Health Affairs January 1, 2026
Abstract
Housing insecurity, an important determinant of mental health, worsened during the COVID-19 pandemic in the US. The federal Emergency Rental Assistance (ERA) program sought to reduce housing insecurity among low-income renters. Using 2021–23 Household Pulse Survey data, we employed a quasi-experimental design to assess the effects of ERA on anxiety and depression symptoms and on mental health care use. We conducted causal mediation analyses to determine whether and how ERA affected these outcomes through indirect effects—by alleviating housing insecurity—or through direct effects, which freed up resources to seek care. ERA significantly reduced anxiety and depression symptoms through both indirect and direct effects. Among renters with anxiety or depression symptoms, it increased psychotherapy use through direct effects. Future rental assistance...
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