Screening for adverse childhood experiences that can influence future trajectories of child health has become a priority for child healthcare professionals. Most of us are familiar with the two-question food insecurity questions embedded in the AAP’s Bright Futures and Bright Futures Toolkit, but have you ever considered housing instability to also provide a window into adverse child health for children and their caregivers? Sandel et al. ( 10.1542/peds.2017-2199) provide a window into the importance of asking about unstable housing situations in a new study being released this week in our journal. The authors interviewed caregivers of young children from birth to age 4 year looking at physical and mental health issues for caregivers and patients, and then asked about three housing circumstances—whether they were behind on rent in the past year, had two or more moves in the past year, or whether they had been homeless since their child was born. When the authors controlled for potential confounders, they found that these three forms of housing instability were associated with adverse caregiver and child health outcomes in low income renter households. This study could potentially open doors that other screening questions might not and enable you to be more proactive in ensuring that services and programs are implemented for patients who may be more susceptible to physical and mental health issues based on their unstable housing situations.
Do you ask about housing instability when you intake new patients? You may want to do so after reading this important and interesting study—so check it out and let us know whether implementing this three question housing screen makes a difference.
