Long-term Implications of Early Life Exposure to the US Public Housing Program

The objective of this project is to identify the long-term effects of early life exposure to public housing in the mid- 20th century—a well-funded, well-maintained, high-quality housing program—on life course health and aging. Housing is crucial for population health, but remains underemphasized as a primary social determinant. Housing is a platform of stability that allows families to invest in healthy development. The lack of affordable housing in the US—i.e. the housing affordability crisis—strains household finances, forcing families to opt for poor quality or unsafe housing, with potential implications for health and wellbeing across the life course. Short-term benefits of high-quality stable and affordable housing are well-documented, but it is unknown whether early-life improvements in housing have long-term benefits for health and aging later in life. Fundamental evidence for life course theories of health and aging indicates that social and economic conditions in early life affect health and mortality in later life. However, data limitations have precluded comprehensive research on the long-term effects of improved housing. The current project focuses on the US public housing program in 1940 and 1950. The early public housing program stands out as a major public policy achievement in that it built high quality housing for the urban working and middle class and provides a lens through which to examine the long-term effects of a large-scale public investment in housing. The project draws on a long-run multisource linkage that merges early- life housing information with later-life economic, housing, health, and mortality outcomes. The research team identified all residents of public housing in the full count 1940 census and the project proposes to expand this dataset to the full count 1950 census. The project will link these data at the individual level to a) the 2000, 2010, and 2020 Decennial Census, b) the American Community Survey 2000-2024, c) IRS 1040 tax records (1969- 1994), d) Census Numident (1975-2030), and e) Cause of death from death certificates. The analysis uses an innovative design, comparing individuals in public housing to their counterparts in surrounding neighborhoods and cities, based directly on the admission criteria for public housing during the 1930s and 1940s. The project examines the effects of early-life public housing experience on later life health and mortality outcomes, including cognitive and physical functioning, all-cause mortality, and cause of death (Aim 1). Using tax data and subsequent census information, the project also considers effects of public housing on later life socioeconomic outcomes, housing conditions, and neighborhood outcomes (Aim 2). Finally, in recognition of substantial racial discrimination in the housing market and racial residential segregation present in the mid-20th century and today, the project examines the effects of public housing on subsequent outcomes separately for Black and White individuals (Aim 3). The results will provide the most comprehensive picture of the long-term health impacts of improved housing, and, in the context of the modern housing affordability crisis, offer evidence of the population health improvements that may result from greater investment in safe, affordable, high-quality housing. Project Number: 1R01AG094811-01 | Fiscal Year: 2026 | NIH Institute/Center: National Institute on Aging (NIA) | Principal Investigator: Andrew Fenelon | Institution: UNIVERSITY OF MINNESOTA, MINNEAPOLIS, MN | Award Amount: $679,589 | Activity Code: R01 | Study Section: Social Sciences and Population Studies B Study Section[SSPB] View on NIH RePORTER: https://reporter.nih.gov/project-details/11204704