Physical and mental health, cognitive development, and health care use by housing status of low-income young children in 20 American cities: a prospective cohort study

Am J Public Health. 2011 Dec;101 Suppl 1(Suppl 1):S255-61. doi: 10.2105/AJPH.2010.300098. Epub 2011 May 6.


Objectives: We assessed the independent effect of homeless and doubled-up episodes on physical and mental health, cognitive development, and health care use among children.

Methods: We used data from 4 waves of the Fragile Families and Child Wellbeing Study, involving a sample of 2631 low-income children in 20 large US cities who have been followed since birth. Multivariate analyses involved logistic regression using the hybrid method to include both fixed and random effects.

Results: Of the sample, 9.8% experienced homelessness and an additional 23.6% had a doubled-up episode. Housing status had little significant adverse effect on child physical or mental health, cognitive development, or health care use.

Conclusions: Family and environmental stressors common to many children in poverty, rather than just homeless and doubled-up episodes, were associated with young children's poor health and cognitive development and high health care use. Practitioners need to identify and respond to parental and family needs for support services in addition to housing assistance to effectively improve the health and development of young children who experience residential instability, particularly those in homeless families.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development
  • Child Welfare
  • Child, Preschool
  • Cognition / physiology*
  • Cohort Studies
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Homeless Youth / statistics & numerical data
  • Housing / standards*
  • Humans
  • Infant
  • Male
  • Mental Health*
  • Physical Fitness / physiology*
  • Poverty*
  • Prospective Studies
  • United States
  • Urban Population*