San Francisco Children Living In Redeveloped Public Housing Used Acute Services Less Than Children In Older Public Housing

Abstract

Understanding the links between housing and health is increasingly important. Poor housing quality is a predictor of poor health and developmental problems in low-income children. We examined associations between public housing type and recurrent pediatric emergency and urgent care hospital visits. Children ages 0-18 with public insurance who sought emergency care from any of three large medical systems in San Francisco were categorized by whether they lived in public housing redeveloped through the federal HOPE VI program, nonredeveloped public housing, or nonpublic housing in a census tract that also contained public housing. After we adjusted for potential confounding characteristics, we found that children living in nonredeveloped public housing were 39 percent more likely to have one or more repeat visits within one year for acute health care services unrelated to the initial visit, compared to children who lived in redeveloped HOPE VI housing. We observed no differences in repeat visits between children in redeveloped HOPE VI housing and those in nonpublic housing. These findings support the continued redevelopment of public housing as a means of both improving the health of vulnerable high-risk children from low-income neighborhoods and reducing health care costs.

Material Needs of Emergency Department Patients: A Systematic Review

“…Some studies attempted to use validated questionnaires for material needs. Most studies were cross‐sectional surveys, five were retrospective cohort studies, and three used prospective cohorts . Several studies described their methods as “case‐control” or “prospective” but were in fact cross‐sectional.…”

“…Several studies reported a range of 18.1% to 43.8% of patients residing in variably defined unstable housing situations . A few studies included living in public or subsidized housing as housing‐related variables …”

“…Several studies reported data on patients’ enrollment in safety net programs such as food stamps, WIC, housing subsidies, welfare, and SSI . Some studies examining food insecurity also reported on use of community food resources such as food pantries .…”

“…Studies varied considerably with respect to how they gathered material needs data. Twelve studies extracted material needs data from the medical chart or from a database, five of which used NHAMCS data . The remaining studies used self‐administered questionnaires or in‐person interviews.…”

Child Health Disparities: What Can a Clinician Do?

“…18 For instance, poor housing is linked to health status. 19,20,21 A child with asthma living in housing with cockroach infestation or mold will require assistance from social workers, legal advocates and housing organizations to reduce allergen exposure and improve health. Addressing these new vital signs will require research on effective screeners and interventions, partnerships with community organizations and appropriate payment for screening and management.…”