{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:06:03Z","timestamp":1792040763631,"version":"4.4.0"},"reference-count":46,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To evaluate how 3 forms of housing instability relate to caregiver and child health among low-income renter households.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Caregivers of children 0 to 48 months of age were interviewed in 5 urban medical centers from May 2009 to December 2015. Caregivers reported on the following: caregiver health, maternal depressive symptoms, child\u2019s health, lifetime hospitalizations, developmental risk, and 3 housing circumstances, which were categorized as being behind on rent in the past 12 months, multiple moves (\u2265 2 in past 12 months), and child\u2019s lifetime history of homelessness. Associations with caregiver and child health outcomes were examined through multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Of 22\u2009324 families, 34% had at least 1 of the following adverse housing circumstances: 27% had been behind on rent, 8% had made multiple moves, and 12% had a history of being homeless. Overlap between these was limited; 86% experienced only 1 adverse housing circumstance. Each circumstance was individually associated with increased adjusted odds of adverse health and material hardship compared with stable housing. Households behind on rent had increased adjusted odds of fair and\/or poor caregiver health (adjusted odds ratio [aOR]: 1.91; 95% confidence interval [CI]: 1.77\u20132.05), maternal depressive symptoms (aOR: 2.71; 95% CI: 2.51\u20132.93), child lifetime hospitalizations (aOR: 1.19; 95% CI: 1.10\u20131.27), fair and\/or poor child health (aOR: 1.41; 95% CI: 1.28\u20131.56), and household material hardships. Families with multiple moves and history of homelessness had similar adverse caregiver, child, health, and hardship outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Three forms of housing instability were associated with adverse caregiver and child health among low-income renter households. The American Academy of Pediatrics recommends social screening within health care; providers could consider assessing for behind on rent, multiple moves, and homelessness in high-risk practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2017-2199","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T03:31:24Z","timestamp":1516591884000},"source":"Crossref","is-referenced-by-count":212,"title":["Unstable Housing and Caregiver and Child Health in Renter Families"],"prefix":"10.1542","volume":"141","author":[{"given":"Megan","family":"Sandel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sheward","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Ettinger de Cuba","sequence":"additional","affiliation":[{"name":"Data Coordinating Center and Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Data Coordinating Center and Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Chilton","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Heeren","sequence":"additional","affiliation":[{"name":"Data Coordinating Center and Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Pasquariello","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Ochoa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Cutts","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,2,1]]},"reference":[{"key":"2021121014414967300_B1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/00333549101250S402","article-title":"Include a social determinants of health approach to reduce health inequities.","volume":"125","author":"Satcher","year":"2010","journal-title":"Public Health Rep"},{"key":"2021121014414967300_B2","unstructured":"Johnson\u2008A, Meckstroth\u2008A. Ancillary Services To Support Welfare To Work. Princeton, NJ: Mathematica Policy Research, Inc, US Department of Health and Human Services Office of Human Services Policy; 1998. Available at: http:\/\/aspe.hhs.gov\/hsp\/isp\/ancillary\/front.htm. Accessed November 1, 2016"},{"key":"2021121014414967300_B3","volume-title":"Housing Insecurity Among Urban Fathers. Working Paper Number 1231","author":"Curtis","year":"2010"},{"issue":"8","key":"2021121014414967300_B4","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1017\/S0033291703008377","article-title":"Socio-economic status, family disruption and residential stability in childhood: relation to onset, recurrence and remission of major depression.","volume":"33","author":"Gilman","year":"2003","journal-title":"Psychol Med"},{"issue":"1","key":"2021121014414967300_B5","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1525-1497.2005.00278.x","article-title":"Housing instability and food insecurity as barriers to health care among