Child Homelessness Leads to Preventable Health Care Costs

Child Homelessness Leads to Preventable Health Care Costs
Megan Sandel, John Cook, Ph.D., Ana Poblacion, Richard Sheward, Sharon Coleman, Janet Viveiros, Lisa Sturtevant, Ph.D.
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Past research from the Children’s Health Watch has shown that homelessness, both pre-natal and post-natal has a detrimental impact on the health of children. Compared to children that have not experienced homelessness, children who experienced homelessness had higher rates of hospitalization, and the hospitalization risk was compounded for children who were homeless both prenatally and postnatally – this group was 41 percent more likely to have been hospitalized than children who were never homeless. In contrast, children who were homeless only in the postnatal period or only prenatally were 22 percent and 20 percent, respectively, more likely to have been hospitalized.

In the report Housing as a Health Care Investment, researchers from Children’s HealthWatch and the National Housing Conference estimate the costs of this increased hospitalization risk.

Major findings:

  • In 2014, an estimated 671,000 children age four or under had experienced homelessness either prenatally or postnatally.
  • The approximately 18,600 hospitalizations attributable to early childhood/prenatal homelessness in the United States cost more than $238 million annually.
  • 55 percent of these hospitalization costs are for children less than 12 months of age.
  • In food-insecure families (those who report not having regular access to adequate food) with rental assistance during the prenatal period, infants were 43 less likely to be hospitalized compared with those in similar families that did not receive rental assistance.
  • While 21 percent of infants in food-insecure families without rental assistance had been hospitalized prior to their first birthday, just 14 percent of similar infants in families with rental assistance had been hospitalized.
  • The avoided hospitalizations among infants in food-insecure families with rental assistance generated health care cost savings of approximately $20 million in 2015.

Policy recommendations:

  • Expand rental assistance programs, which have been demonstrated to reduce family homelessness. This includes support for Housing Choice Vouchers and other federal, state, and local rental subsidies; capital subsidy programs for new affordable development; as well as programs for preserving existing affordable housing and redeveloping poor quality public housing developments.
  • Ensure sufficient family-sized units are available and accessible with voucher assistance. This may include project-basing vouchers to add larger apartments to new affordable housing.
  • Support families in using housing vouchers by improving their administration and prohibiting discrimination against families with vouchers.
  • Connect families to supportive services such as case management and other social service programs.
  • Make the case to prioritize homeless and at-risk families as a special population for comprehensive housing-inclusive health care plans, similar to chronically ill or homeless individuals.