Pandemic relief policies and public health: A study on emergency rental assistance and COVID-19 deaths in the USA

Objectives: The COVID-19 pandemic risked exacerbating housing instability, prompting the allocation of substantial emergency rental assistance. This study leveraged the variation in county-level program adoption to investigate the relationship between the enactment of rental assistance programs and COVID-19 mortality rates. Study design: Quasi-experimental study. Methods: We identified counties that implemented rental assistance programs in 2020 from the COVID-19 Emergency Rental Assistance Database linked to administrative data. We contrasted the characteristics between counties with and without rental assistance programs. We estimated the effects of county-level emergency rental assistance programs on COVID mortality rates by applying propensity score matching combined with differencing techniques. Results: A total of 2,993 US counties were included in this study, of which 170 counties (5.7 %) implemented COVID-19 emergency rental assistance programs in 2020 while 2,823 counties (94.3 %) did not. A comparative analysis of the counties revealed notable differences in race/ethnicity, education levels, income, poverty rates, healthcare resources, and health outcomes. COVID-19 emergency rental assistance programs were found to be significantly associated with an estimated reduction in monthly COVID death rates by 636 per 100,000 population. Conclusion: Early-stage rental assistance funding played a crucial role in flattening the peak of the COVID-19 pandemic. These findings underscore the importance of incorporating financial support mechanisms into pandemic preparedness strategies, particularly before effective vaccines. Policymakers should consider these insights in future policy formulations aimed at enhancing epidemic response capabilities.