Rental assistance programs could help patients with diabetes

Story at a glance

  • Diabetes can be a costly condition to manage, due in part to the high costs of insulin.

  • In addition, several social determinants of health have been linked to an increased risk of diabetes and poor diabetes-related outcomes.

  • New research suggests certain rental assistance programs could lower the risk of uncontrolled diabetes in patients. 

In the past, housing instability has been linked with increased risks of poor diabetes-related outcomes and in some cases can even worsen the condition. 

Because of this, researchers sought to explore what impact rental assistance programs might have on patients with diabetes. 

A study of a nationally representative sample of more than 1,000 patients published in JAMA Network Open last week concluded “living in project-based, federally subsidized housing was associated with a reduced likelihood of uncontrolled diabetes.” 

Authors went on to add, “affordable housing programs may be associated with improved diabetes outcomes.”

Data were gleaned from the National Health and Nutrition Examination Survey (NHANES) and U.S. Department of Housing and Urban Development records. Researchers assessed individuals’ diabetes control based on glycated hemoglobin (A1C) level measurements. All participants were at least 45 years old and lived in either project-based housing or received housing vouchers. 

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A1C levels of these patients were compared with levels of individuals on a waitlist to get project-based housing within two years.

Of participants included, 450 were living in project-based housing, while 345 had housing vouchers. Two-hundred and fifty-five individuals received rental assistance within two years of the survey. 

Compared with those on the waitlist, individuals in project-based housing had a lower risk of uncontrolled diabetes. No differences were seen among those receiving housing vouchers and the waitlisted group. 

The negative effects of unstable housing fall disproportionately on the nation’s low-income and racial and ethnic minority individuals. These individuals also happen to have the rates of diabetes in the country. 

“Access to rental assistance may be associated with improved diabetes self-management and control by reducing housing costs that can compete with diabetes-related expenses, such as those related to healthy food and medications,” authors wrote. 

“Access to stable housing arrangements may be associated with improved mental health and reduced distress, which can increase feelings of self-efficacy regarding managing chronic disease,” they added, noting outcomes may be dependent upon the specific housing programs employed.

More research is needed to better understand any changes in A1C over time among those in housing assistance programs, researchers concluded.