Social
Indirect effects of receiving a Section 8 housing voucher on the prevalence of psychiatric disorders among boys and girls through aspects of neighborhood affluence and racial/ethnic composition Anna Krasnova* Anna Krasnova Dustin T. Duncan Jeremy Kane Keely Cheslack-Postava Sarah E. Tom Kara E. Rudolph
Background: The Moving to Opportunity (MTO) experiment randomized low-income predominantly Black and Hispanic families in high-poverty neighborhoods to a housing voucher, resulting in moves that changed neighborhood affluence and racial/ethnic composition. Unexpectedly, voucher receipt increased the risk of harmful mental health outcomes among boys but decreased it among girls. We utilized causal mediation to estimate the effect of voucher receipt in 1994-1998 on mental health outcomes in 2008-2010 through aspects of neighborhood racial/ethnic composition and affluence in 2001-2002, stratifying by sex.
Methods: Black and Hispanic adolescents 10-19 years at final follow-up were selected from the MTO. We estimated natural indirect effects of voucher receipt on past-year self-reported: 1) mood disorder, 2) externalizing disorder, and 3) post-traumatic stress disorder (PTSD) through a bundle of mediators, stratifying by sex. Mediators included the proportion of time spent in Census tracts with less than 20% poverty, share of college graduates, share of Black residents, and share of Hispanic residents. We used a recently developed nonparametric, multiply robust estimator.
Results: Voucher receipt increased time living in more affluent and slightly less segregated neighborhoods, which was protective against externalizing disorders, though not statistically significantly so, among boys (RD: -0.03, 95% CI: -0.09, 0.03) and girls (RD: -0.02, 95%: -0.05, 0.02), and mood disorders among girls (RD: -0.01, 95%: -0.04, 0.02). However, among boys, these neighborhood changes explained most of the harmful effect of voucher receipt on mood disorders (RD: 0.02, 95% CI: 0, 0.03).
Conclusions: These findings suggest that voucher receipt had a heterogeneous indirect effect on mental health outcomes through aspects of neighborhood affluence and racial/ethnic composition. (U.S. Census Bureau authorization Project P-7504667: CBDRB-FY24-CES018-008 and CBDRB-FY24-0355).