By Charles Oberg, MD, FAAP, program director of the Maternal and Child Health program at the University of Minnesota and practicing pediatrician at Hennepin County Medical Center
In the June issue of Pediatrics, the AAP Committee on Community Pediatrics released a policy statement titled “Providing Care for Children and Adolescents Facing Homelessness and Housing Insecurity.” The statement provides an important framework for thinking about the context of homelessness in our practices. It outlines both the antecedents of homelessness as well as the health, developmental, educational and social adverse outcomes of a child being raised in a transitory or less than permanent home environment. The statement concludes with a series of recommendations for the pediatrician to be cognizant of resources that might assist them in the care and management of these children.
What is the magnitude of this problem? The National Center on Family Homelessness recently released a report titled “America’s youngest outcasts 2010” and places the number of homeless children at 1.6 million children or close to 1 in 45 children. The center estimates that Minnesota had 15,898 homeless children. This is substantially less than the 337,105 in Texas, the state with the largest number of homeless children. However, for each of these children this housing instability can severely affect their life trajectory. A more recent study was conducted by the Amherst H. Wilder Foundation in 2012, which intermittently surveys the homeless population in Minnesota. It estimated there were 10,214 homeless adults, youth, and children statewide in 2012. This was a 6 percent increase over the 2009 survey. Surprisingly, the results show that nearly half (46 percent) of all homeless persons in the state of Minnesota were 21 years of age or younger. This included 3,546 children with their parents and 1,151 youth who were homeless on their own.
The table provides a listing of statewide resources designed to decrease the burden that homelessness places on a family. The list provides a description of services as well as contact information that might assist in the coordination of care for this vulnerable population.
The AAP and the Committee on Community Pediatrics should be applauded for their efforts to re-familiarize us with this most extreme form of risk for an infant, child or adolescent. The recent dialogue on Toxic Stress and Adverse Childhood Events emphasizes the importance of this risk. The contributing factor of homelessness such as parental unemployment, mortgage foreclosure, poverty, mental illness, substance abuse and/or domestic violence are magnified when a family slips into a homelessness, exponentially worsening the adverse health outcomes for children. As pediatricians, we should be familiar with these invaluable resources that might assist us in our coordination of care and to provide linkages to essential community services for these vulnerable families and their children.
References:
Policy Statement on Care for Children Facing Homelessness and House Insecurity, Council on Community, Pediatrics, 2013; 131: 1206
The National Center on Family Homelessness, America’s Youngest Outcasts 2010: state report card on child homelessness. Available at: www.FamilyHomelessness.org
Gerrard M, Shelton E, Pittman B, and Owen G: Initial findings: Characteristics and trends of people experiencing homelessness in Minnesota,
2012 Minnesota Homeless Study, Amherst H. Wilder Foundation, 2012
