Food Insecurity in Homeless Families in the Paris Region (France): Results from the ENFAMS Survey

Abstract

The number of families living in shelters in the Paris region (France) has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the developmental problems in children. This probability survey was conducted in 17 languages among 801 homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers, and social hotels in the Paris region. Among the 772 families that provided data on food security only 14.0% were with food security, whereas 43.3% were with low food security and 9.8% with very low food security (a situation where children are also affected). Stratified multivariate robust Poisson models showed that some characteristics are associated with a higher risk of food insecurity and/or of falling into very low food security, such as residential instability, single parenthood, having more than three children, depressive symptoms, housing in social hostels, and difficult access to cheap or free food locally. Given the wealth of the Paris region, resources and programs should be concentrated on improving the living situation of this vulnerable population. It needs better detection of these families, a closer social follow-up, and an increase in food aid.

Experiences of Homeless Families in Parenthood: A Systematic Review and Synthesis of Qualitative Evidence

“…The lack of housing brings high social costs [23] and in families, has profound consequences, including the risk of health deterioration in family members [24,25]; the disruption of family dynamics, and the separation of parents and children [25]. Homeless families present multiple problems and needs that are interrelated (e.g., social, educational and health care) [15].…”

“…Homelessness is rarely an isolated event. Children from homeless families are prone to have a history of: low birth weight; anaemia; tooth decay; delayed immunizations; growth deficits; increased accident frequency, mainly injuries and burns [16]; developmental deficits; mental health problems [16,24,26,27]; behaviour disorders (e.g., sleep disorders, eating disorders, aggression and hyperactivity in young children); anxiety and post-traumatic stress [16]. A combination of multiple adverse childhood experiences may weaken their resilience [28] and they may become homeless as adults [28,29].…”

Fruit and vegetable consumption and emotional distress tolerance as potential links between food insecurity and poor physical and mental health among homeless adults

“…According to the 2017 data, 553,742 people, including 67% single adults and 33% individuals with families, were experiencing homelessness in the United States (Henry et al, 2017). Even though food insecurity is not universal among homeless people, they are more likely to experience food insecurity compared to their housed counterparts (D'Andreamatteo and Slater, 2018; Lee and Greif, 2008; Martin-Fernandez et al, 2018). Potential reasons for the higher food insecurity among homeless adults include the inability to purchase food, the inaccessibility of adequate cooking and food storage facilities, and being unable to access foods that meet dietary needs (Davis et al, 2008; Martin-Fernandez et al, 2018; Oliveira and Goldberg, 2002; Rodriguez et al, 2009).…”

“…There is evidence of associations between food insecurity and poor health, depression, and PTSD among domiciled adults (Golin et al, 2016; Hernandez et al, 2017; Wang et al, 2015). However, there is scant evidence for such a relationship for adults experiencing homelessness even though they are disproportionately affected by food insecurity (Martin-Fernandez et al, 2018; Palar et al, 2015; Whitbeck et al, 2015). Further, there is no evidence of pathways that link the associations between food insecurity and poor health, depression, and PTSD among this vulnerable population.…”

Diphtheria-Tetanus-Polio, Measles-Mumps-Rubella, and Hepatitis B Vaccination Coverage and Associated Factors among Homeless Children in the Paris Region in 2013: Results from the ENFAMS Survey

“…This could be explained by the fact that most of our study population were migrants, living in social hotels with poor levels of housing comfort and limited services; most of them therefore experienced housing instability. These living conditions have a dramatic impact on health in terms of food insecurity and mental health as described previously [25,26], while women encounter many barriers to accessing health services such as the cost, language, transportation and discrimination or because of other priorities. As homeless women are regularly relocated from shelter to shelter (depending on the available facilities in the chronically under-resourced greater Paris area), primary care professionals must be better informed and aware that every contact with the healthcare services is an opportunity to check whether a child's VC is up to date.…”