Prenatal, postnatal homelessness tied to poor health in children

(HealthDay)—Homelessness is associated with an increased risk of adverse pediatric outcomes regardless of whether it occurs prenatally or postnatally, according to a study published online Sept. 3 in Pediatrics.

Megan Sandel, M.D., M.P.H., from Boston Medical Center, and colleagues interviewed 20,571 low-income caregivers of children <4 years of age in urban pediatric clinics and/or emergency departments in five U.S. cities. The authors examined how the timing (prenatal, postnatal, both, or never) and duration of homelessness related to postnatal child health.

The researchers found that, compared with never-homeless children, children who were homeless both prenatally and postnatally were at the highest risk for postneonatal hospitalizations (adjusted odds ratio [aOR], 1.41), fair or poor child health (aOR, 1.97), and developmental delays (aOR, 1.48). However, there was no significant relationship with risk of underweight or overweight status. Children <1 year of age with more than six months of homelessness had high risks of fair or poor health (aOR, 3.13) compared with those who were never homeless. Similarly, children 1 to 4 years old who were homeless for more than six months were at risk for fair or poor health (aOR, 1.89).

"Pediatrics has made significant strides toward addressing family homelessness in just a few years," write the authors of an accompanying editorial. "We can make even faster progress by implementing tools to prevent homelessness that transcend current limitations in care coordination, reimbursement, and clinical convention while reshaping pediatric practice to protect child health."

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