title: San Francisco children living in redeveloped public housing used acute services less than children in older public housing.
abstract: Understanding the links between housing and health is increasingly important. Poor housing quality is a predictor of poor health and developmental problems in low-income children. We examined associations between public housing type and recurrent pediatric emergency and urgent care hospital visits. Children ages 0-18 with public insurance who sought emergency care from any of three large medical systems in San Francisco were categorized by whether they lived in public housing redeveloped through the federal HOPE VI program, nonredeveloped public housing, or nonpublic housing in a census tract that also contained public housing. After we adjusted for potential confounding characteristics, we found that children living in nonredeveloped public housing were 39 percent more likely to have one or more repeat visits within one year for acute health care services unrelated to the initial visit, compared to children who lived in redeveloped HOPE VI housing. We observed no differences in repeat visits between children in redeveloped HOPE VI housing and those in nonpublic housing. These findings support the continued redevelopment of public housing as a means of both improving the health of vulnerable high-risk children from low-income neighborhoods and reducing health care costs.
authors.affiliation: Ellen E. Kersten (ekersten@berkeley.edu) is a PhD candidate in environmental science, policy, and management at the University of California, Berkeley.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Kersten
authors.affiliation: Kaja Z. LeWinn is an assistant professor of psychiatry at the University of California, San Francisco.
authors.forename: Kaja Z
authors.initials: KZ
authors.lastname: LeWinn
authors.affiliation: Laura Gottlieb is an assistant professor of family and community medicine at the University of California, San Francisco.
authors.forename: Laura
authors.initials: L
authors.lastname: Gottlieb
authors.affiliation: Douglas P. Jutte is an associate professor at the School of Public Health, University of California, Berkeley, and executive director of the Build Healthy Places Network, in San Francisco.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Jutte
authors.affiliation: Nancy E. Adler is a professor of psychiatry and pediatrics and director of the Center for Health and Community at the University of California, San Francisco.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D011638:Public Housing / Q000706:statistics & numerical data*; D012495:San Francisco
keywords: Acute care; Children’s Health; Disparities; HOPE VI; Housing