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Housing Instability Among Families With Young Children With Special Health Care Needs.
Pediatrics. 2019 08; 144(2)Ped

Abstract

BACKGROUND AND OBJECTIVE

Children with special health care needs (SHCNs) have significant medical and educational expenses affecting household finances. Housing instability can be detrimental to family well-being. Our objective was to evaluate housing instability in households of children with and without SHCNs.

METHODS

Cross-sectional surveys (2013-2017) in English and Spanish of caregivers with children <4 years old were conducted at 5 hospitals. The children with SHCN screener and caregiver report of child Supplemental Security Income (SSI) receipt were used to categorize children into the following groups: (1) no SHCNs, (2) SHCNs and no SSI, or (3) SHCNs and receiving SSI. Housing instability was determined by positive endorsement of ≥1 adverse circumstance: behind on rent or mortgage, or moving twice or more in the past year, or homelessness in the child's lifetime. Analyses used multivariable logistic regression models, adjusting for demographics and housing subsidies.

RESULTS

Of 14 188 children, 80% had no SHCNs, 16% had SHCNs and no SSI, and 4% had SHCNs and received SSI. Compared with the no-SHCNs group, the SHCNs-no-SSI group but not the SHCN-receiving-SSI group experienced significantly greater adjusted odds of being behind on rent or mortgage (adjusted odds ratio [aOR] 1.28 [95% confidence interval (CI) 1.14-1.44]; P < .001), multiple moves (aOR 1.29 [95% CI 1.05-1.59]; P = .01), and homelessness (aOR 1.44 [95% CI 1.20-1.72]; P < .001).

CONCLUSIONS

Families of children with SHCNs are at risk for housing instability. Child SSI receipt decreased the risk of housing instability among families of children with SHCNs. Protecting families of young children with SHCNs from housing instability is an important investment.

Authors+Show Affiliations

Department of Pediatrics, School of Medicine, and rrosejac@bu.edu. Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.Department of Pediatrics, School of Medicine, and.Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, Maryland. RTI International, Durham, North Carolina.Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, Massachusetts.Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota.Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; and.Department of Biostatistics and.Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.Department of Pediatrics, School of Medicine, and. Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.Department of Pediatrics, School of Medicine, and. Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.

Pub Type(s)

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

Language

eng

PubMed ID

31292218

Citation

Rose-Jacobs, Ruth, et al. "Housing Instability Among Families With Young Children With Special Health Care Needs." Pediatrics, vol. 144, no. 2, 2019.
Rose-Jacobs R, Ettinger de Cuba S, Bovell-Ammon A, et al. Housing Instability Among Families With Young Children With Special Health Care Needs. Pediatrics. 2019;144(2).
Rose-Jacobs, R., Ettinger de Cuba, S., Bovell-Ammon, A., Black, M. M., Coleman, S. M., Cutts, D., Chilton, M., Heeren, T., Casey, P., Ochoa, E., Frank, D. A., & Sandel, M. (2019). Housing Instability Among Families With Young Children With Special Health Care Needs. Pediatrics, 144(2). https://doi.org/10.1542/peds.2018-1704
Rose-Jacobs R, et al. Housing Instability Among Families With Young Children With Special Health Care Needs. Pediatrics. 2019;144(2) PubMed PMID: 31292218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Housing Instability Among Families With Young Children With Special Health Care Needs. AU - Rose-Jacobs,Ruth, AU - Ettinger de Cuba,Stephanie, AU - Bovell-Ammon,Allison, AU - Black,Maureen M, AU - Coleman,Sharon M, AU - Cutts,Diana, AU - Chilton,Mariana, AU - Heeren,Timothy, AU - Casey,Patrick, AU - Ochoa,Eduardo, AU - Frank,Deborah A, AU - Sandel,Megan, Y1 - 2019/07/10/ PY - 2019/05/01/accepted PY - 2019/7/12/pubmed PY - 2020/1/9/medline PY - 2019/7/12/entrez JF - Pediatrics JO - Pediatrics VL - 144 IS - 2 N2 - BACKGROUND AND OBJECTIVE: Children with special health care needs (SHCNs) have significant medical and educational expenses affecting household finances. Housing instability can be detrimental to family well-being. Our objective was to evaluate housing instability in households of children with and without SHCNs. METHODS: Cross-sectional surveys (2013-2017) in English and Spanish of caregivers with children <4 years old were conducted at 5 hospitals. The children with SHCN screener and caregiver report of child Supplemental Security Income (SSI) receipt were used to categorize children into the following groups: (1) no SHCNs, (2) SHCNs and no SSI, or (3) SHCNs and receiving SSI. Housing instability was determined by positive endorsement of ≥1 adverse circumstance: behind on rent or mortgage, or moving twice or more in the past year, or homelessness in the child's lifetime. Analyses used multivariable logistic regression models, adjusting for demographics and housing subsidies. RESULTS: Of 14 188 children, 80% had no SHCNs, 16% had SHCNs and no SSI, and 4% had SHCNs and received SSI. Compared with the no-SHCNs group, the SHCNs-no-SSI group but not the SHCN-receiving-SSI group experienced significantly greater adjusted odds of being behind on rent or mortgage (adjusted odds ratio [aOR] 1.28 [95% confidence interval (CI) 1.14-1.44]; P < .001), multiple moves (aOR 1.29 [95% CI 1.05-1.59]; P = .01), and homelessness (aOR 1.44 [95% CI 1.20-1.72]; P < .001). CONCLUSIONS: Families of children with SHCNs are at risk for housing instability. Child SSI receipt decreased the risk of housing instability among families of children with SHCNs. Protecting families of young children with SHCNs from housing instability is an important investment. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/31292218/Housing_Instability_Among_Families_With_Young_Children_With_Special_Health_Care_Needs_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=31292218 DB - PRIME DP - Unbound Medicine ER -