Linking National Health Surveys and HUD Administrative Data, An Interview with Jon Sperling & Veronica Helms
In this column, Jon Sperling, HUD Senior Policy Analyst, Geographic Information and Analysis, and Veronica Helms, HUD Social Science Analyst, describe how HUD and other federal agencies are collaborating to match data that will provide a better understanding of HUD’s assisted population.
The Anita Stroud Senior Center complex in Charlotte, NC. Credit: U.S. Department of Housing and Urban Development Flickr
Social determinants of health are conditions in which people are born, grow, learn, work, play, live, and age. These conditions affect a wide range of forces and systems shaping health outcomes and risks. Conditions associated with these various environments (e.g., school, workplace, and neighborhood) are referred to as “place.” The “place” terminology applies to both physical, material settings (such as schools and homes) and invisible social forces such as patterns of social engagement, perceived safety, and belongingness. When social systems focus on research through the lens of place and social determinants of health, policies and programs can greatly influence population health outcomes. Housing is a significant social determinant of health since homes and neighborhoods represent physical and social conditions which can greatly affect individual and population health.
Until recently, data have not been available to provide nationally representative estimates of health indicators among HUD assisted households. In collaboration with the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), both agencies matched 13 years of HUD administrative data with data from two national health surveys – the National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES).
During the week of January 18, 2016, NCHS and HUD’s Office of Policy Development & Research (PD&R) announced the availability of this nationally linked dataset. This data allows HUD researchers and policymakers to understand the sociodemographic and health characteristics of HUD assisted tenants. Previously, such national estimates were unavailable and assumptions were based on targeted, local research efforts primarily conducted by academia. HUD anticipates that this new national resource will set off a chain of research papers and interest in the housing and health research community that may help inform future policy.
Until this innovative and model partnership that overcame a series of confidentiality and privacy challenges, it had not been possible to reliably estimate the prevalence of health conditions or healthcare utilization among HUD’s assisted, low-income population. Linking HUD administrative records with health surveys now make such estimations a reality. This linked dataset will support research regarding health outcomes, health care access and utilization, and health disparities among HUD’s assisted population. Analysts and researchers will be able to study countless health issues, including self-reported health status, prevalence of disability and chronic disease, health behavior, and health care coverage.
HUD and NCHS developed a written agreement to link CDC health survey data with HUD administrative data. Through this extraordinary and innovative, no-cost, collaborative and strategic research partnership with NCHS, HUD can support strategic research priorities. Instead of HUD contracting to conduct its own health survey that would costs millions of dollars, HUD leveraged existing NCHS data linkage expertise. The NCHS-HUD data linkage is a model data sharing effort that aligns with Office of Management and Budget (OMB) directives for sharing data across federal agencies to reduce respondent burden and improve federal programs. The project also aligns with HHS’ strategic goal to advance scientific knowledge and innovation as well as HUD’s strategic goal to use “housing as a platform to improve quality of life”. In addition to this win/win scenario, HUD provides NCHS with its enterprise state-of-the-art geocoding and address validation services, enabling a consistent and high quality level of locational specificity of its health survey respondents.
Interested researchers should visit the NCHS-HUD Linked data website for information about this data product. The webpage contains data documentation, including data dictionaries, public-use feasibility files for determining the available sample size, details about how to access the restricted-use files, and analytic guidelines for using the NCHS-HUD linked data files. The webpage will be updated frequently to reflect necessary documentation changes. To access the files, researchers must submit a research proposal for approval to the NCHS Research Data Center. Applications will be reviewed for approval by NCHS staff and HUD staff. The website provides information on preparing the proposal submission and, if approved, accessing the restricted data. For specific questions, please email NCHS_HUD_DataLinkage@hud.gov.