Housing instability increases risk of poor health outcomes and material hardships

When families don't have stable housing, their risk of struggling with poor health outcomes and material hardships, such as food insecurity, increases, according to a new study from Children's HealthWatch. Researchers surveyed over 22,000 families and found that one third of low-income renters were housing unstable, which was associated with negative impacts on their health.

To determine housing instability, researchers asked families if they had been behind on rent or moved more than twice in the past year, and if their child had experienced homelessness. All three circumstances were associated with increased odds of adverse health outcomes, such as poor caregiver health, poor child health, maternal depressive symptoms, and food and energy insecurity, when compared to families with stable housing.

"Two-thirds of the families who said they were housing insecure were behind on rent in the past year," said Megan Sandel, MD, MPH, principal investigator at Children's HealthWatch and associate director of the GROW Clinic at Boston Medical Center (BMC). "This should be something doctors pay attention to when screening patients for housing instability, as it hasn't been recognized as a factor in the past."

The study also explored how multiple unstable housing circumstances affected family health. They found as the number of adverse housing circumstances increased, the odds of child and caregiver health risks also increased. However, there was limited overlap between the three circumstances, with 86 percent of families only experiencing one circumstance.

"Asking questions specific to all three circumstances can help providers asses both individual and community health and housing needs, and identify families who are at risk of poor health associated with housing instability," added Sandel. "Since there is little overlap in the circumstances, it is vital to assess each circumstance to keep families from slipping through the cracks."

Families were surveyed in five urban medical centers in Baltimore, MD, Minneapolis, MN, Boston, MA, Little Rock, AR, and Philadelphia, PA. All of the families were renters and had public health insurance or were uninsured. The study is published online in Pediatrics.