Housing Instability: A New Screen for Adverse Health Issues for Caregivers and Children
LewisFirst, MD, MA, Editor in Chief, Pediatrics
Screening for adverse childhood experiences that can influence future trajectories
of child health has become a priority for child healthcare professionals. Most of
us are familiar with the two-question food insecurity questions embedded in the AAP’s
Bright Futures and Bright Futures Toolkit, but have you ever considered housing instability
to also provide a window into adverse child health for children and their caregivers?
Sandel et al. (10.1542/peds.2017-2199) provide a window into the importance of asking about unstable housing situations
in a new study being released this week in our journal. The authors interviewed caregivers
of young children from birth to age 4 year looking at physical and mental health issues
for caregivers and patients, and then asked about three housing circumstances—whether
they were behind on rent in the past year, had two or more moves in the past year,
or whether they had been homeless since their child was born. When the authors controlled
for potential confounders, they found that these three forms of housing instability
were associated with adverse caregiver and child health outcomes in low income renter
households. This study could potentially open doors that other screening questions
might not and enable you to be more proactive in ensuring that services and programs
are implemented for patients who may be more susceptible to physical and mental health
issues based on their unstable housing situations.
Do you ask about housing instability when you intake new patients? You may want to
do so after reading this important and interesting study—so check it out and let us
know whether implementing this three question housing screen makes a difference.