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Associations between housing instability and food insecurity with health care access in low-income children.
Ambul Pediatr. 2008 Jan-Feb; 8(1):50-7.AP

Abstract

OBJECTIVE

Homelessness and hunger are associated with poor health care access among children. Housing instability and food insecurity represent milder and more prevalent forms of homelessness and hunger. The aim of this study was to determine the association between housing instability and food insecurity with children's health care access and acute health care utilization.

METHODS

We conducted a cross-sectional analysis of 12,746 children from low-income households included in the 2002 National Survey of America's Families (NSAF). In multivariate models controlling for important covariates, we measured the association between housing instability and food insecurity with 3 health care access measures: 1) no usual source of care, 2) postponed medical care, and 3) postponed medications. We also measured 3 health care utilization measures: 1) not receiving the recommended number of well-child care visits, 2) increased emergency department visits, and 3) hospitalizations.

RESULTS

Our analysis showed that 29.5% of low-income children lived in households with housing instability and 39.0% with food insecurity. In multivariate logistic regression models, housing instability was independently associated with postponed medical care, postponed medications, and increased emergency department visits. Food insecurity was independently associated with no usual source of care, postponed medical care, postponed medications, and not receiving the recommended well-child care visits.

CONCLUSION

Families that experience housing instability and food insecurity, without necessarily experiencing homelessness or hunger, have compromised ability to receive adequate health care for their children. Policy makers should consider improving programs that decrease housing instability and food insecurity, and clinicians should consider screening for housing instability and food insecurity so as to provide comprehensive care.

Authors+Show Affiliations

Department of Pediatrics, University of California, San Francisco, San Francisco General Hospital, CA 94143-1364, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18191782

Citation

Ma, Christine T., et al. "Associations Between Housing Instability and Food Insecurity With Health Care Access in Low-income Children." Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association, vol. 8, no. 1, 2008, pp. 50-7.
Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambul Pediatr. 2008;8(1):50-7.
Ma, C. T., Gee, L., & Kushel, M. B. (2008). Associations between housing instability and food insecurity with health care access in low-income children. Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association, 8(1), 50-7. https://doi.org/10.1016/j.ambp.2007.08.004
Ma CT, Gee L, Kushel MB. Associations Between Housing Instability and Food Insecurity With Health Care Access in Low-income Children. Ambul Pediatr. 2008 Jan-Feb;8(1):50-7. PubMed PMID: 18191782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between housing instability and food insecurity with health care access in low-income children. AU - Ma,Christine T, AU - Gee,Lauren, AU - Kushel,Margot B, PY - 2007/02/13/received PY - 2007/07/31/revised PY - 2007/08/18/accepted PY - 2008/1/15/pubmed PY - 2008/3/22/medline PY - 2008/1/15/entrez SP - 50 EP - 7 JF - Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association JO - Ambul Pediatr VL - 8 IS - 1 N2 - OBJECTIVE: Homelessness and hunger are associated with poor health care access among children. Housing instability and food insecurity represent milder and more prevalent forms of homelessness and hunger. The aim of this study was to determine the association between housing instability and food insecurity with children's health care access and acute health care utilization. METHODS: We conducted a cross-sectional analysis of 12,746 children from low-income households included in the 2002 National Survey of America's Families (NSAF). In multivariate models controlling for important covariates, we measured the association between housing instability and food insecurity with 3 health care access measures: 1) no usual source of care, 2) postponed medical care, and 3) postponed medications. We also measured 3 health care utilization measures: 1) not receiving the recommended number of well-child care visits, 2) increased emergency department visits, and 3) hospitalizations. RESULTS: Our analysis showed that 29.5% of low-income children lived in households with housing instability and 39.0% with food insecurity. In multivariate logistic regression models, housing instability was independently associated with postponed medical care, postponed medications, and increased emergency department visits. Food insecurity was independently associated with no usual source of care, postponed medical care, postponed medications, and not receiving the recommended well-child care visits. CONCLUSION: Families that experience housing instability and food insecurity, without necessarily experiencing homelessness or hunger, have compromised ability to receive adequate health care for their children. Policy makers should consider improving programs that decrease housing instability and food insecurity, and clinicians should consider screening for housing instability and food insecurity so as to provide comprehensive care. SN - 1530-1567 UR - https://www.unboundmedicine.com/medline/citation/18191782/Associations_between_housing_instability_and_food_insecurity_with_health_care_access_in_low_income_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1530-1567(07)00155-4 DB - PRIME DP - Unbound Medicine ER -