by reduced parental economic and psychological distress.
  • The positive effects of rental subsidies on child sleep problems were largely direct, with limited evidence of mediation.
  • Housing interventions demonstrated a significant, albeit complex, influence on family well-being and child health.

Conclusions:

  • Stable housing is fundamental for child well-being, with benefits extending to reduced parental stress.
  • While housing stability directly improves child sleep, its impact on behavioral issues is partly explained by alleviating parental stressors.
  • Further research is needed to identify additional modifiable pathways for enhancing child health outcomes in families experiencing homelessness.

Keywords:
Child well-beingFamily Options StudyFamily homelessnessHousing interventionRental subsidy

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