What homelessness does to the health of a child

Homeless children have more physical problems than children with a home.

Studies show that inadequate diets, poor access to health care, poor living conditions, and stress cause homeless children to have more health issues.

An inadequate diet causes it to be six times more likely that the growth of homeless children will be stunted  and seven times more likely that they will have iron deficiencies.

Half of homeless children experience two or more illnesses per month. They are twice as likely to have a respiratory infection as a child in a home. Frequent illnesses contribute to extreme absenteeism in school, which in turn leads to poor academic performance.

Children who have stressful childhood experiences also have major health problems in their adult life. They are 2 ½ times as likely to have chronic obstructive pulmonary disease, twice as likely to have heart disease, and twice as likely to have hepatitis as an adult.

One of our goals is to alleviate the impact of homelessness for children. We provide mental wellness therapy to help our children deal with the trauma and stress they have experienced in their lives.

Another way we help is by diverting the parents from using an ER as the primary form of medical care. So we hold a monthly wellness clinic for the children of the homeless families we serve.

Our volunteer pediatrician and his staff see firsthand a microcosm of the physical problems caused by homelessness. He shared several anecdotes about the kids he has seen at the clinic recently.

The older children in a family from out of state all had asthma, but none had inhalers. They were all having symptoms, but had no regular doctor. Because they came into our clinic, we were able to get them prescriptions for their inhalers.  

A couple of other examples of diversions from the ER:

• A child who came in turned out to have a fever. 
• Another child put a bead in his ear. Mom had no idea and the child wasn’t about to tell her. Our doctor could see it, but the little boy said he didn't put anything in there. The doctor not only prevented the ER visit, he prevented complications from an undetected foreign body. 

We provide the parents with samples of over the counter medicine. Plus, because of our partnership with Reach Out and Read, every child gets to pick out a book when the appointment is over.

What we do may be on a small scale, but it can be a big help to a homeless family. It isn't easy to haul a sick kid on a bus to go wait in an ER. Plus, a diversion from the ER cuts the hospital costs not covered by Medicaid coverage for homeless children.

"So that homeless children will be successful now and the rest of their lives"

Last month, I blogged about some of the things homelessness does to a child. The impact is undeniable, but there is good news, too.

First, the bad news.

As our Children’s Program Director wrote, “Homelessness influences every aspect of a child’s life from the moment they are born all the way into adulthood.”

“Homeless children are often confronted with stressful situations and traumatic events that lead to severe emotional distress which is evident in their emotional and behavioral development.”

“Chronic stress has such a tremendous impact on the anatomy of a child’s brain because the younger a person is, the more malleable their brain is. These changes harmfully affect functions like self-regulation and impulse control, goal oriented behaviors, the ability to plan, and to persevere. These character traits aren’t an indication of IQ, but they are a better determinate of success in adulthood.”

Now for the good news.

“Unlike IQ, these character traits are learnable, and the outcome is that students do better academically.”  And, that is the purpose of our Children’s Program.

Again, from our Children’s Program Director, “We decrease the tremendous negative impact that poverty and homelessness have on a child’s life. We give children hope for their future by providing them with the skills and resources they need to be successful now and for the rest of their lives. What I personally try to do for our kids is to help them become caring ethical decision makers. So no matter what is thrown their way, they know the right way to deal with it.”

He shared one story of the impact on one child. “We were able to work a lot with this particular student because she spent the days she was suspended from school with us.”

“One of our major topics that we discuss with our students is anger management and impulse control. Many of our students struggle with understanding how their actions now will have negative consequences later. This was the case for one of our previous 7^th graders named Tina. Tina attends a very rough school and is picked on a lot because of her height. She has shared stories with me about being spit on, made fun of, and beaten up. Tina’s grades have suffered tremendously because she has been suspended many times for fighting at school. The last conversation we had with Tina she told us a story about an altercation with several girls after school.”

“She explained when the bullying started she wanted to fight them but thought about the advice she received here. She said she knew it would just lead to another school suspension and she was able to walk away from the confrontation.”

“I think she felt empowered knowing that she now has a choice of how to react (she always thought fighting was the only option), and proud of herself knowing that she was able walk away. She has also told me that she knows her younger sisters look up to her and that she wants to be a better example for them.”

What homelessness does to a child

We’ve always believed that part of the “hand up” we provide is a safe, stable place for a homeless family to live while they regain their footing. We see it as a respite for the parent from all consuming financial pressures.

But we’re also providing respite for the children. One of the young men who went through our Teen Program while his mother went through the Adult Program told us, “Prior to being accepted into the program at Community LINC my family stayed in shelters and with friends and family. I hated the thought of having to change schools again.  I was a good student and always thought about having the opportunity to attend college.” Because of the instability in his life, he didn’t think he would ever have that chance.

To paraphrase a research paper by our Children’s Program Director, “Homelessness influences every aspect of a child’s life from the moment they are born all the way into adulthood. Worrying about where they will sleep and what they will eat creates an enormous amount of distress for a child. The overlying problem is that traumatic situations connected with being homeless cause children to have abnormally high levels of stress in their lives. Although there are many factors that culminate to negatively influence a homeless child’s life, stress is the main contributor. Much less, about a quarter of all homeless children witness domestic violence.”

“Repeated stress changes the way the brain develops by changing pathways in the prefrontal cortex. Children in poverty show similar brain patterns to what is seen in patients who suffer from lesions to the brain caused by strokes. Chronic stress has such a tremendous impact on the anatomy of children’s brains because the younger a person is the more malleable their brain is.”

Julius, the young man who wanted to go to college, but was afraid it wouldn’t be possible, is in college now. Both he and his older brother have broken with the cycle their mother has experienced in her life.

