Characteristics and health of homeless families: the ENFAMS survey in the Paris region, France 2013.
BACKGROUND
The objectives were to estimate the size of homeless family population in Paris region, to describe their living conditions and health and to analyse the impact of homelessness on children's growth and development, which was never investigated in France.


METHODS
A cross-sectional survey was conducted on a random sample of homeless sheltered families in 2013. Families were interviewed in 17 languages and a nurse took anthropometric measures, blood samples and collected health data from child health reports.


RESULTS
The population size was estimated at 10 280 families. Half were single-parent female families and 94% were born outside France. Most families had experienced housing instability and 94% were living below the poverty line (828 euros/month). Malnutrition was a major problem: the prevalence of food insecurity was high (77% of parents and 69% of children), as well as anaemia (50% of mothers and 38% of children), overweight (38% of mothers and 22% of children) and obesity (32% of mothers and 4% of children). High rates of depressive disorders were found in 30% of homeless mothers and 20% of children had signs of possible mental health disorders.


CONCLUSIONS
These first results highlight the important number of families among the homeless population in Paris region. Families differed from other homeless people regarding social characteristics such as birthplace, single-parent status and residential instability that are likely to influence schooling, social ties, health and access to care. These results demonstrate the need for urgent actions targeting homeless families, in terms of reducing housing instability and providing adequate care, especially for children.
Observatoire du Samusocial de Paris, Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France Institut de veille sanitaire, département des alertes et coordination des régions, Saint Maurice, France.
Stéphanie
S
Vandentorren
Observatoire du Samusocial de Paris, Paris, France.
Erwan
E
Le Méner
Observatoire du Samusocial de Paris, Paris, France Université François Rabelais, Laboratoire Citeres, UMR CNS 7324, Tours, France.
Nicolas
N
Oppenchaim
Observatoire du Samusocial de Paris, Paris, France Institut de veille sanitaire, département des maladies infectieuses, Saint Maurice, France.
Amandine
A
Arnaud
Observatoire du Samusocial de Paris, Paris, France Laboratoire Espace, Santé et Territoires, Université Paris Ouest Nanterre La Défense, Nanterre, France.
Candy
C
Jangal
Observatoire du Samusocial de Paris, Paris, France.
Carme
C
Caum
Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
Cécile
C
Vuillermoz
Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
Judith
J
Martin-Fernandez
Early ORigin of the Child's Health and Development Team (ORCHAD), INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS). Paris Descartes University, France.
Sandrine
S
Lioret
Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
Mathilde
M
Roze
Institut de veille sanitaire, département des maladies infectieuses, Saint Maurice, France.
Yann
Y
Le Strat
Observatoire du Samusocial de Paris, Paris, France.
Emmanuelle
E
Guyavarch
D000293:Adolescent; D000328:Adult; D001837:Body Weights and Measures; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology; D010297:Paris; D011203:Poverty / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult