{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:15:08Z","timestamp":1787022908417,"version":"build-2736575974"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                    <jats:p>Children with special health care needs (SHCNs) have significant medical and educational expenses affecting household finances. Housing instability can be detrimental to family well-being. Our objective was to evaluate housing instability in households of children with and without SHCNs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Cross-sectional surveys (2013\u20132017) in English and Spanish of caregivers with children &amp;lt;4 years old were conducted at 5 hospitals. The children with SHCN screener and caregiver report of child Supplemental Security Income (SSI) receipt were used to categorize children into the following groups: (1) no SHCNs, (2) SHCNs and no SSI, or (3) SHCNs and receiving SSI. Housing instability was determined by positive endorsement of \u22651 adverse circumstance: behind on rent or mortgage, or moving twice or more in the past year, or homelessness in the child\u2019s lifetime. Analyses used multivariable logistic regression models, adjusting for demographics and housing subsidies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Of 14\u2009188 children, 80% had no SHCNs, 16% had SHCNs and no SSI, and 4% had SHCNs and received SSI. Compared with the no-SHCNs group, the SHCNs\u2013no-SSI group but not the SHCN\u2013receiving-SSI group experienced significantly greater adjusted odds of being behind on rent or mortgage (adjusted odds ratio [aOR] 1.28 [95% confidence interval (CI) 1.14\u20131.44]; P &amp;lt; .001), multiple moves (aOR 1.29 [95% CI 1.05\u20131.59]; P = .01), and homelessness (aOR 1.44 [95% CI 1.20\u20131.72]; P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Families of children with SHCNs are at risk for housing instability. Child SSI receipt decreased the risk of housing instability among families of children with SHCNs. Protecting families of young children with SHCNs from housing instability is an important investment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2018-1704","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T08:25:17Z","timestamp":1562747117000},"source":"Crossref","is-referenced-by-count":19,"title":["Housing Instability Among Families With Young Children With Special Health Care Needs"],"prefix":"10.1542","volume":"144","author":[{"given":"Ruth","family":"Rose-Jacobs","sequence":"first","affiliation":[{"name":"Department of Pediatrics, School of Medicine, and"},{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Ettinger de Cuba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Bovell-Ammon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen M.","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, Maryland;"},{"name":"RTI International, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, Massachusetts;"}],"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"}]},{"given":"Mariana","family":"Chilton","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Heeren","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and"}],"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"}],"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, and"},{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Sandel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, and"},{"name":"Department of Pediatrics, Boston Medical Center, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"issue":"1","key":"2021121012450603000_B1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1367\/1539-4409(2002)002<0038:ICWSHC>2.0.CO;2","article-title":"Identifying children with special health care needs: development and evaluation of a short screening instrument.","volume":"2","author":"Bethell","year":"2002","journal-title":"Ambul Pediatr"},{"key":"2021121012450603000_B2","unstructured":"US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. 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