Community Views and News
As the health care system increasingly focuses on
population health improvement activities, pediatricians may have the opportunity to encourage their
institutions to engage in efforts that improve housing
security in their communities.
Across the country, health care systems and hospitals
are investing in the development of affordable
housing, healthy housing and neighborhood
revitalization initiatives. These types of investments have the potential to improve child health
outcomes, reduce health care costs and create
Pediatricians also can assist individual families
impacted by housing instability.
Impacts of housing instability on health
Adequate housing provides more than just
shelter; it supports a safe and stable environment for children to live and play. Many families, however, are unable to find a stable and
affordable place to live, leading to frequent
moves, overcrowding, unsafe living conditions
Housing insecurity and homelessness are associated with a variety of threats to children’s
health, including increased risk for chronic disease, poor nutrition and developmental delay.
A lack of stable housing also has been shown to
negatively impact children’s school attendance
and educational achievement. Substandard
housing can expose children to safety risks, including lead, mold, fires and other injuries.
Families without secure housing also may experience economic hardships such as food and
utility insecurity. Over one-third of all families
report that they pay more than 30% of income
for housing, often leaving them unable to meet
other critical needs.
Megan T. Sandel, M.D., M.P.H., promotes
the concept of a stable and affordable home as
a “vaccine” to keep kids healthy.
“Housing insecurity is just the part of the
iceberg that we can see,” Dr. Sandel said. “We
know there’s a lot more under the surface forcing
families to choose between rent, food, heat or
The AAP policy statement Providing Care for
Children and Adolescents Facing Homelessness and
Housing Insecurity recommends that pediatricians seek
to identify housing insecurity and homelessness in
their patient populations. Frequent address changes, a
history of scattered care or mail returned to the practice
can indicate that a family is dealing with housing
instability. Additional unmet needs also may be
revealed when discussing a family’s housing situation.
Work with community to improve housing security for patients, families
from the AAP Department of Community and Chapter Affairs and Quality Improvement
• For more information on housing insecurity
and children’s health, email the AAP Council on
Community Pediatrics at firstname.lastname@example.org.
• AAP policy statement Providing Care for Children
and Adolescents Facing Homelessness and
Housing Insecurity, http://bit.ly/2vi1xsU
• National Coalition for the Homeless Directory,
• AAP Poverty and Child Health Resources, http://
• Housing as a Health Care Investment, http://bit.