Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six

Area of Science:

• Pediatrics
• Public Health
• Health Services Research

Background:

• Homeless infants experience poor birth outcomes.
• Longitudinal health, healthcare utilization, and spending impacts of infant homelessness are understudied.

Purpose of the Study:

• To examine the long-term health outcomes, healthcare use, and costs for infants experiencing homelessness.

Main Methods:

• Linked Massachusetts emergency shelter records (2008-2015) with Medicaid claims.
• Compared 5,762 infants with a homeless episode to 5,553 matched controls.
• Analyzed health conditions, neonatal intensive care unit stays, emergency department visits, and annual spending.

Main Results:

• Homeless infants had higher rates of low birthweight, respiratory problems, and fever.
• Longer neonatal intensive care unit stays and more emergency department visits were observed in the homeless group.
• Significant increases in asthma diagnoses, emergency department visits, and healthcare spending persisted through age six.

Conclusions:

• Infant homelessness is associated with persistent adverse health outcomes and increased healthcare utilization and costs.
• While improving screening and access to care is important, long-term solutions necessitate addressing housing and income instability.
• Policy interventions should focus on stable housing to mitigate the long-term health and economic consequences for homeless infants.