Federal rental assistance and housing outcomes among disability households: Cost burden relief without health or housing quality gains

BACKGROUND: Housing is a key social determinant of health, particularly for people with disabilities who face compounded challenges related to affordability, accessibility, and housing quality. Despite the aims of federal rental housing assistance to alleviate these issues, little is known about its association with the health and housing conditions of disability households at the national level. OBJECTIVE: To assess disparities in health, housing quality, and housing insecurity between rental households with and without a person with a disability, and to examine whether federal rental housing assistance is associated with these disparities. METHODS: We analyzed data from the 2023 American Housing Survey, focusing on renter households with or without household members with disabilities. Weighted descriptive statistics and logistic regressions (with marginal effects and predicted probabilities) were used to examine associations between disability status, housing assistance, and multiple health and housing indicators. RESULTS: Households with members with disabilities were significantly more likely to report poor health, housing quality issues, and affordability challenges. For all households, federal rental assistance was associated with lower levels of affordability concern and housing cost burden, but was not associated with health and quality gaps. Interaction terms revealed a more mixed picture as rental assistance was associated with some but not all health disparities for households that included a person with a disability. CONCLUSION: Federal rental housing assistance provides partial but insufficient support for households with disabilities. To promote health equity, policy efforts must extend beyond affordability to address structural deficiencies in housing quality, accessibility, and broader determinants of health for people with disabilities.