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HOUSING CHALLENGES AND CHILD HEALTH AND DEVELOPMENT

HOUSING CHALLENGES AND CHILD HEALTH AND DEVELOPMENT. Patrick Casey, M.D. Harvey and Bernice Jones Professor of Developmental Pediatrics Department of Pediatrics College of Medicine University of Arkansas for Medical Sciences Arkansas Children’s Hospital. Food Insecurity.

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HOUSING CHALLENGES AND CHILD HEALTH AND DEVELOPMENT

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  1. HOUSING CHALLENGES AND CHILD HEALTH AND DEVELOPMENT Patrick Casey, M.D. Harvey and Bernice Jones Professor of Developmental Pediatrics Department of Pediatrics College of Medicine University of Arkansas for Medical Sciences Arkansas Children’s Hospital

  2. Food Insecurity Energy Insecurity Housing Insecurity

  3. FOOD INSECURITY AND RISK FACTORS NON-FOOD EXPENDITURES housing hospital care emergencies taxes discretionary items gasoline heating, cooling other HOUSEHOLD RESOURCES (money, time, information, health) FOOD ACQUISITION HOUSEHOLD FOOD SUPPLY NORMAL FOOD SYSTEM grocery stores and food service operations food availability (type and quantity) food accessibility (cost and distance) GOVERNMENT FOOD ASSISTANCE Food Stamps WIC School Lunch and Breakfast ALTERNATE FOOD SOURCES PRIVATE FOOD ASSISTANCE gifts from family & friends gardening, hunting, fishing scavenging Nutrition Program for the Elderly (Title 3c) Modified from Campbell, CC: Food Insecurity: A Nutritional Outcome or a Predictor Variable? J Nutr. 1991.121:408

  4. FOOD INSECURITY Limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.

  5. 2011 Food Insecurity of all Households: 14.9% Food Insecurity of Households with Children: 20.6%

  6. TRENDS IN PREVALENCE OF FOOD INSECURITY2003 – 2011 %Households 03 05 07 09 11

  7. FOOD SECURITY BY STATE2011 Worst 50: Mississippi 19.2% 50: Arkansas 19.2% 48: Texas 18.5% 47: Alabama 18.2% 46: Georgia 17.4% Best 5: Wisconsin 11.3% 4: Minnesota 10.2% 3: New Hampshire 9.6% 2: Virginia 9.1% 1: North Dakota 7.8%

  8. FOOD HARDSHIP States: 2008-2009 Arkansas #2 @ 24% 2011 Arkansas #12 @ 21.1% Metropolitan Area: 2008-2009: Little Rock/Conway #18 @ 20% 2011: Little Rock/Conway #47 @ 18.1%

  9. CHILDREN AND FOOD INSECURITY Food Insecurity is associated with poorer child: • general health (and more hospitalizations) • developmental status in pre-school years • educational achievement • mental health • academic problems while controlling for demographic characteristics

  10. HOUSING SPECTRUM Stable Poor Quality Housing Insecure: Homeless - behind on rent - crowding - multiple moves

  11. HOUSING AND DISEASE:ASTHMA • Increased prevalence, worse in lower SES • Direct effect: molds, dust mites, • environmental pollutants • Indirect effects: problem affording • medications, follow-up with doctor visits

  12. Children’s Health Watch A consortium of academic pediatricians who focus on infant growth (all have growth clinics), which collects data to influence public policy, and for academic publications

  13. WHAT WE DO: Collect datain five urban, safety-net hospitals Produce scientific research that is original and timely Inform policy decisions with state and national partners

  14. STUDY METHODS • 5 medical centers • 3 emergency departments (ED) • 3 hospital based clinics • August 1998 to present • Cross-sectional convenience sample • Children ≤48 months of age

  15. STUDY METHODS • Caretaker Survey: • Demographics • Child health • Child development concern: Peds • State & federal program participation • USDA 18-question food security scale • Medical Record Audit: • Child weight & height • Medical diagnosis • Admission & dehydration status

  16. FEDERAL ASSISTANCE PROGRAMS–monitored by • Food Stamps (SNAP) • Temporary Assistance for Needy Families (TANF) • Women, Infants and Children (WIC) • Medicaid • Federal Housing Subsidies • Energy Assistance (LIHEAP) • Food Insecurity • Hospitalizations • Child Wellbeing • Maternal Depression • Child Growth • Child Development Primary Household And Child Outcomes

  17. U.S. HOUSING INSECURITY AND THE HEALTH OF VERY YOUNG CHILDREN American Journal of Public Health. 2011, June 16:e1 – e7

  18. HOUSING INSECURITY • Crowding: more than 2 people per bedroom, or • Moved two or more times in the past year

  19. INSECURE HOUSING AND CHILD AND HOUSEHOLD STATUS Adjusted for multiple family and child characteristics

  20. FOOD, HOUSING, AND ENERGY INSECURITYLITTLE ROCK Percent

  21. CHILDREN’S HEALTHWATCH ARKANSAS HOUSEHOLDS Frequent Moves Behind on Rent Homeless

  22. Increased Odds of Poor Outcomes

  23. INSECURE HOUSING IN ARKANSAS:ASSOCIATION WITH CHILD AND MATERNAL HEALTH

  24. www.ChildrensHealthWatch.org

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