A new multisite study by UCLA and RAND Corp. researchers and colleagues has found that 7 percent of fifth-graders and their families have experienced homelessness at some point in their lives and that the occurrence is even higher — 11 percent — for African American children and those from the poorest households.
The study also found that children who had experienced homelessness at some point during their lives were significantly more likely to have an emotional, behavioral or developmental problem; were more likely to have witnessed serious violence with a knife or a gun; and were more likely to have received mental health care.
The research is the first population-based study to describe the lifetime prevalence of family homelessness among children and its association with health and health care.
The findings will be published in the August issue of the American Journal of Public Health and are currently available online by subscription.
"It was unexpected to see such a high prevalence of family homelessness in this sample of fifth-grade students, especially since this number only included children whose parents reported that they were literally homeless — staying in places like shelters, cars or on the streets," said lead author Dr. Tumaini R. Coker, clinical instructor of pediatrics at Mattel Children's Hospital UCLA and an associate natural scientist at RAND. "Our results suggest that in a classroom of 28 fifth-graders, two students would have been homeless at some point in their lives."
Researchers analyzed data from Healthy Passages, a multisite study of 5,147 fifth-grade students funded by the Centers for Disease Control and Prevention. Interviews of students and parents were conducted over the 2004–05 and 2005–06 school years and included children from Birmingham, Ala.; Houston, Texas; and Los Angeles.
After controlling for sociodemographic factors, indicators of general child health were similar for children who had experienced homelessness (ever-homeless) and those who had never been homeless (never-homeless), but indicators of emotional, behavioral and developmental health were not.
"Ever-homeless children were significantly more likely to have a parent report that they had an emotional, behavioral or developmental problem and to have received mental health–related services," Coker said. "Our study is not able to say whether an experience of homelessness caused these problems. Further research will help us understand the relationship between the emotional, behavioral and developmental problems and the episodes of homelessness."
"Clinicians should be aware of the possibility that their patients could be homeless," said senior author Dr. Mark A. Schuster, the William Berenberg Professor of Pediatrics at Children's Hospital Boston and Harvard Medical School. "In addition to helping such families obtain housing services, clinicians may find that their patients also have mental health problems that should be addressed."
The next stage of research will be to use longitudinal data to understand the temporal relationships between emotional, developmental and behavioral problems and episodes of homelessness.
Additional sites involved in the study included the University of Alabama at Birmingham and the University of Texas, Houston.
In addition to Coker and Schuster, study authors included Marc N. Elliott, David E. Kanouse, Jo Anne Grunbaum, Janice Gilliland, Susan R. Tortolero and Paula Cuccaro.
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