1 Housing Insecurity, Budget Trade-offs and Young Children’s Health Stephanie Ettinger de Cuba, MPH Children’s HealthWatch National Conference on Ending Homelessness July 14, 2011
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Housing Insecurity, Budget Trade-offs and Young Children’s Health
Stephanie Ettinger de Cuba, MPHChildren’s HealthWatch
National Conference on Ending HomelessnessJuly 14, 2011
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Overview• Brief intro to Children’s HealthWatch
•Definition of terms
•Food insecurity
•Housing insecurity
•Trends
•Impact of being behind on rent
•How many families are behind on rent?
•What does it mean for mothers’ and children’s health?
•How does impact family ability to meet other basic needs?
•Policy implications
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Children’s HealthWatch
•
Non-partisan, pediatric research & public policy center
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Impact of economic conditions and public policy → young children’s health & well-being–
Housing
–
Food–
Energy
•
Provide policy makers with evidence to develop policies that protect young children’s health and development
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Where our data comes from:
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Emergency Departments and Primary Care Clinics in Boston, Baltimore, Philadelphia, Little Rock and Minneapolis
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Interviews -
caregivers with children 0 to 4 years old–
“invisible”
group
–
critical window of time
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Neural Connections for Different Functions Develop Sequentially
Months Years Decades
Conception
Age
Source: Thompson & Nelson, 2000
Human Brain Development Vulnerable Period: Birth – Age 3
Fetus Late Infancy/Toddler Puberty
Birth
Sensory Pathways(Hearing, Vision)
Language
Higher Cognitive Functions
Adult neural connections
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What is food insecurity?
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Limited, uncertain access to enough nutritious food for all household members to lead active, healthy life due to economic constraints (USDA)
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Child food insecurity
–reductions in quantity, quality of children’s meals because caregivers can no longer buffer from inadequate household food resources
7Source: USDA, ERS 2006-2009
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Food Insecurity is a health issue Infection-Malnutrition Cycle
Illness/Infection
Hunger/Malnutrition
Weakened Immune System
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What is Housing Insecurity?
Moderate Housing InsecurityCrowded living conditions – more than 2 people per bedroom
Doubling up – living temporarily with another family for economic reasons
Severe Housing InsecurityFrequent moves – moving twice or more in the past year
Defined based on prevalence and child health outcomes
Source: DB Cutts, AJPH, June 2011
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What percent of young children live in housing insecure families?
0
10
20
30
40
50
60
5-city Baltimore Boston Little Rock Minneapolis Philadelphia
Source: Children’s HealthWatch, 1998-2010
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Housing insecurity Harmful to Young Children’s Health & Development
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Crowding/Doubling up –
increased risk of household & child food insecurity
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Frequent moves particularly damaging to young children
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Young children whose families have moved 2 or more times
in the past year are more likely to be:
–
Food insecure–
Child food insecure
–
In fair or poor health–
At risk for developmental delays
–
Lower weight for their ageDB Cutts, AJPH, June 2011
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I am a single mother of two children and am having a hard time making ends meet. I have a decent job but fell behind on my bills and now I am facing eviction. I have tried every single resource available out there. But everywhere I turn I hit a closed door and my hope dies a little again…
www.aidpage.com
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Behind Closed Doors:The
hidden health impacts of being behind on rent
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Much known –
children’s health and homelessness
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Little research health impact for children and families → being behind on rent
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Not included in original definition of housing insecurity
Research funded by the Fireman Foundation
Proportion of families struggling to pay rent increased over recession years
0%
5%
10%
15%
20%
25%
30%
2007 2008 2009 2010
14Source: Children’s HealthWatch
Struggle to pay rent –
risk to children’s health
•
Compared to young children in stable housing–
Young children in families behind on rent more likely•
Child food insecure
•
Poor health•
Developmental delays
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How do children in shelter fare compared to children in families
behind on rent?Children in shelter more likely to:
–
Be in fair/poor health–
Have history of hospitalization
–
Be at risk for developmental delay
BUT
Less likely to:–
Be child food insecure
Household and Maternal Well- being Compromised
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Household – increased risk:
– Food insecurity– Difficulty paying
utility bills (energy insecurity)
•
Mothers – increased risk:
– Poor health
– Depression
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Health Care Trade-offs & Foregone Care
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Has the cost of medical care or prescriptions ever stopped you from being able to pay for rent, mortgage, utility bills, food…?
•
Was there any time when [you or your child] needed a prescription medicine or medical care, but [were/was] unable to get it because the family couldn’t afford it?
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Household Balancing Act between Basic Needs
19Source: Children’s HealthWatch
What do we know about policy solutions?
Young children in subsidized housing less likely to be housing insecure
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Children’s HealthWatch, Rx for Hunger: Affordable Housing, 2009
Compared to young children on wait list, young children in subsidized housing
• More likely food secure• Less likely seriously underweight•
More likely classified as “well”
(composite of
several health indicators)
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Policy Implications•
Food & housing security = health issues
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Food & housing policy interrelated -
need for:–
Increased supply affordable housing
–
Stable, adequate funding subsidized housing–
Stable, adequate funding for stabilization (assistance with arrearages, security deposits)
–
Coordination btw housing/food advocates–
Outreach/assistance programs for those on wait list AND those struggling to pay rent
Stable housing is an economic development issue
Keeping families out of shelter (“front”
and “back door”) and stably housed is often better for children, families and city/state finances
Children are our country’s future leaders, our future workers, and our future community members.
An investment in affordable housing now is an investment in our country’s future. 22
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Thank You!
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