Not having secure housing is a huge stress for anyone. But when children experience this, especially in early childhood, it can affect their health years down the line.
That鈥檚 the finding of a new study in the , which says that teens who experienced housing insecurity earlier in life were more likely to report worse health.
鈥淧ediatricians, for a long time, have suspected that housing insecurity is associated with negative health outcomes,鈥� says , a pediatrician at in New York City.
But this is important evidence from a longitudinal study that follows children from infancy to adolescence and connects their experiences of housing insecurity with long term health, she adds.
In-depth research over time
The following a group of children across the country since their birth over 20 years ago.
Researcher Kristyn Pierce and her colleague in the department of pediatrics at NYU Grossman School of Medicine mined data from that study to get a good sense of kids鈥� experiences with housing from birth to age 15.
鈥淲e took measures of housing insecurity that were collected throughout their participation,鈥� says Pierce.
That included indicators like 鈥渉omelessness, eviction, doubling up, meaning like overcrowding in the house and spending a night in a place that wasn't meant for residents and also difficulty paying for rent or mortgage.鈥�
Degrees of difference
A majority of the kids in the study 鈥� 47% 鈥� had stable housing throughout the study. 鈥淭here was not one indicator [of housing insecurity] throughout their 15 years of participation,鈥� says Pierce.
A similarly large group 鈥� 46% 鈥� was what Pierce and her colleagues call 鈥渕oderately insecure.鈥�
鈥淢aybe they just had insecurity at one time point, and then were fully secure at another one,鈥� says Pierce. 鈥淪o it was sort of fluctuating and low.鈥�
The third and smallest group 鈥� 6% of the study population 鈥� had high levels of housing insecurity, especially in early childhood, but with stable housing later on.
Kids with any level of housing insecurity 鈥� low or high 鈥� had worse self-reported health at age 15, says Pierce. They also reported worse mental health.
鈥淐hildren in both insecure groups reported higher levels of depression,鈥� says Pierce. 鈥淎nd then only those in the highly insecure group reported higher levels of anxiety.鈥�
A measure for children
Most past studies have looked at the health impacts of housing problems in adults, says , the national director of , a program that supports low income families with kids between the ages of zero and three.
鈥淭his study is really important in terms of focusing our attention on teens,鈥� says Briggs, who wasn鈥檛 involved in the new study.
鈥淓verything we know about [early] childhood is that it's the most critically important time to get your foundation right,鈥� she adds.
So it makes sense that experiencing housing instability in those early years would affect health in adolescence.
This goes back to , explains Briggs.
鈥淚t's got five levels to it. And at the very, very bottom is what they call physiological needs breathing, food, water, sleep and shelter,鈥� she says. 鈥淪o just as foundational as breathing and water and food and sleep is this idea of shelter.鈥�
The absence of a safe and secure shelter creates 鈥渃hronic and unrelenting鈥� stress for the parents or caregivers, which is then picked up by kids, as well.
鈥淭he acute stress of the parent and chronic stress with parents leads to dysregulation in children,鈥� which in turn affects their development and mental health down the line.
鈥淚t tells us that, you know, you need to intervene early,鈥� says , a pediatrician and the chief of Division of Academic General Pediatrics at Montefiore and Albert Einstein College of Medicine.
Pediatricians can help
That early intervention starts with screening families with young children, says , a pediatrician at and co-author of the new study. 鈥淎s a primary care pediatrician, I'm a big believer in the primary care clinic as sort of a population health based place where we can reach a lot of children, especially young children.鈥�
Pediatricians who are part of the Healthy Steps effort already screen families with newborns up to age three several times during well-child visits .
鈥淣inety percent of young children regularly attend well-child visits. It is the single and only setting that we have in this country to regularly reach young children in their families. Furthermore, families trust pediatricians,鈥� Briggs says.
It鈥檚 something Montefiore has also been doing.
鈥淗ere at Montefiore, we screen all of our clinic pediatric patients for social needs,鈥� says Muleta, including housing insecurity.
Both at Healthy Steps clinics and at Montefiore, families who need help with housing are connected to resources in the community through a social worker or a community health worker.
Montefiore鈥檚 Community Health Worker Institute, which opened in 2021, has reached more than 6,000 families with social needs, including housing, says Oyeku.
However, Muleta admits that 鈥渙f all the social needs that we screen for and intervene upon, I would say that housing insecurity is probably one of the most difficult and the longest to be able to resolve.鈥�
It鈥檚 a reality tied to the limited availability of affordable housing, she adds.
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