Investment in Affordable Housing Lowers Children's Healthcare Costs

Public investment in affordable and stable housing, through rental assistance for food-insecure families, improves the health of infants and children and is associated with better health outcomes and lower spending on their healthcare, according to a new report from Children’s HealthWatch, a nonpartisan network of pediatricians, public health researchers, and children’s health and policy experts dedicated to improving children’s health in the United States.

“Homelessness is costly for families and society, keeping many young children from getting a healthy start in life,” the March 2016 report noted. “Rental assistance can make a significant difference for infants, especially those from highly vulnerable families.”

Previous research by Children’s HealthWatch demonstrated the harmful impact of homelessness on the health of young children and showed that negative health effects are made worse when a mother is homeless before and after her child is born. Children whose mothers were homeless when pregnant but were housed after their birth were 20% more likely to have been hospitalized since birth. Children who experienced postnatal homelessness were 22% more likely to have been hospitalized. And children who experienced both prenatal and postnatal homelessness were 41% more likely to have been hospitalized since birth.

In 2015, the average annual cost of hospitalizations attributable to homelessness among children age 4 years and younger was more than $238 million nationally. More than half of those costs were associated with hospitalizations of infants.

Children’s HealthWatch researchers collected data from over 2000 low-income food-insecure households with infants under 12 months of age from 2009 through 2014. Caregivers were interviewed in urban pediatric clinics and emergency departments. Nearly one-fourth of these households received some type of rental assistance during pregnancy.

The data were analyzed to assess infants’ health and development and to compare health outcomes for infants in food-insecure families receiving rental assistance versus families eligible for, but not receiving, rental assistance. After adjusting for family characteristics and other factors, researchers found that infants in food-insecure families with rental assistance during the prenatal period were 43% less likely to have been hospitalized compared with infants in food-insecure families who did not receive rental assistance.

The researchers concluded that the reduced rate of hospitalization among the infants whose family had rental assistance in the prenatal period resulted from better overall health and fewer instances of serious illness.

The report’s recommendations included expanding funding of rental assistance programs, ensuring access to supportive services for families receiving rental assistance, and considering vulnerable families to be a special population similar to chronically ill and homeless individuals.

Programs that house families in need have the potential to also reduce public spending on healthcare, so it’s a win-win proposition for policy makers considering ways to help vulnerable families and reduce spending on healthcare.