Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six
UMass Chan AffiliationsCommonwealth Medicine, Center for Health Law and Policy
Department of Population and Quantitative Health Sciences
Department of Family Medicine and Community Health
maternal and child health
social determinants of health
Community Health and Preventive Medicine
Health Law and Policy
Health Services Administration
Health Services Research
Maternal and Child Health
MetadataShow full item record
AbstractHomeless infants are known to have poor birth outcomes, but the longitudinal impact of homelessness on health, health care use, and health spending during the early years of life has received little attention. Linking Massachusetts emergency shelter enrollment records for the period 2008-15 with Medicaid claims, we compared 5,762 infants who experienced a homeless episode with a group of 5,553 infants matched on sex, race/ethnicity, location, and birth month. Infants born during a period of unstable housing resulting in homelessness had higher rates of low birthweight, respiratory problems, fever, and other common conditions; longer neonatal intensive care unit stays; more emergency department visits; and higher annual spending. Differences in most health conditions persisted for two to three years. Asthma diagnoses, emergency department visits, and spending were significantly higher through age six. While screening and access to health care can be improved for homeless infants, long-term solutions require a broader focus on housing and income.
Health Aff (Millwood). 2019 May;38(5):721-728. doi: 10.1377/hlthaff.2019.00090. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/27005
RightsCopyright Project HOPE—The People-to-People Health Foundation, Inc. This open access article is distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license.
Except where otherwise noted, this item's license is described as Copyright Project HOPE—The People-to-People Health Foundation, Inc. This open access article is distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license.
Showing items related by title, author, creator and subject.
Policy Brief: Addressing Social Determinants of Health through Community Health Workers: A Call to ActionLondon, Katharine; Damio, Grace; Ferrazo, Meredith; Perez-Escamalla, Rafael; Wiggins, Noelle (2018-01-30)This technical report was compiled by the Hispanic Health Council in partnership with Southwestern AHEC and a panel of Community Health Worker Policy Research Experts which included our Katharine London from the Center for Health Law and Economics. The report offers a number of policy recommendations for community health workers for communities that might benefit from community-based services. The report offers recommendations on; payment of community health workers; community health worker caseloads; community health worker recruitment; community health worker training; reflective and trauma-informed mentoring and supportive supervision of community health workers; integration of community health workers into care teams; documenting the effect of community heal worker services on social determination of health. The Hispanic Health Council believes a service design that effectively supports community health workers would incorporate the seven areas of policy recommendation included in this report.
A Public Health Framework for the State Mental Health Authority: A Call for Action by Massachusetts Consumers and Family MembersDelman, Jonathan (2006-01-01)During the Spring of 2006, Consumer Quality Initiatives (CQI) conducted 20 focus groups across the state, 12 with adults with mental illness, 3 with parents of youth with serious emotional disorder, 2 with youth with SED, 1 with family members of adult consumers, and 2 with youth in transition. Supported by a contract with Massachusetts Department of Mental Health (DMH), the goal was to assist DMH in framing the criteria for its upcoming reprocurement. Our findings reveal a frustration with an approach to health care delivery that focuses primarily on the provision of psychiatric care (egs, medication, therapy, hospitalization). We reviewed the focus group reports to identify the most significant themes, which clustered within eight broad categories.
Making the Case for Sustainable Funding for Community Health Worker Services: Talking to Payers and ProvidersLondon, Katharine (2018-01-27)In this presentation, Katharine London of the Center for Health Law and Economics makes her case for offering sustainable funding for community health worker services. Research has shown community health workers can have a distinct impact on health systems, helping them improve population health and contain costs, while also promoting health equity and community engagement. This presentation was designed to assist CHWs and other advocates in engaging with policymakers and payers to support CHW sustainability and develop a financial plan for their CHW work. It was presented as part of a CHW Sustainability event held at the Families USA’s annual conference, Health Action 2018: Staying Strong for America’s Families, in Washington, DC. See Katharine London's blog post on payment delivery methods for community health workers here.