Importance Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma outcomes. Objectives To examine whether participation in the US Department of Housing and Urban Development's (HUD) rental assistance programs is associated with childhood asthma outcomes and to examine whether associations varied by program type (public housing, multifamily housing, or housing choice vouchers). Design, Setting, and Participants This survey study used data from the nationally representative National Health Interview Survey linked to administrative housing assistance records from January 1, 1999, to December 31, 2014. A total of 2992 children aged 0 to 17 years who were currently receiving rental assistance or would enter a rental assistance program within 2 years of survey interview were included. Data analysis was performed from January 15, 2018, to August 31, 2019. Exposures Participation in rental assistance provided by HUD. Main Outcomes and Measures Ever been diagnosed with asthma, 12-month history of asthma attack, and 12-month history of visiting an emergency department for the treatment of asthma among program participants vs those waiting to enter a program. Overall participation was examined, and participation in public or multifamily housing was compared with participation in housing choice vouchers. Results This study included 2992 children who were currently participating in a HUD program or would enter a program within 2 years. Among children with an asthma attack in the past year, participation in a rental assistance program was associated with a reduced use of emergency departments for asthma of 18.2 percentage points (95% CI, -29.7 to -6.6 percentage points). Associations were only found after entrance into a program, suggesting that they were not confounded by time-varying factors. Statistically significant results were found for participation in public or multifamily housing (percentage point change, -36.6; 95% CI, -54.8 to -18.4) but not housing choice vouchers (percentage point change, -7.2; 95% CI, -24.6 to 10.3). No statistically significant evidence of changes in asthma attacks was found (percentage point change, -2.7; 95% CI, -12.3 to 7.0 percentage points). Results for asthma diagnosis were smaller and only significant at the 10% level (-4.3; 95% CI, -8.8 to 0.2 percentage points). Conclusions and Relevance Among children with a recent asthma attack, rental assistance was associated with less emergency department use. These results may have important implications for the well-being of low-income families and health care system costs.

中文翻译：

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儿童哮喘协会与联邦租金援助

重要性 美国数以百万计的低收入儿童居住在不合标准或负担不起的住房中。减轻这些负担可能与哮喘结果的变化有关。目的 调查参与美国住房和城市发展部 (HUD) 的租金援助计划是否与儿童哮喘结果相关，并检查关联是否因计划类型（公共住房、多户住房或住房选择券）而异。设计、设置和参与者 这项调查研究使用了来自全国代表性的全国健康访谈调查的数据，这些数据与 1999 年 1 月 1 日至 2014 年 12 月 31 日的行政住房援助记录相关。共有 2992 名 0 至 17 岁的儿童目前正在接受租金援助或将在调查访谈后的 2 年内参加租金援助计划。数据分析时间为 2018 年 1 月 15 日至 2019 年 8 月 31 日。 参与 HUD 提供的租赁援助。主要结果和措施 计划参与者与等待加入计划的参与者中曾被诊断出患有哮喘、12 个月的哮喘发作史和 12 个月的急诊科治疗哮喘病史。检查了总体参与情况，并将参与公共或多户住宅与参与住房选择券进行了比较。结果 本研究包括 2992 名目前正在参加 HUD 计划或将在 2 年内参加计划的儿童。在过去一年哮喘发作的儿童中，参与租赁援助计划与哮喘急诊室的使用减少 18.2 个百分点（95% CI，-29.7 至 -6.6 个百分点）有关。只有在进入程序后才发现关联，这表明它们没有被时变因素混淆。发现参与公共或多户住宅的结果具有统计学意义（百分比变化，-36.6；95% CI，-54.8 至 -18.4），但没有发现住房选择券（百分比变化，-7.2；95% CI，-24.6 至10.3)。没有发现哮喘发作变化的统计学显着证据（百分比变化，-2.7；95% CI，-12.3 至 7.0 个百分点）。哮喘诊断结果较小，仅在 10% 水平（-4.3；95% CI，-8. 8 到 0.2 个百分点）。结论和相关性 在近期哮喘发作的儿童中，租金援助与较少使用急诊室有关。这些结果可能对低收入家庭的福祉和医疗保健系统成本具有重要意义。