low-income Americans.","volume":"21","author":"Kushel","year":"2006","journal-title":"J Gen Intern Med"},{"issue":"2","key":"2021121014414967300_B6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.amepre.2006.10.008","article-title":"Intimate partner violence and housing instability.","volume":"32","author":"Pavao","year":"2007","journal-title":"Am J Prev Med"},{"issue":"8","key":"2021121014414967300_B7","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.2105\/AJPH.2011.300139","article-title":"US Housing insecurity and the health of very young children.","volume":"101","author":"Cutts","year":"2011","journal-title":"Am J Public Health"},{"issue":"8","key":"2021121014414967300_B8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1097\/DBP.0b013e3182a509c0","article-title":"Social and behavioral risk factors for obesity in early childhood.","volume":"34","author":"Suglia","year":"2013","journal-title":"J Dev Behav Pediatr"},{"key":"2021121014414967300_B9","doi-asserted-by":"crossref","first-page":"E109","DOI":"10.5888\/pcd12.140511","article-title":"Housing insecurity and the association with health outcomes and unhealthy behaviors, Washington State, 2011.","volume":"12","author":"Stahre","year":"2015","journal-title":"Prev Chronic Dis"},{"key":"2021121014414967300_B10","article-title":"Housing instability impacts food security and wellbeing in young children.","volume-title":"American Public Health Association 136th Annual Meeting","author":"Cutts"},{"key":"2021121014414967300_B11","unstructured":"March\u2008E, Ettinger de Cuba\u2008S, Cook\u2008JT, et al. Behind closed doors: the hidden health impact of being behind on rent. Children\u2019s HealthWatch. 2011. Available at: http:\/\/childrenshealthwatch.org\/behind-closed-doors-the-hidden-health-impact-of-being-behind-on-rent\/. Accessed February 2, 2017"},{"issue":"5","key":"2021121014414967300_B12","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/S0306-4603(98)00023-9","article-title":"Frequent childhood geographic relocation: its impact on drug use initiation and the development of alcohol and other drug-related problems among adolescents and young adults.","volume":"23","author":"DeWit","year":"1998","journal-title":"Addict Behav"},{"issue":"2","key":"2021121014414967300_B13","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1542\/peds.93.2.303","article-title":"Geographic mobility and children\u2019s emotional\/behavioral adjustment and school functioning.","volume":"93","author":"Simpson","year":"1994","journal-title":"Pediatrics"},{"issue":"5","key":"2021121014414967300_B14","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1542\/peds.91.5.934","article-title":"Families on the move and children\u2019s health care.","volume":"91","author":"Fowler","year":"1993","journal-title":"Pediatrics"},{"issue":"7","key":"2021121014414967300_B15","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1136\/jech.2007.060103","article-title":"Residential mobility in childhood and health outcomes: a systematic review.","volume":"62","author":"Jellyman","year":"2008","journal-title":"J Epidemiol Community Health"},{"issue":"11","key":"2021121014414967300_B16","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1001\/jama.1993.03510110074035","article-title":"Impact of family relocation on children\u2019s growth, development, school function, and behavior.","volume":"270","author":"Wood","year":"1993","journal-title":"JAMA"},{"issue":"12","key":"2021121014414967300_B17","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1001\/archpedi.159.12.1104","article-title":"Childhood residential mobility and multiple health risks during adolescence and adulthood: the hidden role of adverse childhood experiences.","volume":"159","author":"Dong","year":"2005","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2021121014414967300_B18","unstructured":"United States General Accounting Office . Elementary School Children: Many Change Schools Frequently, Harming Their Education. Washington, DC: United States General Accounting Office; 1994. Available at: www.gao.gov\/assets\/220\/219151.pdf. Accessed November 1, 2016"},{"issue":"7","key":"2021121014414967300_B19","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.2105\/AJPH.93.7.1144","article-title":"Childhood residential stability and health at midlife.","volume":"93","author":"Bures","year":"2003","journal-title":"Am J Public Health"},{"issue":"1","key":"2021121014414967300_B20","doi-asserted-by":"crossref","first-page":"6","DOI":"10.2307\/3211287","article-title":"The causes and consequences of student mobility.","volume":"72","author":"Rumberger","year":"2003","journal-title":"J Negro Educ"},{"issue":"3, pt 