The number of very poor unsubsidized families struggling to pay their monthly rent and who may also be living in substandard housing increased between 2013 and 2015, according to a new report released by the Department of Housing and Urban Development (HUD).

In 2015, 8.3 million households had worst-case needs, up from 7.72 million in 2013 and approaching the record high of 8.48 million in 2011. These households are defined as very low-income renters who do not receive government housing assistance and who paid more than half of their income for rent, lived in severely inadequate conditions, or both.

“Severe housing problems have grown 41% since the beginning of the Great Recession in 2007 and 66% since 2001,” says the Worst Case Housing Needs: 2017 Report to Congress. “Worst-case needs continue to affect all subgroups, whether defined by race and ethnicity, household structure, or location within metropolitan areas or regions.”

The report also highlights the importance of housing assistance to reducing these worst-case needs, says Andrew Aurand, vice president for research at the National Low Income Housing Coalition. “Too many very low-income households eligible for assistance do not receive it,” he says. “The cuts to HUD’s budget proposed by the Trump administration and by the House would have a devastating impact and increase the number of families with worst case housing needs even further.”

The White House’s fiscal 2018 budget proposal calls for the tenant-based rental assistance program to receive $19.3 billion, a nearly 5% decrease from $20.3 billion this year. The president’s budget would lead to more than 250,000 of the lowest-income people losing their housing vouchers, putting them at immediate risk of eviction and, in worst cases, homelessness, according to NLIHC. The House plan calls for $20.5 billion, and the Senate proposal seeks $21.4 for the program.

For project-based rental assistance, the administration seeks $10.4 billion for project-based rental assistance, a drop from $10.8 billion this year. The House seeks $11.1 billion and the Senate proposes $11.5 for the program.

“While fewer regulatory barriers to housing production would help in high-cost markets where the rental supply has not kept up with demand, housing assistance is a necessity for the lowest-income households,” Aurand says. “Without housing assistance, what these families can afford to pay in rent is often too low to cover the costs for the private market to serve them.”

While it appears that the nation’s continuing economic recovery is having some beneficial effect on the incomes of very low-income renters, a limited supply of affordable housing, a rising population of renter households, a widening rental assistance gap, and rising rents continue to drive severe housing problems.

“Most cases of worst-case needs are caused by severe rent burdens—paying more than one-half of income for rent,” says the report. “Inadequate housing caused only 2% of worst-case needs. An increase by 700,000 in the number of very low-income renters who lack housing assistance—the group at risk of experiencing worst-case needs—explains about 402,000 of the 582,000 new cases of worst-case needs between 2013 and 2015.”

HUD points out that a shift from homeownership to renting contributed most to the increase in worst-case needs between 2013 and 2015. “Modest gains in household incomes were met with rising rents, shrinking the supply of affordable rental housing stock in an increasingly competitive market,” the report explains. “Even with the supply of more expensive units growing, higher-income renters occupy a growing share—43%—of the most affordable units. Only 62 affordable units are available per 100 very low-income renters, and only 38 units are available per 100 extremely low-income renters.”

The number of families with children having worst-case needs increased by 55,000 during the 2013-to-2015 period to 2.89 million—partially offsetting the 400,000 decrease observed in the previous two years. Worst-case needs increased despite a reduction of 61,000 in the number of very low-income renters with children.

During 2015, 1.85 million elderly renters had worst-case needs, an increase of 382,000 since 2013. The proportion of elderly very low-income renters with worst-case needs was 39.8% in 2015, less than the rate for families with children but representing a 2.6-point increase since 2013.

For the first time, HUD is reporting estimates of worst-case housing needs for select metropolitan areas across the country. More than half of the very low-income renters residing in and around Los Angeles, Miami, Phoenix, and Riverside, Calif., experienced worst-case needs in 2015. The Miami-Fort Lauderdale area had the highest percentage, with nearly 61% with worst-case needs.

Homeless people are not included in official estimates of worst-case needs because the American Housing Survey (AHS), which is used in the report, covers only housing units and the households that live in them, and persons experiencing homelessness, by definition, do not live in a housing unit and are not surveyed by the AHS.