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The Relationship Between Housing Instability and Access to Social Safety Net Programs

February 9, 2024

Editor’s Note: Elizabeth Zeichner (she/her) is a former high school teacher and fourth-year medical student at Emory University School of Medicine. - Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics

Housing instability negatively affects child health. There are potentially even more downstream effects when families are displaced from their homes through “cost-driven moves,” whether due to affordable housing costs, evictions, or foreclosures.

This week, Pediatrics is early releasing an article entitled, “Moving Because of Unaffordable Housing and Disrupted Social Safety Net Access Among Children,” by Kathryn M. Leifheit, PhD, from the University of California-Los Angeles and colleagues from University of California-San Francisco, Johns Hopkins University, Drexel University, University of Maryland, and RTI International (10.1542/peds.2023-061934). The authors investigate the association of cost-driven moves and access to social safety net programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the Supplemental Nutrition Assistance Program (SNAP), and Medicaid.

The authors used data from the Children’s HealthWatch study, which is a 2011–2019 cross-sectional survey from families with 9,344 children who were financially eligible for social safety net programs in Baltimore and Philadelphia.

The authors found that families who had to make a cost-driven move were 44% more likely to have disrupted access to at least one safety net program. Interestingly, they found that non-cost-driven moves were also associated with some disruption to safety net programs (14%), but less strongly than cost-driven moves.

The authors discuss some of the factors that contribute to disruption in accessing safety net programs for families displaced through cost-driven moves:

  • If families are suddenly displaced or struggling to find an affordable place to live, it can be challenging to keep track of all administrative tasks.
  • Many social safety net programs require physical documentation to be mailed, which can be lost in a move.
  • Different programs have different requirements if families move between states.

To make things more complicated, losing access to these programs can also make it more challenging for families to afford living expenses, which may then make a cost-driven move more likely.

In an invited commentary, “Involving Families in Public Policy Innovation to Reduce Cost-Driven Moves and Related Disruption,” Stephanie Ettinger de Cuba, PhD, and Sharon M. Coleman from Boston University explore some of advocacy and policy opportunities for pediatric providers (10.1542/peds.2023-063971). They discuss the need for more studies looking at these impacts. They also emphasize that we need to make access to these programs easier for families.

I encourage you to read this article and the corresponding commentary to further explore the important role that all of us have in connecting families to existing social programs and advocating for policy change that improves access to these programs. We need to ask families if they are having trouble paying rent, or if they are moving or have recently moved, and from there, help connect them with resources that allow continued access to important social support programs.

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