Impact of COVID-19 on Rural and Nonrural Recovery Housing in the United States

This study aimed to assess the impact of COVID-19 on recovery housing (RH), an important resource for individuals in recovery from substance use disorder (SUD). A cross-sectional survey was disseminated electronically between June and July of 2020 to RH owners and operators affiliated with Oxford House or the National Alliance of Recovery Residences nationwide. The survey intended to develop an understanding of the impact of COVID-19 on RH in terms of (a) resident housing access, (b) mitigation strategies to reduce COVID-19 spread, (c) RH financials, and (d) health and well-being of residents and staff. Impacts were assessed among all houses in the sample and then by rurality of RH location (rural vs. nonrural). Among 1,419 respondents, only 4.6% reported positive COVID-19 cases, and 85% reported having implemented centers for disease control-recommended policies. More than half (59%) reported financial impacts, and close to half (49%) reported COVID-19 had "a lot of impact" on residents attending meetings. Rural RH represented only 9% of respondents and a greater fraction of rural RH respondents reported spending more on all COVID-19 expense categories compared to nonrural RH respondents. Compared to nonrural RH, rural RH were significantly more likely to report having a process for evaluating COVID-19 (p = .007), wearing masks (p = .047), taking temperatures (p = .042), and spending more on food due to COVID-19 (p = .015). With SUD rates and the associated morbidity and mortality from SUD continuing to rise, addressing the financial viability of RH, an important resource supporting individuals in recovery is crucial. Public Health Significance Statement This study suggests that recovery housing, an important resource for individuals seeking or in recovery from a substance use disorder (SUD), is proactive in ensuring resident safety during national emergencies such as COVID-19. The most prominent impacts found in this study were financial (for the recovery home) and residents' ability to attend mutual aid recovery support meetings.