Under the National Housing Strategy, the Canadian government will make historic investments in housing over the next decade. The Canadian Mortgage and Housing Corporation is leading a research strategy to evaluate the impact of these investments. As part of this initiative, the Manitoba Center for Health Policy is conducting a pilot study to determine whether administrative data can be used to assess impacts, specifically looking at health, education and involvement in the justice system.
Using administrative data we tested for changes in healthcare use and justice involvement in the two years before and after a cohort of individuals moved into public housing. Additionally, to determine if changes in the outcomes over time were unique to public housing, we included a matched comparison group of individuals who did not reside in public housing. GLM with generalized estimating equations tested for differences over time and between cohorts in the number of hospitalizations, inpatient days, emergency department visits, and contacts with the criminal justice system. The data were modeled using a Poisson distribution (rate ratio, RR).
Compared to the matched cohort, individuals accepted into public housing showed a significant decline in number of hospitalizations (pre RR=1.58 (1.53, 1.63), post RR=1.23 (1.19, 1.27), days in hospital (pre RR=1.66 (1.64, 1.68), post RR=1.24 (1.23, 1.26) and visits to the emergency department (pre RR=1.57 (1.52, 1.62), post RR=1.42 (1.38, 1.47). A trend towards fewer involvements with the criminal justice system was also observed (pre RR=1.37 (1.32, 1.43), post RR=1.28 (1.22, 1.34). No significant differences were noted for total respiratory morbidity or high school grades.
Administrative data show good potential to be used for the evaluation of public housing impacts on a wide range of health and social outcomes. Additional indicator comparisons will be reported at the conference.