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Unstable Housing and Caregiver and Child Health in Renter Families.
Pediatrics. 2018 02; 141(2)Ped

Abstract

OBJECTIVES

To evaluate how 3 forms of housing instability relate to caregiver and child health among low-income renter households.

METHODS

Caregivers of children 0 to 48 months of age were interviewed in 5 urban medical centers from May 2009 to December 2015. Caregivers reported on the following: caregiver health, maternal depressive symptoms, child's health, lifetime hospitalizations, developmental risk, and 3 housing circumstances, which were categorized as being behind on rent in the past 12 months, multiple moves (≥ 2 in past 12 months), and child's lifetime history of homelessness. Associations with caregiver and child health outcomes were examined through multivariable logistic regression.

RESULTS

Of 22 324 families, 34% had at least 1 of the following adverse housing circumstances: 27% had been behind on rent, 8% had made multiple moves, and 12% had a history of being homeless. Overlap between these was limited; 86% experienced only 1 adverse housing circumstance. Each circumstance was individually associated with increased adjusted odds of adverse health and material hardship compared with stable housing. Households behind on rent had increased adjusted odds of fair and/or poor caregiver health (adjusted odds ratio [aOR]: 1.91; 95% confidence interval [CI]: 1.77-2.05), maternal depressive symptoms (aOR: 2.71; 95% CI: 2.51-2.93), child lifetime hospitalizations (aOR: 1.19; 95% CI: 1.10-1.27), fair and/or poor child health (aOR: 1.41; 95% CI: 1.28-1.56), and household material hardships. Families with multiple moves and history of homelessness had similar adverse caregiver, child, health, and hardship outcomes.

CONCLUSIONS

Three forms of housing instability were associated with adverse caregiver and child health among low-income renter households. The American Academy of Pediatrics recommends social screening within health care; providers could consider assessing for behind on rent, multiple moves, and homelessness in high-risk practices.

Authors+Show Affiliations

Department of Pediatrics, Boston Medical Center, Boston, Massachusetts; megan.sandel@bmc.org.Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.Data Coordinating Center and Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts.Data Coordinating Center and Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts.Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, Maryland.Data Coordinating Center and Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts.Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and.Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and.Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota.

Pub Type(s)

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

Language

eng

PubMed ID

29358482

Citation

Sandel, Megan, et al. "Unstable Housing and Caregiver and Child Health in Renter Families." Pediatrics, vol. 141, no. 2, 2018.
Sandel M, Sheward R, Ettinger de Cuba S, et al. Unstable Housing and Caregiver and Child Health in Renter Families. Pediatrics. 2018;141(2).
Sandel, M., Sheward, R., Ettinger de Cuba, S., Coleman, S. M., Frank, D. A., Chilton, M., Black, M., Heeren, T., Pasquariello, J., Casey, P., Ochoa, E., & Cutts, D. (2018). Unstable Housing and Caregiver and Child Health in Renter Families. Pediatrics, 141(2). https://doi.org/10.1542/peds.2017-2199
Sandel M, et al. Unstable Housing and Caregiver and Child Health in Renter Families. Pediatrics. 2018;141(2) PubMed PMID: 29358482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unstable Housing and Caregiver and Child Health in Renter Families. AU - Sandel,Megan, AU - Sheward,Richard, AU - Ettinger de Cuba,Stephanie, AU - Coleman,Sharon M, AU - Frank,Deborah A, AU - Chilton,Mariana, AU - Black,Maureen, AU - Heeren,Timothy, AU - Pasquariello,Justin, AU - Casey,Patrick, AU - Ochoa,Eduardo, AU - Cutts,Diana, Y1 - 2018/01/22/ PY - 2017/11/09/accepted PY - 2018/1/24/pubmed PY - 2019/1/22/medline PY - 2018/1/24/entrez JF - Pediatrics JO - Pediatrics VL - 141 IS - 2 N2 - OBJECTIVES: To evaluate how 3 forms of housing instability relate to caregiver and child health among low-income renter households. METHODS: Caregivers of children 0 to 48 months of age were interviewed in 5 urban medical centers from May 2009 to December 2015. Caregivers reported on the following: caregiver health, maternal depressive symptoms, child's health, lifetime hospitalizations, developmental risk, and 3 housing circumstances, which were categorized as being behind on rent in the past 12 months, multiple moves (≥ 2 in past 12 months), and child's lifetime history of homelessness. Associations with caregiver and child health outcomes were examined through multivariable logistic regression. RESULTS: Of 22 324 families, 34% had at least 1 of the following adverse housing circumstances: 27% had been behind on rent, 8% had made multiple moves, and 12% had a history of being homeless. Overlap between these was limited; 86% experienced only 1 adverse housing circumstance. Each circumstance was individually associated with increased adjusted odds of adverse health and material hardship compared with stable housing. Households behind on rent had increased adjusted odds of fair and/or poor caregiver health (adjusted odds ratio [aOR]: 1.91; 95% confidence interval [CI]: 1.77-2.05), maternal depressive symptoms (aOR: 2.71; 95% CI: 2.51-2.93), child lifetime hospitalizations (aOR: 1.19; 95% CI: 1.10-1.27), fair and/or poor child health (aOR: 1.41; 95% CI: 1.28-1.56), and household material hardships. Families with multiple moves and history of homelessness had similar adverse caregiver, child, health, and hardship outcomes. CONCLUSIONS: Three forms of housing instability were associated with adverse caregiver and child health among low-income renter households. The American Academy of Pediatrics recommends social screening within health care; providers could consider assessing for behind on rent, multiple moves, and homelessness in high-risk practices. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/29358482/Unstable_Housing_and_Caregiver_and_Child_Health_in_Renter_Families_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=29358482 DB - PRIME DP - Unbound Medicine ER -