1","key":"2021121014414967300_B21","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1542\/peds.102.3.554","article-title":"Determinants of health and service use patterns in homeless and low-income housed children.","volume":"102","author":"Weinreb","year":"1998","journal-title":"Pediatrics"},{"issue":"9","key":"2021121014414967300_B22","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.2105\/AJPH.76.9.1097","article-title":"Characteristics of sheltered homeless families.","volume":"76","author":"Bassuk","year":"1986","journal-title":"Am J Public Health"},{"key":"2021121014414967300_B23","volume-title":"Families Who Left Welfare: Who are They and How are They Doing?","author":"Lopres","year":"1999"},{"issue":"1","key":"2021121014414967300_B24","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/001440290807500104","article-title":"Material hardship in US families raising children with disabilities.","volume":"75","author":"Parish","year":"2008","journal-title":"Except Child"},{"key":"2021121014414967300_B25","volume-title":"Food, Housing Insecurity and Health: Report From the Arizona Health Survey.","author":"Wolfersteig","year":"2011"},{"key":"2021121014414967300_B26","doi-asserted-by":"crossref","first-page":"E37","DOI":"10.5888\/pcd11.130334","article-title":"Relationships between housing and food insecurity, frequent mental distress, and insufficient sleep among adults in 12 US states, 2009.","volume":"11","author":"Liu","year":"2014","journal-title":"Prev Chronic Dis"},{"issue":"4","key":"2021121014414967300_B27","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/j.1540-4560.1990.tb01802.x","article-title":"Pathways to homelessness among New York city families.","volume":"46","author":"Weitzman","year":"1990","journal-title":"J Soc Issues"},{"key":"2021121014414967300_B28","volume-title":"Racial and Ethnic Disparities: Key Findings From the National Survey of America\u2019s Families","author":"Staveteig","year":"2000"},{"key":"2021121014414967300_B29","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.1749-6632.1999.tb08114.x","article-title":"Race, socioeconomic status, and health. 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Economic Research Report","author":"Coleman-Jensen","year":"2015"},{"issue":"4","key":"2021121014414967300_B41","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1093\/jn\/136.4.1073","article-title":"Child food insecurity increases risks posed by household food insecurity to young children\u2019s health.","volume":"136","author":"Cook","year":"2006","journal-title":"J Nutr"},{"issue":"6","key":"2021121014414967300_B42","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1093\/jn\/134.6.1432","article-title":"Food insecurity is associated with adverse health outcomes among human infants and toddlers.","volume":"134","author":"Cook","year":"2004","journal-title":"J Nutr"},{"issue":"1","key":"2021121014414967300_B43","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1542\/peds.2006-3717","article-title":"Household food insecurity: associations with at-risk infant and toddler development.","volume":"121","author":"Rose-Jacobs","year":"2008","journal-title":"Pediatrics"},{"issue":"6","key":"2021121014414967300_B44","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1007\/s10995-014-1633-6","article-title":"Homelessness during pregnancy: a unique, time-dependent risk factor of birth outcomes.","volume":"19","author":"Cutts","year":"2015","journal-title":"Matern Child Health J"},{"key":"2021121014414967300_B45","article-title":"Screening for housing insecurity: behind on rent is associated with increased risk of adverse child\/maternal health outcomes.","volume-title":"Pediatric Academic Societies Annual Meeting","author":"Schaefer"},{"issue":"4","key":"2021121014414967300_B46","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2008-0286","article-title":"A brief indicator of household energy security: associations with food security, child health, and child development in US infants and toddlers.","volume":"122","author":"Cook","year":"2008","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-2199\/916562\/peds_20172199.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2017-2199\/916562\/peds_20172199.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T19:54:55Z","timestamp":1660334095000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/141\/2\/e20172199\/38056\/Unstable-Housing-and-Caregiver-and-Child-Health-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,1]]},"references-count":46,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2,1]]},"published-print":{"date-parts":[[2018,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2017-2199","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,1]]},"article-number":"e20172199"}}