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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.147785v1 99/8/1446    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Coker, T. R. Articles by Schuster, M. A. PubMed PubMed Citation Articles by Coker, T. R. Articles by Schuster, M. A. Related Collections Homelessness Mental Health Low-Income Children

Tumaini R. Coker, MD, MBA, Marc N. Elliott, PhD, David E. Kanouse, PhD, Jo Anne Grunbaum, EdD, M. Janice Gilliland, PhD, Susan R. Tortolero, PhD, Paula Cuccaro, PhD and Mark A. Schuster, MD, PhD

Tumaini R. Coker is with the Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine, University of California, Los Angeles, and the RAND Corporation, Santa Monica, CA. Marc N. Elliott and David E. Knouse are with the RAND Corporation, Santa Monica. Jo Anne Grunbaum is with the Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA. M. Janice Gilliland is with the Department of Maternal and Child Health, University of Alabama, Birmingham. Susan R. Tortolero and Paula Cuccaro are with the Center for Health Promotion and Prevention Research, Health Science Center, University of Texas, Houston. Mark A. Schuster is with the Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, and the RAND Corporation, Santa Monica.

Correspondence: Correspondence should be sent to Tumaini R. Coker, MD, MBA, UCLA/RAND Center for Adolescent Health Promotion, 1072 Gayley Ave, Los Angeles, CA 90024 (e-mail: tcoker{at}mednet.ucla.edu). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. We describe the lifetime prevalence and associated health-related concerns of family homelessness among fifth-grade students.

Methods. We used a population-based, cross-sectional survey of 5147 fifth-grade students in 3 US cities to analyze parent-reported measures of family homelessness, child health status, health care access and use, and emotional, developmental, and behavioral health and child-reported measures of health-related quality of life and exposure to violence.

Results. Seven percent of parents reported that they and their child had experienced homelessness (i.e., staying in shelters, cars, or on the street). Black children and children in the poorest families had the highest prevalence of homelessness (11%). In adjusted analyses, most general health measures were similar for children who had and had not been homeless. Children who had ever experienced homelessness were more likely to have an emotional, behavioral, or developmental problem (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.1, 2.6; P = .01), to have received mental health care (OR = 2.2; 95% CI = 1.6, 3.2; P < .001), and to have witnessed serious violence with a knife (OR = 1.6; 95% CI = 1.1, 2.3; P = .007) than were children who were never homeless.

Conclusions. Family homelessness affects a substantial minority of fifth-grade children and may have an impact on their emotional, developmental, and behavioral health.