In collaboration with the John D. and Catherine T. MacArthur
Foundation’s How Housing Matters
Initiative, Spotlight on Poverty and
Opportunity will be running a series of commentaries for the next two
months exploring the relationship between housing and three topics: health,
economic opportunity, and education. Please be sure to read Michael Stegman’s “An
Introductory Note” to learn more.
This commentary is the second installment in the series, which is
entitled “How Housing Matters to Families and Communities.”
sometimes ask us why, as practicing pediatricians, we care so much about
housing. Our answer is “How can we not?” For many of our patients, a safe,
decent, affordable home is like a vaccine—it literally keeps children healthy.
That’s why it’s essential for policymakers to take account of children’s health
when making housing policy.
medical and educational research shows clearly how much housing matters to
children. We, with our pediatric and public health colleagues, conduct such
research as part of Children’s HealthWatch, a
pediatric research center studying the impact of nutrition, housing, and energy
policy on very young children from birth to three years old. Our research has
shown how profound the influence of housing policy is on young children’s
health, growth, and development, with its impact extending into the womb.
of the uniquely rapid rates of growth of both the body and brain in the
earliest years, young children are immensely vulnerable to deprivation. Unfortunately,
this deprivation is often invisible to all but their families and their
can housing problems lead to destructive deprivation?
it’s critical to recognize that family homelessness represents the extreme end
of a continuum of economically driven housing conditions that endanger young
children. We term this range of conditions “housing insecurity”—a concept analogous
to the measurement of food insecurity.
insecurity,” quantifies less visible forms of housing stress than homelessness.
This consists of doubling up with other families for economic reasons,
overcrowding, or moving two or more times in a year—conditions that put
children at risk of negative impacts on their health.
in families who move this frequently are not only more likely to be food
insecure but are 50 percent more likely to be in fair or poor health - as
opposed to good or excellent health - and children in these families are 70
percent more likely to be at risk of developmental delays than similar children
whose families do not move that often.
insecurity can also impact child health even before children are born. Our most
recent analyses show that women who experience homelessness during pregnancy are
50 percent more likely to have a low birth weight baby and over 30 percent more
likely to have a pre-term delivery than similar women who were not homeless
good news is that housing policy can make a difference. Our research has shown
that housing subsidies will protect families from both housing insecurity and
food insecurity. Similar to receiving one shot against multiple diseases, young children who live in subsidized housing
are much more likely to be “well”—developmentally
normal, not underweight or overweight, in good or excellent health, and with no history of hospitalizations.
subsidies can alleviate the negative impacts of housing insecurity may not be
surprising. Yet few recognize just how protective subsidized housing can be for
young children in the face of other kinds of deprivation. In the same way that
some vaccines decrease the severity of an illness though they may not fully
prevent it, housing subsidies double the chances that young children in
families suffering from food insecurity will avoid stunted growth when compared
to other young food insecure children whose families do not receive housing
the negative effects of poor housing and the potential upside of housing
subsidies, and it’s clear housing is one of the best investments we can make. We
spend substantial public funds each year to care for low
birth weight babies or to alleviate the impact of ill health and developmental
delays in early childhood. Yet every dollar spent in housing can play a part in
helping to prevent many of these negative outcomes before they happen.
David Williams put it best in the documentary Unnatural Causes: “Housing policy
is health policy.” Housing matters, particularly to young children. Strategic
investments in the critical developmental window from pregnancy to three years
of age can, quite literally, change the trajectory of a child’s life.
administering childhood vaccinations, we make sure a child receives the right
dose. The same goes for housing. Just as vaccines in early childhood have a lifelong
payoff for a child and society, making sure families can avoid housing
insecurity is preventive medicine that will help put a child on the right path
from the beginning.
To print a PDF version of this document, click here.
Dr. Megan Sandel is a
research scientist at Children’s HealthWatch.
Dr. Deborah A. Frank is the
founder and principal investigator of Children’s HealthWatch.