Housing Instability Among Families With Young Children With Special Health Care Needs.


Journal

Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422

Informations de publication

Date de publication:
08 2019
Historique:
accepted: 01 05 2019
pubmed: 12 7 2019
medline: 9 1 2020
entrez: 12 7 2019
Statut: ppublish

Résumé

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. 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. 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]; 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.

Sections du résumé

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];
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.

Identifiants

pubmed: 31292218
pii: peds.2018-1704
doi: 10.1542/peds.2018-1704
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2019 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

POTENTIAL CONFLICT OF INTEREST: Dr Sandel holds an unpaid position on the board of Enterprise Community Partners, a national housing organization; the other authors have indicated they have no potential conflicts of interest to disclose.

Auteurs

Ruth Rose-Jacobs (R)

Department of Pediatrics, School of Medicine, and rrosejac@bu.edu.
Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.

Stephanie Ettinger de Cuba (S)

Department of Pediatrics, School of Medicine, and.

Allison Bovell-Ammon (A)

Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.

Maureen M Black (MM)

Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, Maryland.
RTI International, Durham, North Carolina.

Sharon M Coleman (SM)

Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, Massachusetts.

Diana Cutts (D)

Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota.

Mariana Chilton (M)

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; and.

Timothy Heeren (T)

Department of Biostatistics and.

Patrick Casey (P)

Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Eduardo Ochoa (E)

Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Deborah A Frank (DA)

Department of Pediatrics, School of Medicine, and.
Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.

Megan Sandel (M)

Department of Pediatrics, School of Medicine, and.
Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.

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Classifications MeSH