The nation's housing crisis is also a health crisis - especially for children. When families lose stable housing, children lose the bedrock that anchors them to schools, neighborhoods, medical services, child care and social services, often with serious consequences for their health.
As of today, the Housing Authority of Baltimore City is closing the waiting list for the Housing Choice Voucher Program (Section 8) because it has enough applicants for the next 12 months. In other words, families who need stable housing have to wait at least a year before getting onto a waiting list.
A recent story about a Baltimore family illustrates how central housing is to children's health, and why in any plan for financial recovery or economic stimulus, housing needs to be part of the discussion.
The Growth and Nutrition Clinic at the University of Maryland School of Medicine treats children who are severely underweight and therefore at risk for multiple health and developmental problems. At a recent visit, 6-year-old Brandi and her 7-year-old brother, Keonte, who are both severely underweight with long histories of poor growth, had each gained more than 2 pounds over two months - more than they had gained in the preceding year. The children radiated enthusiasm as they arrived wearing clean, neatly pressed school uniforms and sporting wide smiles.
What was the "treatment" that resulted in this success? Their move to Section 8 housing.
The children's parents have been lost to the drug world, and their grandmother recently died of liver disease; they are in the care of their 65-year-old, disabled great-grandmother, Carolyn Beane. With few resources, the family moved twice in the past year, ultimately crowding into a friend's house. They were discouraged by the long waiting list for housing. The children's weight faltered, and the lack of basic resources, such as table and chairs, made it difficult to follow our recommendations, including eating together to model positive mealtime behaviors.
When their housing application was approved, the family moved to their own home in the Clifton Park area. The children were excited to each have their own rooms. The security of a home alleviated the stress and anxiety of the family's near-homelessness and enabled Ms. Beane to attend to the details of daily life - establishing routines, making healthy family meals they could enjoy together around a table, and ensuring that the children were prepared for school each day. A safe, secure home led to emotional changes in the family, enabling them to build the daily mealtime routines that led to the children's healthy weight gain and propelled them onto a positive growth trajectory.
Many families across America could tell similar stories. Data from the National Center on Family Homelessness and from the Children's Sentinel Nutrition Assessment Program, a collaborative project of the University of Maryland School of Medicine and medical centers in five other states with data on more than 30,000 young children, have found that housing instability increases children's risks for multiple health challenges. These include poor growth, asthma, ear infections, anxiety, depression and delayed development.
The foreclosure crisis is forcing thousands of families out of their homes. Each day in the United States, more than 200,000 children have no place to live. In Baltimore, more than 3,000 city residents are homeless, and thousands more are crowded into unstable housing. Families with children are one of the fastest-growing segments of the homeless population.
Rates of homelessness and housing instability are expected to increase as more families lose housing in today's market and deepening recession.
Although closing the waiting list for the Housing Choice Voucher Program will make a bad situation worse, the shortage of vouchers themselves is the real problem. In this time of economic crisis, conversations should focus on including vouchers in the economic stimulus and bailout package to help families who have lost or are on the verge of losing their homes.
Facilitating secure housing for families is a critical step toward ensuring the health and development of our nation's children. Healthy children learn in school, are proud of their successes and become healthy, productive adults. Is there any better investment we can make?
Margo Candelaria and Sarah Oberlander are postdoctoral fellows and Maureen Black ( email@example.com) is a professor in the department of pediatrics at the University of Maryland School of Medicine.