As your workday comes to a close, can you imagine not being sure where you were going to sleep that night? Unfortunately, housing instability is a reality for millions of American children. A recent report by the National Center for Homeless Education found that at some point during the 2017-2018 school year, over 1.5 million public school students in the United States were homeless. This is the highest number reported in over twelve years.
The contributors to housing instability for children are varied, ranging from natural disasters to inadequate affordable housing, opioid and methamphetamine addiction among parents, local economic downturns that lead to unemployment and more. Not only does homelessness take a toll on a child’s educational performance, it also has lasting health effects.
The American Hospital Association reports that housing instability is associated with several health risks among children including asthma, low weight, developmental delays and an increased lifetime risk of depression.
In addition to these chronic health problems, homeless people of all ages are at significant risk of contracting COVID-19. In shelters, as well as in encampments, social distancing can be difficult, if not impossible to maintain.
Potential Solutions to Homelessness and Its Health Effects
Addressing social determinants of health, such as housing instability, can be challenging, long-term endeavors. Some health systems and nonprofit organizations, however, are exploring ways that they can support affordable housing.
Kaiser Permanente, for example, is involved in three multimillion-dollar projects to create affordable housing in its service areas. Fourteen hospitals and health systems also recently committed over $700 million for “place-based investing” with the goal of creating affordable housing, equitable economic development and small and/or diverse business development. Their hope is to cultivate economic ecosystems that will promote both economic and health wellness.
In Texas, CitySquare provides an array of social services focused on health, housing, hunger, and hope. Its Transition Resource Action Center (TRAC) is a one-stop assessment and referral facility for youth that are aging out of foster and juvenile care in North Texas. CitySquare also addresses youth homelessness through its OnTRAC Permanent Housing Project and TRAC Transitional Living Housing Program.
In addition to attacking the root causes of housing instability, more work can be done to address the health implications of this problem on young people. Health plans should proactively reach out to parents to underscore the importance of preventive care visits and vaccinations for children. Contacting this population may require using multiple forms of communication, such as text messages, emails or phone calls to mobile numbers.
Health plans that serve Medicaid populations may also consider partnering with community outreach workers in an effort to deliver essential services to at-risk children. In the days prior to the COVID-19 pandemic, outreach initiatives often took place in community settings like public libraries or homeless shelters. The Sacramento Public Library, for instance, used to host a Homeless Navigator four days a week to build relationships with patrons. These workers connected people to various social service programs.
Given current concerns about the spread of the novel coronavirus, some communities may serve homeless youth in different ways. The United States Interagency Council on Homelessness has suggested that one option is to keep certain schools or community sites open to provide healthcare services, food and hygiene facilities to homeless youth.
Housing instability can have a lifelong health impact on children. Unfortunately, the end to homelessness is nowhere in sight. Until this problem can be solved, the healthcare sector has a responsibility to do as much as possible to address the health issues faced by young, vulnerable populations. This duty is more important than ever, as we face the COVID-19 pandemic.