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Primary Submission Category: Life-course/developmental

Cumulative Burden of Housing Insecurity Among Children in the United States from Birth to Adolescence

Authors:  Audrey Renson, Matthew Fowle, Sarah Pachman, Giselle Routhier,

Presenting Author: Giselle Routhier*

Background: Housing insecurity is a key social determinant of a wide range of health outcomes, subject to large racial inequities, and with a likely sensitive period in childhood. Housing insecurity can manifest in multiple ways and change over time, but previous studies have primarily focused on single dimensions or a single time point. This study examines cumulative burden of multidimensional housing insecurity among children in the U.S.

Methods: We used data from n=3,308 children enrolled in the Future of Families and Child Wellbeing Study (FFCWS), designed to be representative of births in 1998-2000 in large US cities. We operationalized multidimensional housing insecurity using repeated measures of eviction, homelessness, doubling up, not paying full rent or mortgage, utility shut-offs, and frequent moves. We estimated cumulative incidence and mean cumulative counts for each measure from age 1-15, overall and by mother’s race/ethnicity. Missing data, due primarily to gaps between waves, were accounted for using 2 methods: (i) a lower bound approach that imputes zeros, and (ii) imputation based on jointly modeling all 6 housing insecurity variables given baseline covariates.

Results: Between 45% (lower bound) and 71% (modeled) of children experienced at least one form of housing insecurity by age 15. Among children experiencing at least one event, the average number of events was between 2.6 (lower bound) and 6.1 (modeled) by age 15. Children of non-Hispanic Black and Hispanic mothers, compared to those of white mothers, were more likely to experience an initial event of housing insecurity across all forms, but once experienced, had similar numbers of events.

Discussion: Our results highlight a massive and cyclical burden of housing insecurity among children in the U.S. Large racial differences in incidence of first events, but not repeated events, suggest that preventive interventions would be most effective at combating racial inequities in housing insecurity.