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Understanding the Harm of Homelessness for the Present and Future :

September 4, 2018

In the quest to recognize social determinants of health and intervene when those determinants suggest an adverse effect on the health and well-being of children, we have begun to ask questions in health maintenance visits focused on such areas as food insecurity and more recently about homelessness.

In the quest to recognize social determinants of health and intervene when those determinants suggest an adverse effect on the health and well-being of children, we have begun to ask questions in health maintenance visits focused on such areas as food insecurity and more recently about homelessness. Yet how significant is homelessness as a contributor to future hospitalizations of an infant or toddler, developmental delay, or overall health?    Sandel et al. (10.1542/peds.2017-4254) address the importance of recognizing homelessness in a large study of more than 20,500 low-income caregivers of infants and children less than 4 years of age who were interviewed in clinics and emergency departments in five cities.  The authors asked families questions about prenatal and postnatal homelessness and found that any homelessness has significant implications for child health and well-being.  The authors also found that longer periods of homelessness is associated with worse outcomes. 

 While this study implores us to ask about homelessness at health maintenance visits, we should not only be reactive to this unfortunate situation but need to think about prevention of homelessness before it occurs.  To better understand the need for prevention of homelessness, we asked UCLA pediatricians and health policy experts Drs. Adam Schickedanz and Paul Chung to provide their thoughts in an accompanying commentary to this study (10.1542/peds.2018-2328).  Drs. Schickedanz and Chung give us several good examples of just how those prevention strategies are being implemented in parts of the country.  You’ll be right at home updating your understanding of the important role homelessness plays as a social determinant of health and what more you can be doing about it, by checking out this study and commentary. 

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