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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Trauma experts alarmed at recent rise in pediatric drownings

Children With Friends Enjoying Evening Swim In Countryside Lake

Emergency physicians and trauma specialists are extremely concerned about the alarming number of drowning victims — especially children — who are dying in area lakes and pools.

“When we experience extreme heat waves, more families seek relief in the water at beaches and pools,” explains emergency physician Ashley Strobel, MD. “While this may be an effective way to beat the heat, safety must remain the focus. It’s just heartbreaking to care for children who are brought in with this type of preventable trauma.”

Julie Philbrook, RN, Trauma Prevention Specialist at Hennepin Healthcare, agrees.

“As of June 14, there have been at least 25 fatal drownings reported in Minnesota so far in 2021. Five were children ranging  from age 4-12 years old. With the Independence Day holiday coming up and continued warm weather, we want to make sure that everyone is aware of how quickly this can happen – and how easily these tragedies can be entirely prevented.”

Their colleague, Ashley Bjorklund, MD, Medical Director of Pediatric Critical Care at Hennepin Healthcare, warns that “It’s so important to have a designated ‘watcher’ and to keep young children – especially any child under the age of 4 – at arm’s length of a supervising adult. Swim lessons and water safety education are a worthy investment. And if you have teenage babysitters, walking through the rules of kids and water with them is really, really essential.”

All three trauma experts weigh in with the following Consumer Product Safety Commission recommendations to help prevent both fatal and nonfatal drownings and keep children safer no matter where they are spending time around the water this summer:

  • Never leave a child unattended in or near water, and always designate an adult Water Watcher. This person should not be reading, texting, using a smartphone or be otherwise distracted. In addition to pools and spas, this warning includes bathtubs, buckets, decorative ponds, and fountains.
  • If you own a pool or spa, install layers of protection, including a four-sided fence with a self-closing, self-latching gate.
  • Learn how to perform CPR on children and adults. Many communities offer online CPR training.
  • Learn how to swim and enroll your child in swimming lessons.  Check with your city’s community education services for local swimming safety programs.
  • Do not rely on inflatable water wings to keep your child safe — they can give a false sense of security for both the child and caregiver.
  • Keep children away from pool drains, pipes and other openings to avoid entrapments.
  • Ensure any pool and spa you use has drain covers that comply with federal safety standards and if you do not know, ask your pool service provider about safer drain covers.
  • In a boat, children under 10 years old must wear a Coast Guard-approved life jacket, all others should consider wearing  one as well.

Here are some local resources:

For more information for swimming lessons through the city of Minneapolis click here.
For information on programs through the YWCA click here. 
For programs through the Hennepin County Sheriff’s Office click here.

Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital with the largest emergency department in Minnesota.

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