Moving Because of Unaffordable Housing and Disrupted Social Safety Net Access Among Children

• Published in: Pediatrics (Evanston) 2024-03, Vol.153 (3), p.1
• Main Authors: Leifheit, Kathryn M, Schwartz, Gabriel L, Pollack, Craig E, Althoff, Keri N, Lê-Scherban, Félice, Black, Maureen M, Jennings, Jacky M
• Format: Article
• Language: English
• Subjects: Affordable housing; Baltimore; Child; Child, Preschool; Children; Children & youth; Cross-Sectional Studies; Dietary supplements; Emergency medical care; Emergency Service, Hospital; Female; Food stamps; Head; Housing; Humans; Infant; Infants; Medicaid; Nutrition; Primary care; Safety; United States
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2023-061934

To measure associations between residential moves because of unaffordable housing costs and disruptions in access to the Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; and Medicaid in a health care-based sample of families with young children. We used cross-sectional survey data on social safety net-eligible caregivers and children recruited into the Children's HealthWatch study from emergency departments and primary care clinics in Baltimore and Philadelphia (2011-2019). Children's HealthWatch measured residential moves (cost-driven and noncost-driven) in the past year and disruptions in safety net access. We used logistic regression to estimate associations between each type of move and disrupted access to social safety nets. Across 9344 children, cost-driven residential moves were associated with higher odds of disrupted access to at least 1 safety net program (Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; or Medicaid; adjusted odds ratio 1.44; 95% confidence interval 1.16-1.80), as well as higher odds of disruption to each program separately. Noncost-driven moves were also associated with disruptions to at least 1 safety net program, but less strongly so (adjusted odds ratio 1.14; confidence interval 1.01-1.29; P value for comparison with cost-driven = .045). Residential moves, particularly cost-driven moves, are associated with social safety net benefit disruptions. The association between these events suggests a need for action to ensure consistent safety net access among children facing cost-driven moves and vice versa (ie, access to housing supports for children with disrupted safety net access).