Does Housing Stability Affect Gaps in Children Having Health Insurance?

What is the relationship between housing stability and having health insurance coverage for young children? This study by Carroll and coauthors is the first to explore this association. The researchers analyzed data from the Early Childhood Longitudinal Study, Birth Cohort. They studied preschool-age children—as health care is crucial to their health and development—looking at survey results from when the children were 9 months old and follow-up surveys from when they were 2 and 4 years old. The authors defined unstable housing as homelessness, moving multiple times, or living with others and not paying rent. Their findings are particularly relevant in a climate of rising housing costs and stagnant incomes, and they offer several policy implications that could reduce the risk of unstable housing among preschool-age children in the future.

Key Findings:

• In a nationally representative birth cohort of the United States, children who were unstably housed at age 2 were 27 percent more likely than stably housed children of the same age of experiencing health insurance gaps between ages 2 and 4.
• Mothers who were unstably housed were more likely to be younger, non-Hispanic black, live in English-speaking households, report suboptimal health, be less educated, and live in nonurban areas than their stably housed counterparts.
• Streamlining the enrollment and renewal process for public insurance (which could increase coverage and reduce costs) and having pediatricians screen for housing instability and refer families to appropriate social services, could help improve outcomes for children. Without such interventions, these children are more likely to experience gaps in health insurance coverage resulting from housing instability.