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Children's HealthWatch: Exploring the Link Between Housing and Children's Health

Both stable housing and quality housing are important social determinants, particularly for children, for both health- and school-related outcomes. Specific unhealthy housing conditions, such as pests, molds and chronic dampness, and tobacco smoke, have been tied to the development of and worsening asthma, and lead exposure has long-term negative health impacts for children.1  In addition to negatively impacting children’s physical health, housing mobility and instability can lead to consequences related to children’s academic performance. For example, children who move between the age of 4 and 15 have a lower likelihood of graduating high school.2

Children’s HealthWatch is a network of pediatricians, public health researchers, and children’s health and policy experts who conduct research to better understand the social and economic factors that impact children’s health. Since 1998, the organization has administered a household survey to caregivers of children under 4 years old at 5 hospitals in 5 different cities (Baltimore, Little Rock, Boston, Philadelphia, and Minneapolis) and to caregivers of children accessing emergency departments and clinics in Children’s HealthWatch medical centers.3  Researchers use this survey data to explore how policies and economic conditions impact the health of low-income children and families, and their findings inform the decision making of policymakers regarding these important issues. Children’s HealthWatch has conducted 2 recent studies using data collected during 1998–2009 that investigated issues related to housing and children’s health. 

In one study, researchers investigated whether linking housing and food assistance through a streamlined application process could improve housing security for children. The analysis focused on the association between receipt of housing subsidies, WIC and/or SNAP, and housing security.i  Researchers found that housing subsidies increase housing security among low-income, urban families with young children. Specifically, the group receiving housing subsidies combined with nutrition benefits was most strongly associated with higher odds of housing security. This study suggests that promoting both housing and nutrition assistance and improving access to these subsidies could increase family housing security, which, in turn, could positively impact children’s health.4

The second study explored the timing and duration effects of homelessness on children’s health. Researchers found that children of mothers who experienced homelessness during pregnancy or after birth had an increased risk of being hospitalized, having fair or poor health, and experiencing developmental delays compared to children who were never homeless. Specifically, the compounding stress of homelessness before and after birth is associated with a 99% increased risk of fair or poor child health, a 59% increased risk for developmental problems, and a 42% increase in child hospitalizations. Researchers also found that children and infants who experience homelessness for longer than 6 months are at higher risk for negative health outcomes. This negative effect of homelessness is especially apparent for infants, as extended homelessness is associated with a 250% increased risk of fair or poor child health and a 118% increased developmental risk. This research highlights the impact a lack of stable housing has on children’s health, specifically during pregnancy and early infancy.5

By conducting research on the impact of social and economic factors, such as housing, on children’s health, Children’s HealthWatch identifies areas and opportunities for addressing the social determinants of health. Continued research enables policymakers to make informed decisions based on the latest data in order to improve the health of the nation. 

1Sandel, M. The Housing Vaccine for Healthier Communities. 
2Cohen, R and Wardrip, K. “Should I Stay or Should I Go? Exploring the Effects of Housing Instability and Mobility on Children.” Center for Housing Policy. February 2011. Available at:
4Sandel, M, Cutts, D, Meyers, A, Ettinger de Cuba, S, and Coleman, S. “Co-enrollment for Child Health: How Receipt and Loss of Food and Housing Subsidies Relate to Housing Security and Statuses for Streamlined, Multi-Subsidy Application.” Journal of Applied Research on Children: Informing Policy for Children at Risk. Vol 5:2(2). 
5Sandel, M, Sheward, R, and Sturtevant, L. “Compounding Stress: The Timing and Duration Effects of Homelessness on Children’s Health.” Insights from Housing Policy Research. June 2015. Available at:
i The securely housed group was families with no more than 1 move in the previous year and no indication of overcrowding, which was defined as having more than 2 people per bedroom or as temporarily living with other people due to economic difficulties.
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Organization Name: Children’s HealthWatch
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Children’s HealthWatch

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Healthy People 2020 Topic Area(s) addressed: 
Healthy People 2020 Objective(s) addressed: 
Healthy People 2020 overarching goal addressed: 
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Create social and physical environments that promote good health for all.
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