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Growth delay in homeless children
A H Fierman1, B P Dreyer, L Quinn
1Department of Pediatrics, New York University School of Medicine, New York 10016.
Insights
Homeless children show stunted growth compared to domiciled peers and national standards, indicating chronic nutritional stress. Family social factors, not homelessness duration, significantly impact their reduced height.
Area of Science:
- Pediatrics
- Public Health
- Child Development
Background:
- Homeless children face unique challenges impacting health and development.
- Growth patterns in vulnerable populations require comparison to established standards and controls.
Purpose of the Study:
- To compare the growth of homeless children against National Center for Health Statistics (NCHS) standards and age-matched domiciled children.
- To identify factors influencing growth differences between homeless and domiciled children.
Main Methods:
- Comparative analysis of height and weight-height percentiles.
- Regression analysis to control for confounding social and familial factors.
- Comparison of growth data with NCHS standards and a matched domiciled cohort.
Main Results:
- Homeless children exhibited significantly lower height percentiles than both NCHS standards and domiciled children.
- Weight-height percentiles did not differ from NCHS standards but were lower in homeless children compared to domiciled children.
- Larger family size and single-mother households were associated with lower height percentiles in homeless children.
Conclusions:
- Homeless children display stunting without wasting, indicative of chronic nutritional stress.
- Preexisting social factors, rather than duration of homelessness, are key determinants of growth abnormalities.
- Further research into social determinants of growth in homeless children is essential.
Abstract:
This study compared the growth of homeless children with National Center for Health Statistics (NCHS) standards and with growth of age-matched domiciled children of similar income level. Homeless children (n = 167) had lower height percentiles when compared with domiciled children (n = 167; P less than .001) and when compared with NCHS standards (P less than .001). The weight-height percentiles of homeless children did not differ from NCHS standards; however, domiciled children had higher weight-heights when compared with the homeless (P less than .001) and with NCHS standards (P less than .001). After controlling via regression analysis for the effects of potentially confounding factors that affect growth, it was found that homeless children from larger families and with single mothers accounted for the lower height percentiles observed. After controlling for confounding factors, domiciled children still had increased weight-height percentiles when compared with the homeless group. Duration of homelessness was not associated with decreased height or weight-height among homeless children. Homeless children in this study exhibited a pattern of stunting without wasting which is characteristic of poor children experiencing moderate, chronic nutritional stress. They exhibited a greater degree of nutritional stress than domiciled children at a similar income level and than that reported in other groups of poor children in the United States. Preexisting social factors in the families of homeless children were important in explaining the observed growth abnormalities. Further exploration of the associations between social characteristics of homeless children and their families and the growth of these children is warranted.