title: Subsidized housing and children's nutritional status: data from a multisite surveillance study.
abstract: BACKGROUND
  A critical shortage of affordable housing for low-income families continues in the United States. Children in households that are food insecure are at high risk for adverse nutritional and health outcomes and thus may be more vulnerable to the economic pressures exerted by high housing costs. Only about one fourth of eligible families receive a federally financed housing subsidy. Few studies have examined the effects of such housing subsidies on the health and nutritional status of low-income children.
  
  
  OBJECTIVE
  To examine the relationship between receiving housing subsidies and nutritional and health status among young children in low-income families, especially those that are food insecure.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  From August 1998 to June 2003, the Children's Sentinel Nutrition Assessment Program interviewed caregivers of children younger than 3 years in pediatric clinics and emergency departments in 6 sites (Arkansas, California, Maryland, Massachusetts, Minnesota, and Washington, DC). Interviews included demographics, perceived child health, the US Household Food Security Scale, and public assistance program participation. Children's weight at the time of the visit was documented. The study sample consisted of all renter households identified as low income by their participation in at least 1 means-tested program.
  
  
  METHODS
  Weight for age, self-reported child health status, and history of hospitalization.
  
  
  RESULTS
  Data were available for 11 723 low-income renter families; 27% were receiving a public housing subsidy, and 24% were food insecure. In multivariable analyses, stratified by household food security status and adjusted for potential confounding variables, children of food-insecure families not receiving housing subsidies had lower weight for age (adjusted mean z score, -0.025 vs 0.205; P<.001) compared with children of food-insecure families receiving housing subsidies. Compared with children in food-insecure, subsidized families, the adjusted odds ratio (95% confidence interval) for weight-for-age z score more than 2 SDs below the mean was 2.11 (1.34-3.32) for children in food-insecure, nonsubsidized families.
  
  
  CONCLUSIONS
  In a large convenience sentinel sample, the children of low-income renter families who receive public housing subsidies are less likely to have anthropometric indications of undernutrition than those of comparable families not receiving housing subsidies, especially if the family is not only low income but also food insecure.
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston, MA 02118, USA. afmeyers@bu.edu
authors.forename: Alan
authors.initials: A
authors.lastname: Meyers
authors.forename: Diana
authors.initials: D
authors.lastname: Cutts
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Frank
authors.forename: Suzette
authors.initials: S
authors.lastname: Levenson
authors.forename: Anne
authors.initials: A
authors.lastname: Skalicky
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.forename: John
authors.initials: J
authors.lastname: Cook
authors.forename: Carol
authors.initials: C
authors.lastname: Berkowitz
authors.forename: Maureen
authors.initials: M
authors.lastname: Black
authors.forename: Patrick
authors.initials: P
authors.lastname: Casey
authors.forename: Nieves
authors.initials: N
authors.lastname: Zaldivar
mesh_terms: D001835:Body Weight; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005523:Food Supply; D006304:Health Status; D006801:Humans; D015999:Multivariate Analysis; D009752:Nutritional Status; D011159:Population Surveillance; D011203:Poverty; D011638:Public Housing; D014481:United States