Prevalence, Characteristics, and Associated Health and Health Care of Family Homelessness Among Fifth-Grade Students

Published In: American Journal of Public Health, v. 99, no. 8, Aug. 2009, p. 1446-1452

Posted on RAND.org on January 01, 2009

by Tumaini Coker, Marc N. Elliott, David E. Kanouse, Jo Anne Grunbaum, M. Janice Gilliland, Susan R. Tortolero, Paula Cuccaro, Mark A. Schuster

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OBJECTIVES. The authors describe the lifetime prevalence and associated health-related concerns of family homelessness among fifth-grade students. METHODS. The authors used a population-based, cross-sectional survey of 5147 fifth-grade students in 3 US cities to analyze parent-reported measures of family homelessness, child health status, health care access and use, and emotional, developmental, and behavioral health and child-reported measures of health-related quality of life and exposure to violence. RESULTS. Seven percent of parents reported that they and their child had experienced homelessness (i.e., staying in shelters, cars, or on the street). Black children and children in the poorest families had the highest prevalence of homelessness (11%). In adjusted analyses, most general health measures were similar for children who had and had not been homeless. Children who had ever experienced homelessness were more likely to have an emotional, behavioral, or developmental problem (odds ratio [OR]=1.7; 95% confidence interval [CI]=1.1, 2.6; P=.01), to have received mental health care (OR=2.2; 95% CI=1.6, 3.2; P<.001), and to have witnessed serious violence with a knife (OR=1.6; 95% CI=1.1, 2.3; P=.007) than were children who were never homeless. CONCLUSIONS. Family homelessness affects a substantial minority of fifth-grade children and may have an impact on their emotional, developmental, and behavioral health.

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