Trajectories of Housing Insecurity From Infancy to Adolescence and Adolescent Health Outcomes
From the August 2024 Edition of Pediatrics
A new paper in Pediatrics focuses on defining housing instability and the impact of housing insecurity on health outcomes of children at age 15.
The data used in this study was from the Future of Families and Child Wellbeing Study. 4,898 participants were enrolled at birth from 20 US cities. The same families were interviewed when the child was 1, 3, 5, 9 and 15.
Read the paper here. The paper includes a short video (3 minutes 40 seconds) summarizing the article, a new method for sharing a paper’s content.
The authors (Kristyn A. Pierce, MPH; Alan Mendelsohn, MD; Brandon Smith, MD, MPH; Sara B. Johnson, PhD, MPH; Carol Duh-Leong, MD, MPP) developed a measure of the extent of housing instability which could be very useful for homeless providers working with families with young children.
Housing instability was defined as having one or more of five housing experiences including:
missed rent or mortgage payment
doubling up with other families
eviction
homelessness (at least 1 night in the past year sleeping in a shelter, car, abandoned building, or another place not meant for residence)
moving more than once during the period between interviews
The authors report both doubled up and ‘literal’ homelessness as two different indicators. Because families were asked if they were doubled-up, this data source might be useful in further research on doubled up families. Doubled up is the solid red line and “literal” homelessness is the yellow dashed line in Chart A and B below.
A measure of housing security was developed based on the count (number of experiences reported at each interview) from 0 (secure) to 5 (highly insecure). Using longitudinal statistical measures, three distinct trajectories were identified. The percentages are from the age 1 interview:
Secure (no insecurity) (47%)
Moderately Insecure (intermittent-moderate insecurity) (46%)
Highly Insecure (high insecurity in early childhood, trending to security in adolescence) (6%)
The data indicate a signficant difference between “Moderately Insecure” and “Highly Insecure.” While skipping rent and doubling up were the highest indicators of housing insecurity for both groups, the “Highly Insecure” group experienced significantly higher rates of skipping rent, doubling-up and frequent moves.
The authors found that adolescents in the moderately and highly insecure groups had a 19% and 33% lower odds, respectively, of reporting “very good” or “excellent” SRH than those in the secure housing group.
They also found that adolescents in the highly insecure housing group reported more depressive symptoms on average than their secure and moderately insecure counterparts. Adolescents in the moderately and highly insecure groups reported depressive symptoms at rates of 1.05 and 1.1 times higher, respectively, than adolescents in the secure group.
Overall, the authors concluded that adolescents who experienced any indicators of housing insecurity from infancy to adolescence had worse health outcomes at age 15 compared to those who had secure housing.
Comments?
What is SRH?