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Housing rehabilitation loan & grant programs

Evidence Rating

Scientifically Supported

Health Factors

Housing rehabilitation loan & grant programs provide funding to repair, improve, or modernize dwellings, and remove health or safety hazards from those dwellings. Programs primarily serve families with low and median incomes, and may prioritize services for households with vulnerable members such as young children and elderly adults. These programs can adopt a comprehensive housing improvement strategy or focus on individual housing components such as heating and insulation, plumbing, structural concerns, lead, asbestos, or mold. Programs can be focused at local, state, and federal levels.

Expected Beneficial Outcomes (Rated)

  • Improved health outcomes

  • Improved mental health

Other Potential Beneficial Outcomes

  • Increased energy efficiency

  • Reduced hospital utilization

  • Reduced absenteeism

  • Improved neighborhood quality

Evidence of Effectiveness

There is strong evidence that housing improvements result in health benefits, especially when improvements focus on increasing warmth through insulation and energy efficiency measures (Thomson 2015Gibson 2011Howden-Chapman 2007NICE-Taske 2005). A Washington DC-based study suggests general housing rehabilitation initiatives can also generate health benefits (Jacobs 2014).

Housing improvements that increase warmth have shown consistently positive effects on respiratory outcomes, overall physical and mental health, and measures of well-being such as self-rated general health. Such improvements have also been shown to reduce children’s absences from school, adult absences from work, doctor’s visits, and hospitalizations (Thomson 2015Howden-Chapman 2007). Low income housing rehabilitation projects that comply with green standards can also improve health outcomes such as asthma, sinusitis, and chronic bronchitis symptoms. Green standards require use of sustainable building products and design elements that reduce moisture, mold, pests, and radon, and improve air quality (Jacobs 2014Breysse 2011). Building deficits such as inadequate heating and ventilation, lead paint, pest infestation, and safety hazards are associated with negative health outcomes such as serious injuries, chronic respiratory illnesses, and poor mental health, and the spread of infectious diseases (Saegert 2003, Krieger 2002a).

Programs that designate funds for low income families and individuals can decrease disparities in access to quality housing and housing-related health outcomes (Jacobs 2014). Housing rehabilitation efforts in low income and declining neighborhoods may also have positive effects on neighborhood quality and stability (). 

Partnerships between non-profit organizations and government agencies that coordinate housing rehabilitation, weatherization, and energy conservation programs may avoid redundancies in procedure and streamline application, funding, and inspection processes (). Pooling resources can also support a coordinated approach to addressing safety, health, and energy inefficiencies (HUD-Advancing healthly housing). However, careful coordination is needed to prevent conflicts in funding timelines and renovation schedule requirements among programs ().

Housing rehabilitation grants are especially beneficial for individuals whose credit scores do not qualify them for loans, and for older adults with lower incomes who are hesitant to take on debt to improve the quality of their housing and accept loans that their children may have to repay ().

Impact on Disparities

Likely to decrease disparities

Implementation Examples

The US Department of Housing and Urban Development’s Section 203(k) program supports rehabilitation of single family homes. This federal program can be combined with Community Development Block Grants (CDBGs), HOME Investment Partnership funds, and other programs (US HUD-203k). 

The US Department of Agriculture (USDA) Rural Development program’s Section 504 Home Repair program, known as the Single Family Housing Repair Loans & Grants program, offers loans to very low income homeowners and grants to very low income elderly individuals to improve housing quality and remove safety and health hazards (USDA-Section 504 HRP). The USDA’s Rural Development program also offers Housing Preservation Grants (HPGs) to state and local governments, nonprofit organizations, or federally recognized tribes to repair or rehabilitate low and very low income housing in rural areas; individual homeowners are not eligible (USDA-HPG). In 2015, HPGs were awarded for 106 projects in 46 states (USDA-Feroli 2015).

Partnership programs that focus on housing rehabilitation and energy efficiency improvements exist nationwide. The Green and Healthy Homes Initiative, Local Initiatives Support Corporation, and Build Healthy Places Network are three organizations that create and coordinate partnerships among stakeholders at the state, county, and city level to promote health through safe housing and community development initiatives (GHHI, LISC, BHPN).

EmPOWER Maryland Low Income Energy Efficiency Program (LIEEP) is an example of a state-sponsored effort to assist low income families with energy conservation, air quality, and warmth improvements (MD DHCD-EmPOWER). Maine has more than a dozen programs which provide low income families with cash assistance to remedy health and safety hazards in their homes (Maine 211-HRG).

