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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Housing Instability: Child.

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Strategy. Housing Vouchers and Subsidies. (Child)

Approach. Expand families access to long-term rental vouchers and subsidies to improve outcomes for children.

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Overview. Housing vouchers play a significant role in assisting homeless families by addressing housing instability and its impact on child welfare outcomes. Housing voucher programs, particularly those offered through programs such as the "Family Unification Program," play a crucial role in assisting homeless families by providing them with stable housing, reducing the risk of child welfare involvement, and promoting overall family well-being.[1,2,3]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Policy. This strategy helps to promote decisions, laws, and regulations that promote public health practices and interventions.
  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of families with children who receive information, education, and navigation support to access and utilize housing vouchers and subsidies. (Assesses outreach and engagement efforts to connect families to assistance) Number of landlords, property managers, and housing providers engaged as partners in accepting vouchers and subsidies and providing affordable homes for families with children. (Shows cross-sector collaboration to expand housing options)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of housing voucher and subsidy programs that are designed and implemented with input and leadership from families with children most impacted by housing instability. (Measures family voice and agency in shaping housing assistance policies and practices) Percent of housing navigators and case managers assisting families with vouchers and subsidies who are trained in trauma-informed care and strengths-based family support practices. (Shows workforce capacity and effectiveness in service delivery)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of families with children receiving vouchers and subsidies who report satisfaction with the quality, safety, and appropriateness of their housing for their family's needs. (Measures family perceptions of housing quality and fit) Number of public housing authorities, continuums of care, and other housing system partners engaged in collaborative efforts to align and optimize the utilization of vouchers and subsidies for families with children. (Assesses strategic coordination and continuous improvement within housing assistance ecosystem) Number of communities that achieve measurable reductions in the number of families with children experiencing homelessness or housing instability through the strategic deployment of vouchers and subsidies as part of a coordinated housing assistance system. (Measures population-level impact on preventing and ending family homelessness) Number of housing and social policies influenced or shaped by learnings and evidence from the implementation and evaluation of voucher and subsidy programs for families with children. (Assesses knowledge generation and translation impact on policy and systems change)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of families with children receiving vouchers and subsidies who report satisfaction with the quality, safety, and appropriateness of their housing for their family's needs. (Measures family perceptions of housing quality and fit) Percent of public housing authorities, continuums of care, and other housing system partners engaged in collaborative efforts to align and optimize the utilization of vouchers and subsidies for families with children. (Assesses strategic coordination and continuous improvement within housing assistance ecosystem) Percent of communities that achieve measurable reductions in the number of families with children experiencing homelessness or housing instability through the strategic deployment of vouchers and subsidies as part of a coordinated housing assistance system. (Measures population-level impact on preventing and ending family homelessness) Percent of housing and social policies influenced or shaped by learnings and evidence from the implementation and evaluation of voucher and subsidy programs for families with children. (Assesses knowledge generation and translation impact on policy and systems change)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Fowler, P. J., Brown, D. S., Schoeny, M., & Chung, S. (2018). Homelessness in the child welfare system: A randomized controlled trial to assess the impact of housing subsidies on foster care placements and costs. Child abuse & neglect, 83, 52-61. [2] Brown, S. R., Thurber, A., & Shinn, M. (2023). Mothers’ perceptions of how homelessness and housing interventions affect their children’s behavioral and educational functioning. American Journal of Orthopsychiatry. [3] Gubits, D., Shinn, M., Wood, M., Brown, S. R., Dastrup, S. R., & Bell, S. H. (2018). What interventions work best for families who experience homelessness? Impact estimates from the family options study. Journal of Policy Analysis and Management, 37(4), 835-866.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.