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Health Equity: Tenant-Based Rental Assistance Programs


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 12 studies (search period 1965-2000). The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to promoting health equity.


There is no information for this section.

Summary of Results

Detailed results from the systematic review are available in the CPSTF finding pdf icon [PDF - 134 kB].

Twelve studies qualified for the review of effectiveness of tenant-based rental assistance (or voucher) programs.

  • Household victimization: median decrease of 6% (interquartile interval: -22% to 6%; 5 studies)
  • Social disorder: median decrease of 15.5% (interquartile interval: -89% to 3%; 4 studies)
  • Behavioral problems among youth, measured between 1 and 5 years (mean, 2.9 years) after the intervention took place, decreased by a median of 7.8 percentage points (3 studies).
  • Self-reported symptoms of depression and anxiety among heads of households decreased by a median of 8 percentage points (2 studies).

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.


These findings should be applicable to most low-income families in urban areas.

Evidence Gaps

Each Community Preventive Services Task Force (CPSTF) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the CPSTF finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the CPSTF recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the CPSTF recommendation is based.

Identified Evidence Gaps


The causes of residential segregation and isolation of families by income, race, ethnicity, or social class into neighborhoods of concentrated poverty are complex. Tenant-based rental assistance programs allow families to find affordable housing in safer neighborhoods, but the potential to fully realize housing and neighborhood choice could be advanced by a greater understanding of factors that affect choice.

  • What resources are critical in allowing families to fully realize the potential for housing mobility (e.g., counseling on housing search strategies, transportation resources)?
  • How can the Section 8 program be made more attractive to landlords, particularly when rental units are scarce in a tight rental market?


Our review focused on urban areas, and low SES families with children. Applicability of this intervention to the elderly and to those with special health needs should be assessed.

Other Positive or Negative Effects

Encouraging residential mobility away from poor central-city areas may disrupt existing neighborhood social networks and supports, giving way to greater neighborhood social deterioration.

  • To what extent should housing mobility strategies be coupled with revitalization efforts to make central-city neighborhoods more attractive to families at all income levels?
  • What factors contribute to residential clustering of Section 8 families in particular neighborhoods, which could eventually lead to neighborhood decline and the reconcentration of poverty?

Economic Evidence

Tenant-based rental assistance programs do not add to the stock of housing, but rely on available housing in the private rental market. In tight rental markets, when few units are available, is a voucher approach feasible? How does the program compare in cost with housing built and maintained by public funds? Are rental voucher programs cost effective?

Study Characteristics

Studies represented four broad groups of federal housing evaluation efforts:

  1. The Housing Allowance Experiment
  2. HUD’s Section 8 Rental Certificate and Voucher program
  3. The Gautreaux program, in which rental vouchers were provided to African-American families in racially segregated public housing in Chicago
  4. Moving to Opportunity for Fair Housing research, implemented in five large cities, which combines rental vouchers with household counseling to help low-income families move from public housing to nonpoverty neighborhoods

Studies were conducted among white, Latino, and African-American populations, and effects were similar for all of these groups.