Implementation Resources

GHHI-8 elements - Green & Healthy Homes Initiative (GHHI). The 8 elements of a green & healthy home.

BHPN-Resources - Build Healthy Places Network (BHPN). Network resource library: Access to research, best practices and models demonstrating what works, highlighting the health-related value and impact of community development work.

SWD-Housing resources - SocialWorkDegree.net (SWD). Fair housing & social work: Online resources.

ACEEE-SmarterHouse - American Council for an Energy-Efficient Economy (ACEEE). SmarterHouse: an up-to-date guide on energy savings in the home.

Citations - Evidence

* Journal subscription may be required for access.

Howden-Chapman 2007 - Howden-Chapman P, Matheson A, Crane J, et al. Effect of insulating existing houses on health inequality: Cluster randomized study in the community. BMJ. 2007;334(7591):460.

NICE-Taske 2005 - Taske N, Taylor L, Mulvihill C, et al. Housing and public health: A review of reviews of interventions for improving health - Evidence briefing. London, UK: National Institute for Health and Clinical Excellence (NICE); 2005.

Gibson 2011 - Gibson M, Petticrew M, Bambra C, et al. Housing and health inequalities: A synthesis of systematic reviews of interventions aimed at different pathways linking housing and health. Health & Place. 2011;17(1):175–84.

Breysse 2011 - Breysse J, Jacobs DE, Weber W, et al. Health outcomes and green renovation of affordable housing. Public Health Reports. 2011;126(Suppl 1):64–75.

Smith 2011a* - Smith MM, Hevener CC. The impact of housing rehabilitation on local neighborhoods: The case of small community development organizations. American Journal of Economics and Sociology. 2011;70(1):50–85.

Helms 2012* - Helms AC. Keeping up with the Joneses: Neighborhood effects in housing renovation. Regional Science and Urban Economics. 2012;42(1-2):303–13.

Jacobs 2014 - Jacobs DE, Breysse J, Dixon SL, et al. Health and housing outcomes from green renovation of low-income housing in Washington, DC. Journal of Environmental Health. 2014;76(7):8-16.

Rohe 2010* - Rohe WM, Cowan SM, Quercia R. Supporting low-income homeowners: Lessons from a program to coordinate weatherization and rehabilitation services. Housing Policy Debate. 2010;20(3):523-546.

Thomson 2015 - Thomson H, Thomas S. Developing empirically supported theories of change for housing investment and health. Social Science & Medicine. 2015;124:205-214.

HUD-Advancing healthly housing - Advancing healthy housing: a strategy for action. A report from the Federal Healthy Homes Work Group, US Department of Housing and Urban Development (HUD), 2013.

Saegert 2003 - Saegert SC, Klitzman S, Freudenberg N, et al. Healthy Housing: A Structured Review of Published Evaluations of US Interventions to Improve Health by Modifying Housing in the United States, 1990-2001. American Journal of Public Health. 2003;93(9):1471-1477.

Krieger 2002a - Krieger J, Higgins DL. Housing and health: Time again for public health action. American Journal of Public Health. 2002;92(5):758-768.

Citations - Implementation Examples

* Journal subscription may be required for access.

US HUD-203k - US Department of Housing and Urban Development (US HUD). 203(k) rehabilitation mortgage insurance.

USDA-Section 504 HRP - US Department of Agriculture (USDA) Rural Development Programs & Services. Section 504 Home repair program (HRP): Single family housing repair loans & grants, program 101.

USDA-Feroli 2015 - Feroli C. USDA announces $3.7 million to repair rural housing: Funding will remove health and safety hazards, make homes more energy efficient. US Department of Agriculture (USDA) News Release No. 0299.15; 2015.

USDA-HPG - US Department of Agriculture (USDA), Rural Development Programs & Services. Housing preservation grants (HPG): Program 101.

MD DHCD-EmPOWER - Maryland Department of Housing and Community Development (MD DHCD). EmPOWER Maryland Low Income Energy Efficiency Program (LIEEP).

GHHI - Green & Healthy Homes Initiative (GHHI). Learn about home health hazards: Learn the warning signs of home health hazards and how to create a healthy, safe, energy efficient and sustainable home.

Maine 211-HRG - Maine 211 Directory for Services; United Ways of Maine. Maine home rehabilitation grants (HRG).

LISC - Local Initiatives Support Corporation (LISC). Helping neighbors build communities: LISC equips struggling communities with the capital, strategy and know-how to become places where people can thrive.

BHPN - Build Healthy Places Network (BHPN). Working at the intersection of community development and health.

Date Last Updated

Jul 27, 2016