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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Housing Instability: Pregnancy.

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Strategy. Rent Regulation Policies (Pregnancy)

Approach. Support rent regulation policies with income eligibility requirements to improve housing stability

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Overview. Rent regulation policies affect the landlord-tenant relationship by establishing protections such as limits to the amount landlords can increase rent for existing tenants; such policies also often prohibit landlords from evicting tenants without just cause. Historically, policies used rent control to set price ceilings or strict limits on rent increases. Most current policies regulate markets that otherwise would be too expensive for households experiencing economic challenges using a rent stabilization approach, which provides a moderate return on investment for landlords with annual rent increases that account for the cost of inflation and any property improvements beyond standard maintenance. Current rent regulations vary by scope, standards for permitted rent increases, and enforcement mechanisms.[1] Although many current rent regulation policies do not have income eligibility requirements, policies can be adjusted to focus on tenants experiencing economic challenges.[2] According to reports from Harvard University's Joint Center for Housing Studies, as of 2017, over 21 million U.S. households spend more than 30% of their income on rent.[3]

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts, guidelines, or committee statements; these strategies are consistent with accepted theoretical frameworks and have good potential to work. Often there is literature-based evidence supporting these strategies in related topic areas that indicate this approach would prove effective for this issue. Further research is needed to confirm effects in this topic area.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

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

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • 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. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

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

PROCESS MEASURES:

  • Number of households with lower incomes that are eligible for and served by rent regulation policies. (Shows the potential reach and impact of the approach on the intended population)
  • Number of landlords and rental properties covered by rent regulation policies with income eligibility requirements. (Indicates the scope and penetration of the approach in the housing market)

OUTCOME MEASURES:

  • Number of households with lower incomes that achieve stable, affordable housing as a result of rent regulation policies with income eligibility requirements. (Shows the approach's impact on its primary goal of improving housing stability)
  • Number of evictions or forced displacements prevented among households with lower incomes as a result of rent regulation policies with income eligibility requirements. (Indicates the approach's effect on reducing housing instability and insecurity)

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

PROCESS MEASURES:

  • Percent of households with lower incomes that are aware of and understand their rights and protections under rent regulation policies with income eligibility requirements. (Shows the accessibility and clarity of the approach's communication and outreach efforts)
  • Percent of landlords and property managers that receive education and support to comply with rent regulation policies with income eligibility requirements. (Indicates the level of engagement and capacity-building for key partners in the approach's implementation)

OUTCOME MEASURES:

  • Percent of households with lower incomes in rent-regulated units that spend 30% or less of their income on rent, as a result of policies with income eligibility requirements. (Shows the approach's impact on increasing the affordability and sustainability of housing costs)
  • Percent of households with lower incomes that report increased housing stability, security, and peace of mind as a result of rent regulation policies with income eligibility requirements. (Indicates the approach's effect on improving the well-being and quality of life of the population served)

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

PROCESS MEASURES:

  • Number of community-based organizations, tenant advocacy groups, and legal aid providers engaged in promoting and supporting rent regulation policies with income eligibility requirements. (Shows the level of multi-sector collaboration and capacity-building to advance the approach)
  • Number of data collection and reporting systems established to monitor the implementation, outcomes, and equity impact of rent regulation policies with income eligibility requirements. (Indicates the infrastructure and process for accountability and continuous improvement of the approach)

OUTCOME MEASURES:

  • Number of households with lower incomes that are able to access and benefit from other social services and supports (e.g., healthcare, education, employment) as a result of increased housing stability through rent regulation policies. (Shows the approach's ripple effect on promoting social and economic well-being)
  • Number of policies and programs adopted by other jurisdictions that are modeled after or inspired by the success and learnings of rent regulation policies with income eligibility requirements. (Indicates the approach's potential for replication, scaling, and systemic impact)

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

PROCESS MEASURES:

  • Percent of rent regulation policies with income eligibility requirements that are designed to affirmatively further fair housing goals and address racial and economic disparities in access to affordable housing. (Shows the explicit integration of equity and social justice aims in the approach's intent and design)
  • Percent of the rental housing stock that is covered by rent regulation policies with income eligibility requirements and preserved as affordable in perpetuity or for the long-term. (Indicates the sustainability and longevity of the approach's impact on the housing market)

OUTCOME MEASURES:

  • Percent decrease in the rate of people experiencing homelessness and housing insecurity among households with lower incomes in communities with rent regulation policies with income eligibility requirements, compared to control or pre-approach levels. (Shows the approach's population-level impact on reducing the most severe forms of housing instability)
  • Percent reduction in racial and economic disparities in housing cost burden, eviction rates, and access to affordable housing in communities with rent regulation policies with income eligibility requirements. (Indicates the approach's progress towards advancing housing equity and justice)

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] Pastor 2018 - Pastor M, Carter V, Abood M. Rent matters: What are the impacts of rent stabilization measures? 2018:1-30.

2 McPherson 2004 - McPherson G. It’s the end of the world as we know it (and I feel fine): Rent regulation in New York City and the unanswered questions of market and society. Fordham Law Review. 2004;72(4):1125-1169.

3 JCHS-Rental report 2017 - Joint Center for Housing Studies of Harvard University (JCHS). America's rental housing 2017.

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.