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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. Housing Reparations

Approach. Enact housing reparations for families in communities that haven't previously benefited from past housing and land use policies.

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Overview. Housing reparations programs can come in multiple forms. They can be financial awards to be used at the discretion of eligible recipients, or they can be multi-component interventions that support homeownership for eligible recipients through housing specific means such as down payment grants, housing revitalization grants, or access to government subsidized mortgages with very low interest rates and low or no down payment.[3, 5] Housing reparations programs often increase regulation to de-commodify the housing market, reform tax policies to discourage predatory housing speculation, restructure housing finance systems, and expand the social housing sector by increasing the share of housing resources owned by public, not-for-profit, or community organizations.[3] These programs include initiatives to invest in often-ignored communities,[6] especially to improve housing and infrastructure resources, build community wealth, and increase home values.[3]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

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

Potential Data Sources. Data to support this strategy can be accessed through:

  • Reparations program eligibility, application, and recipient data
  • Supportive service/navigation utilization data
  • Partnership engagement and inter-agency collaboration records

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

  • 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.
  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.

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. Community-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 housing reparations programs collaboratives led by Title V established to address differences among groups in housing stability. (Shows the scale and scope of the approach)
  • Number of eligible individuals or families who are assisted with the application process by Title V for housing reparations. (Indicates the reach and uptake of the approach among the intended beneficiaries)

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

  • Percent of eligible individuals who are assisted with the application process by Title V for housing reparations. (Indicates the reach and uptake of the approach among the intended beneficiaries)
  • Percent of housing reparations programs that incorporate ongoing support from Title V around monitoring, evaluation, and accountability measures to ensure fair distribution and impact. (Indicates the commitment to transparency, learning, and continuous improvement in the approach)

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

  • Number of partnerships and collaborations led by Title V formed between government agencies, community organizations, and private sector entities to design and implement comprehensive housing reparations programs. (Shows the level of multi-sector alignment and coordination to support the approach)
  • Number of initiatives supported by Title V to address structural challenges to housing value and create an enabling environment for reparations (e.g., fair housing laws and tenant protections). (Indicates the broader institutional and regulatory reforms needed to sustain the impact of the approach)
  • Number of individuals or families from historically under resourced groups who achieve stable, affordable, and quality housing as a result of housing reparation collaboratives led by Title V. (Shows the approach's impact on its primary goal of promoting housing stability)
  • Number of individuals or families who receive assistance from Title V with their housing reparation application and report improved physical and mental health outcomes, educational attainment, and overall quality of life. (Indicates the approach's effect on addressing health and well-being)

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

  • Percent of housing reparations program design and decision-making process that are led by and center the voices and priorities of people with practical experience. (Shows the degree of self-determination and representation in the approach)
  • Percent of initiatives supported by Title V to address structural challenges to housing value and create an enabling environment for reparations (e.g., fair housing laws and tenant protections). (Indicates the broader institutional and regulatory reforms needed to sustain the impact of the approach)
  • Percent of individuals or families from historically under resourced groups who achieve stable, affordable, and quality housing as a result of housing reparation collaboratives led by Title V. (Shows the approach's impact on its primary goal of promoting housing stability)
  • Percent of individuals or families who receive assistance from Title V with their housing reparation application and report improved physical and mental health outcomes, educational attainment, and overall quality of life. (Indicates the approach's effect on addressing health and well-being)

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 PRRAC-Haberle 202[1] - Haberle M, House S, eds. Racial justice in housing finance: A series on new directions. Washington, DC: Poverty & Race Research Action Council (PRRAC); 2021.

2 NAARC-Reparations eligibility 2022 - National African-American Reparations Commission (NAARC). Who should receive reparations and in what forms? March 25, 2022.

3 CA-AB 312[1] - State of California, Department of Justice, Office of the Attorney General. Assembly Bill (AB) 3121: Task force to study and develop reparation proposals for African Americans.

4 Williams 2004a - Williams DR, Collins C. Reparations: A viable strategy to address the enigma of African American health. American Behavioral Scientist. 2004;47(7):977-1000.

5 Brookings-Ray 2020 - Ray R, Perry A. Why we need reparations for Black Americans. Washington, DC: Brookings Institute; 2020.

6 Darity 2008 - Darity WA Jr. Forty acres and a mule in the 21st century. Social Science Quarterly. 2008;89(3):656-664.

7 Kaplan 2007 - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.

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.