title: Housing Instability and Children's Health Insurance Gaps.
abstract: To assess the extent to which housing instability is associated with gaps in health insurance coverage of preschool-age children.
  
  
  
  Secondary analysis of data from the Early Childhood Longitudinal Study-Birth Cohort, a nationally representative study of children born in the United States in 2001, was conducted to investigate associations between unstable housing-homelessness, multiple moves, or living with others and not paying rent-and children's subsequent health insurance gaps. Logistic regression was used to adjust for potentially confounding factors.
  
  
  
  Ten percent of children were unstably housed at age 2, and 11% had a gap in health insurance between ages 2 and 4. Unstably housed children were more likely to have gaps in insurance compared to stably housed children (16% vs 10%). Controlling for potentially confounding factors, the odds of a child insurance gap were significantly higher in unstably housed families than in stably housed families (adjusted odds ratio 1.27; 95% confidence interval 1.01-1.61). The association was similar in alternative model specifications.
  
  
  
  In a US nationally representative birth cohort, children who were unstably housed at age 2 were at higher risk, compared to their stably housed counterparts, of experiencing health insurance gaps between ages 2 and 4 years. The findings from this study suggest that policy efforts to delink health insurance renewal processes from mailing addresses, and potentially routine screenings for housing instability as well as referrals to appropriate resources by pediatricians, would help unstably housed children maintain health insurance.
authors.affiliation: Department of Finance and Economics, Rider University, Lawrenceville, NJ.
authors.forename: Anne
authors.initials: A
authors.lastname: Carroll
authors.affiliation: Department of Finance and Economics, Rider University, Lawrenceville, NJ; National Bureau of Economic Research, New York, NY.
authors.forename: Hope
authors.initials: H
authors.lastname: Corman
authors.affiliation: School of Social Work, University of Wisconsin at Madison, Madison, Wis.
authors.forename: Marah A
authors.initials: MA
authors.lastname: Curtis
authors.affiliation: Department of Finance and Economics, Rider University, Lawrenceville, NJ; National Bureau of Economic Research, New York, NY.
authors.forename: Kelly
authors.initials: K
authors.lastname: Noonan
authors.affiliation: Department of Pediatrics, Rutgers University, Robert Wood Johnson Medical School, Child Health Institute of New Jersey, New Brunswick, NJ, and Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: reichmne@rwjms.rutgers.edu.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Reichman
mesh_terms: D000328:Adult; D000067576:Child Health; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D018453:Homeless Youth / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: children's health insurance; health insurance gaps; housing instability