BACKGROUND: The number of families with children living in NYC homeless shelters increased roughly 60 percent from 2008 to 2014. Approximately half of all children living in shelter in 2014 were younger than 6 years of age. Homelessness can result in poor health and homeless families may experience unique barriers to accessing health care services. We compared the sociodemographic and health characteristics of mothers and their newborns residing in shelters to mothers and their newborns in NYCHA housing to assess differences between low-income New Yorkers with and without permanent housing
METHODS: Addresses of NYC Department of Homeless Services shelters and NYC Housing Authority (NYCHA) developments were matched to NYC Department of Health birth data for the years 2008-2013. NYCHA residents were chosen as a comparison group to homeless shelter residents because they are also low-income, but, unlike those residing in shelters, are stably housed with low apartment turnover. The percentage of each birth characteristic within each housing type (homeless vs. public housing) and differences were examined using χ2tests for categorical variables and Wilcoxon tests for non-normal continuous variables.
RESULTS: Compared with NYCHA residents, shelter residents were younger, more likely to be black and less likely to be Hispanic, to be born outside NYC, and to reside in the Bronx. Babies born to mothers living in shelter were more likely than babies born to mothers living in NYCHA housing to have low birth weight (<2500g), require assisted ventilation immediately following delivery, have a NICU admission, have a hepatitis B inoculation administered, and use Medicaid as payment for delivery; they were less likely to breastfeed within 5 days of delivery and to be discharged to their residence.
CONCLUSIONS: In general, homeless mothers and infants had poorer health outcomes compared with those living in public housing. Understanding the health disparities of homeless infants can provide guidance for developing future projects and research initiatives, which may be used to inform the development of new policies to improve health outcomes of homeless infants and their mothers.