Renson Audrey, Fowle Matthew Z, Pachman Sarah, Routhier Giselle
Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA.
Housing Initiative at Penn, Weitzman School of Design, University of Pennsylvania, Philadelphia, PA, USA.
J Urban Health. 2025 Sep 10. doi: 10.1007/s11524-025-01005-7.
Housing insecurity is a key social determinant of a wide range of health outcomes, subject to large racial inequities, and with a likely sensitive period in childhood. Housing insecurity can manifest in multiple ways and change over time, but previous studies have primarily focused on single dimensions or a single time point. This study examines 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, accounting for missing data (due primarily to gaps between waves) using lower bounds and a mixed modeling approach. 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 6.11 (modeled). 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. We find a massive and cyclical burden of housing insecurity during childhood. 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.
住房不安全是多种健康结果的关键社会决定因素，存在巨大的种族不平等，且在童年时期可能存在一个敏感期。住房不安全可以通过多种方式表现出来，并随时间变化，但以往的研究主要集中在单一维度或单一时间点。本研究考察了美国大城市中从出生到青春期多种形式住房不安全的累积暴露情况，总体情况以及按种族划分的情况。利用家庭与儿童福祉未来研究（FFCWS）的数据，我们估计了几种住房不安全形式的累积发病率和平均累积计数，使用下限和混合建模方法处理缺失数据（主要由于各波次之间的间隔）。到15岁时，45%（下限）至71%（建模）的儿童经历过至少一次住房不安全事件。有过任何事件的儿童的平均事件数在2.63（下限）至6.11（建模）之间。与非西班牙裔白人母亲的孩子相比，非西班牙裔黑人母亲和西班牙裔母亲的孩子更有可能经历首次事件，但一旦经历，事件数量相似。我们发现童年时期住房不安全存在巨大的周期性负担。首次事件发生率存在巨大的种族差异，但重复事件不存在这种差异，这表明预防性干预将最有效地减轻住房不安全方面的种族不平等。
