Forced to move: Eviction, household health and hardships in families with very young children

Infant and toddler health and development is affected by housing instability – specifically when families experience eviction. In a new study that focused on a large, geographically, and racially/ethnically diverse sample of families with young children, researchers examined how history of formal and informal evictions affect child and parent health and family economic hardship. The “Eviction and Household Health and Hardships in Families with Very Young Children,” study is available in the October 2022 Pediatrics.

“Most data on evictions relies on court filings to know how many families have been evicted,” explains Dr. Diana Cutts, Chair of Pediatrics at Hennepin Healthcare in Minneapolis and the lead author of the study. “However, evictions don’t always go through the courts and we wanted to capture both formal and informal evictions to understand how that affected child and adult health. We interviewed families in emergency departments and primary care clinics.”

Nearly 2 million US households are evicted or involuntarily displaced annually, and those with children are at an increased risk for eviction – a risk that increases with each additional child.

“You can just imagine how disrupting these evictions can be for families – especially abrupt, informal evictions when there’s a sudden displacement that is catastrophic for families, leading them to accept whatever housing is available at the time, regardless of location or quality,” said Dr. Cutts.

The families in this study are not nationally representative but rather a sentinel sample, primarily composed of families with low incomes accessing urban hospitals with a high proportion of both caregivers of color and immigrant caregivers, compared to national statistics.

Using cross-sectional surveys of 26,441 caregivers with a young child less than 48-month-old from 2011-2019 in emergency departments (ED) and primary care clinics, Dr. Cutts and her team investigated relationships between 5-year history of formal (court-involved) and informal (not court-involved) evictions with caregiver and child health, history of hospitalizations, hospital admission from the ED on the day of the interview, and housing-related and other material hardships.

Compared to no evictions, evictions were associated with 1.43 greater odds of the child to have fair to poor health, 1.55 greater odds of the child to have developmental risk, and 1.24-times greater odds for the child to have hospital admission from the ED, as well as adverse caregiver and hardship outcomes.

While eviction’s causes and consequences may be complex and varied, the study’s findings suggest reducing evictions, both formal and informal, may address health disparities and help young families meet their basic needs. Policymakers, community organizations, and health professionals have important roles in designing evidence-based policy solutions to reduce evictions and improve opportunities for families to meet their basic needs. This study’s findings provide evidence to support investment in rental assistance and affordable housing production, eviction prevention policies, income-focused benefits, and social determinants of health screening and community connections in health care settings. Such multifaceted efforts may decrease formal and informal eviction incidence and mitigate potential harmful associations for very young children and their families.

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Setting limits for kids on TV, video games, phone use

Dr. Marjorie Hogan
Dr. Marjorie Hogan

Dr. Marjorie Hogan, pediatrician at Hennepin County Medical Center (HCMC), is one of the thousands of members of the American Academy of Pediatrics (AAP) who is concerned about the amount of time kids are spending on the phone, watching TV, and playing video games.

Excessive media use has been associated with obesity, lack of sleep, school problems, aggression and other behavior issues. A recent study shows that the average 8- to 10-year-old spends nearly 8 hours a day with different media, and older children and teens spend more than 11 hours per day. Kids who have a TV in their bedroom spend more time with media.  About 75 percent of 12- to 17-year-olds own cell phones, and nearly all teenagers use text messaging.

“This new technology is very interesting and exciting, but it shouldn’t replace healthy activities,” explains Dr. Hogan. “Sleep, for example, is so important to growing children.  But many kids are keeping their cell phones next to them while they are in bed so that they don’t miss a text or a Facebook post. These things can wait until morning — after they’ve gotten a good night’s sleep.”

Dr. Hogan was one of the co-authors of the AAP policy entitled “Children, Adolescents and the Media,” which explains the importance of having a healthy “media diet.”

“A healthy approach to children’s media use should both minimize potential health risks and foster appropriate and positive media use—in other words, it should promote a healthy ‘media diet’,” said Dr. Hogan. “Parents, educators and pediatricians should participate in media education, which means teaching children and adolescents how to make good choices in their media consumption.”

While media by itself is not the leading cause of any health problem in the U.S., it can contribute to numerous health risks. At the same time, kids can learn many positive things from pro-social media.

The AAP policy statement offers recommendations for parents:

  • Parents can model effective “media diets” to help their children learn to be selective and healthy in what they consume. Take an active role in children’s media education by co-viewing programs with them and discussing values.
  • Make a media use plan, including mealtime and bedtime curfews for media devices. Screens should be kept out of kids’ bedrooms.
  • Limit entertainment screen time to less than one or two hours per day; in children under 2, discourage screen media exposure.

Dr. Hogan also recommends that parents monitor what their children are communicating on their social media sites.  “And if you have a concern, talk to your child about it and explain what your family’s boundaries — and values — are when it comes to sharing information,” said Dr. Hogan.

More information for parents on creating a family media use plan​ is available on HealthyChildren.org.

To see Dr. Hogan’s statements on creating a media use plan, go to http://www.aap.org/en-us/about-the-aap/aap-press-room/aap-press-room-media-center/Pages/Family-Media-Use-Plan.aspx