The Cumulative Burden of Housing Insecurity Among Children in the United States from Birth to Adolescence

Housing insecurity is increasingly recognized as a crucial social determinant of health, with a possible sensitive period in childhood. However, knowledge of the true burden of this exposure is limited due to its multidimensional and repetitive nature. Our goal was to characterize cumulative exposure to multiple forms of housing insecurity from birth to adolescence, overall and by race in large US cities. Using data from the Future of Families and Child Wellbeing Study (FFCWS), we estimated cumulative incidence and mean cumulative count of several forms of housing insecurity (homelessness, eviction, multiple moves, having utilities shut off, doubling up, and not paying full rent/mortgage). We accounted for missing data (due primarily to gaps between waves) using lower bounds and a mixed modeling approach. We found that between 45% (lower bound) and 71% (modeled) of children experienced at least one housing insecurity event by age 15. The average number of events among children who had any event was between 2.63 (lower bound) and 6.12 (modeled). Large racial inequities were evident in all event types. Children of non-Hispanic Black and Hispanic mothers, compared to non-Hispanic White mothers, were more likely to experience an initial event, but once experienced, had similar numbers of events. Our findings underscore the public health urgency of mitigating the present housing crisis. Large racial differences in incidence of first events, but not repeated events, suggest that preventive interventions would most effectively mitigate racial inequities in housing insecurity.