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THE EFFECTS OF HOUSING AND NEIGHBORHOOD CONDITIONS ON CHILD MORTALITY

THE EFFECTS OF HOUSING AND NEIGHBORHOOD CONDITIONS ON CHILD MORTALITY

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Published by Patricia Dillon
63293-w17369
63293-w17369

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Published by: Patricia Dillon on Jun 10, 2012
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NBER WORKING PAPER SERIESTHE EFFECTS OF HOUSING AND NEIGHBORHOOD CONDITIONS ON CHILDMORTALITYBrian A. JacobJens LudwigDouglas L. MillerWorking Paper 17369http://www.nber.org/papers/w17369NATIONAL BUREAU OF ECONOMIC RESEARCH1050 Massachusetts AvenueCambridge, MA 02138August 2011
The analysis presented in this paper was supported by grants from the Robert Wood Johnson Foundation(award 59496) and the Centers for Disease Control (award CE001631-01), and is part of a larger series
of studies of housing policy in Chicago supported by the National Consortium on Violence Research,
the Northwestern University / University of Chicago Joint Center for Poverty Research, the Smith
Richardson Foundation, the William T. Grant Foundation, a HUD Urban Studies Postdoctoral Fellowship
(to Jacob) a Brookings Institution post-doctoral fellowship sponsored by the Andrew W. Mellon Foundation
(to Ludwig), and a visiting scholar award from the Russell Sage Foundation (to Ludwig). We thank
Ken Coles, Ron Graf, Jennifer O’Neil, William Riley, Barry Isaacson, Debbie Gibson, Todd Richardson,
Mark Shroder, Robert Sampson, the Chicago Housing Authority, and Robert Goerge and Chapin Hall
for their assistance in obtaining and interpreting the data used in this study. Thanks to Laura Brinkman,
Heather Harris, Dave Kirk, Jack Lesniewski, Sarah Rose, Elias Walsh, Wei Ha, Joshua Hyman, and
Thomas Wei for excellent research assistance, and to Colin Cameron, Philip Cook, Greg Duncan,
Oscar Jorda, Willard Manning, Rebecca Maynard, Paul Rathouz, Elizabeth Stuart, and Tyler Vander
Weele for very helpful discussions. Each of the authors has contributed to the data collection, analysis,
and writing of this manuscript. None of the authors has any financial interest or conflict of interestrelated to the findings reported in this paper. Jacob and Ludwig had complete access to all the data
used in this study. The data used in this analysis are confidential; access to these data requires entering
into a confidentiality agreement with the relevant Illinois state agencies as well as the National Centerfor Health Statistics. Any errors and all opinions are course our own. The views expressed herein are
those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
NBER working papers are circulated for discussion and comment purposes. They have not been peer-
reviewed or been subject to the review by the NBER Board of Directors that accompanies official
NBER publications.
© 2011 by Brian A. Jacob, Jens Ludwig, and Douglas L. Miller. All rights reserved. Short sectionsof text, not to exceed two paragraphs, may be quoted without explicit permission provided that full
credit, including © notice, is given to the source.
 
The Effects of Housing and Neighborhood Conditions on Child MortalityBrian A. Jacob, Jens Ludwig, and Douglas L. MillerNBER Working Paper No. 17369August 2011JEL No. H75,I12,R38
ABSTRACT
In this paper we estimate the causal effects on child mortality from moving into less distressed neighborhood
environments. We match mortality data to information on every child in public housing that applied
for a housing voucher in Chicago in 1997 (N=11,848). Families were randomly assigned to the voucherwait list, and only some families were offered vouchers. The odds ratio for the effects of being offered
a housing voucher on overall mortality rates is equal to 1.11 for all children (95% CI 0.54 to 2.10),
1.50 for boys (95% CI 0.72 to 2.89) and 0.00 for girls – that is, the voucher offer is perfectly protective
for mortality for girls (95% CI 0 to 0.79). Our paper also addresses a methodological issue that may
arise in studies of low-probability outcomes – perfect prediction by key explanatory variables.Brian A. JacobGerald R. Ford School of Public PolicyUniversity of Michigan735 South State StreetAnn Arbor, MI 48109and NBERbajacob@umich.eduJens LudwigUniversity of Chicago1155 East 60th StreetChicago, IL 60637and NBER jludwig@uchicago.eduDouglas L. MillerUniversity of California, DavisDepartment of EconomicsOne Shields AvenueDavis, CA 95616-8578and NBERdlmiller@ucdavis.edu
 
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1. Introduction
 In this paper we seek to estimate the causal effects on mortality amongdisadvantaged children from moving into less dangerous, economically distressedhousing and neighborhood environment. Our study takes advantage of a naturalexperiment created by the random assignment of housing vouchers to public housingfamilies in the 3
rd
largest city in the U.S. (Chicago). Our study sample consists of every public housing family that applied for a voucher in Chicago in 1997, when the cityopened its housing-voucher wait-list for the first time in a dozen years. Ours is thus oneof the largest randomized experiments involving voucher-induced changes in socialenvironments (together with Moving to Opportunity), and the first that we know of toexamine one particularly important and well measured health outcome – mortality.Health outcomes for children and adults vary dramatically across neighborhoodswithin the United States, even after statistically controlling for various individual- or family-level risk and protective factors. These patterns have generated concern among both policymakers and scientists that health outcomes may be causally affected byneighborhood attributes such as the physical environment (e.g., housing stock,environmental toxins, crime), local institutions (e.g., health care providers, grocerystores, parks), or aspects of the social environment that may shape people’s information, preferences and norms about health-related behaviors (Kawachi and Berkman, 2003,Sampson 2003). Yet variation across neighborhoods in health could instead reflectdifferences in neighborhood compositions. Observational studies may confound thecausal effects of neighborhood and housing conditions with those of difficult-to-measureindividual or family attributes associated with both health and residential sorting.

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