Next month, I’ll share more about how children can learn to overcome the damage homelessness has done.

Are we really that different?

In the last couple of weeks I've heard the resentment of a friend and my son toward how the money they pay in taxes is spent. I say I've heard it because so often those of us who are considered liberals (either social or political), don't hear what more conservative people have to say. We dismiss them as having no empathy and as claiming everyone who receives some form of public assistance has a sense of entitlement.

That isn't true of either of them.

My friend is very generous in giving to causes that break the cycle of poverty, especially for the children.

My son has less to give financially, but he appreciates the same thing. What he struggles with is a cousin who didn't work, lived rent free off of parents and friends, and got food stamps for her kids. He has always worked hard for his family and resented it when his taxes went to provide her with food stamps. What surfaced it again for him recently was standing in a checkout line behind a guy using his food stamp debit card to pay for beef jerky and Mountain Dew. His view of people who get public assistance has been tainted by his cousin's sense of entitlement. The guy in the check out line just reinforced his impression of bad judgment and selfishness.

My friend's resentment arises from knowing that his income is being targeted for tax increases. Rather than getting to direct his money to invest in charities he believes in, he will lose control of what it funds.

I respect both of them, so I started thinking about what makes me feel the same way. We definitely see people who make ridiculous demands when they come into our program. I have the same feelings my son does when I hear about one of those demands. Thankfully, the people who make them are unusual enough that they become a "can you believe it" anecdote. I doubt that any of our staff would last in a program serving homeless families if most of them came in with a massive sense of entitlement.

When I think about losing the deduction for the interest I pay on my mortgage, I get the resentment my friend feels at the idea of being taxed more.

There isn't a solution to the dilemma inherent in the fiscal cliff that will overcome the resentment that either of them feel.  Actually, I suspect there isn't a solution that any of us will really like.  We may come at it from different directions, but we usually can find more to understand than the liberal and conservative labels might lead us to believe.

One child at a time

A note I received from our Children’s Program Director:

“One of our teens has been through some tough things, and appears to be a tough 15 year old by the way he looks. I have had conversations with him where he told me about things happening in his life… drug use, gang violence (even in his family), his suspensions from school for being defiant to teachers, his hearing and eye sight disabilities. If you looked at him you would think he is an intimidating looking teen.

Last night after program he was walking home and looking very sad, underneath his hat, and inside his hood. I walked him home and asked him what was going on. He didn’t want to talk and I told him he didn’t have to if he didn’t want to… finally he dropped his toughness for a minute and confessed in a very sincere way that “sometimes the other kids don’t talk to me”. “I don’t know why they don’t like me”.

I spoke with him about his confidence, his appearance, and the way he talks with people. I told him he should smile more. He didn’t realize that he came off as being a little intimidating. I told him that I liked him, and that I thought the other kids liked him, and he smiled.

We both went to the playground and talked basketball with the other boys. When I left he shook my hand and told me to have a good night.

It reminded me that deep down, all children just want to be is accepted.”

It gives you hope doesn’t it? That encounter gives one young man an opening to change how he relates to the world. And, how he relates to the world can change his future.

The housing burden

The Federal Reserve Bank of Kansas City’s Low to Moderate Income Survey for the 3rd quarter showed a slight decrease. Employment improved slightly, but the improvement was offset by the decline in the availability of affordable housing and credit.

Our homeless families, of course, fall into the low income segment the survey measures. We saw some of the same improvement in employment recently. The average wage for the adults who found jobs was hovering around $10/hour until September when it rose to $12.

At $12/hour, a single parent will earn about $25,000 per year. Housing costs will start to become a burden if rent and utilities climb together are above 30% of income = $7,500/year or $624/mo. Rent alone averages $784 for a two bedroom apartment in the Kansas City area, which means our families will remain financially fragile.

However, our families will not be alone. A study from the Joint Center for Housing Studies at Harvard University, a record 20.2 million people spent more than 50% of their income on housing as far back as 2010. Most of these families will live in or on the brink of poverty, but the vast majority will not become homelessness.

If history prevails, 80% of our parents will not become homeless again. They may struggle, but they leave better equipped to provide for themselves and their children. And, the children leave knowing they have options that may break the cycle of poverty.

How important is a father in the life of a child?

In my life, and my son’s, the answer was easy - “he was crucial.”

But, how many of us realize that, for a poor child, a father’s involvement can be the difference between homelessness and stability?

The tenth research brief from the Institute for Children, Poverty and Homelessness highlights the characteristics of “fathers of poor and homeless children and examines the differences in fathers’ involvement, finding that unstably housed children have fathers who contribute less to their financial and developmental well-being.”

That’s what I would have guessed, too.

The parents don’t have to be married for the child to benefit. The father just has to be involved. “Children whose fathers are accessible and engaged display fewer behavioral problems, lower levels of delinquency, higher IQ scores, and less psychological distress than children with less-involved fathers.”

It’s interesting that the father benefits more if the parents are married. “Married men are healthier, happier, and engage in less risky behaviors than men who remain single.” The research shows that poor men who marry “experience greater income growth and are more strongly attached to the labor force than those who remain single.” Poor fathers who don’t marry the mother work and earn less.

Surprisingly, a lot of poor mothers choose not to marry the father, because they’re afraid they won’t be able to rely on the father in the long run, but will lose their benefits (TANF or food stamps) in the short run. Our young mothers often choose not to apply for TANF, because the State of Missouri will first go after the father for child support. Some don’t want to jeopardize the relationship with the father and others want to control the fathers’ involvement with the children. They reason, if they don’t collect child support formally, they can limit the father’s contact.

We have had more two parent families in the last few years than in all the previous years of our program.

One of the two parent families spoke to the current residents at our graduation ceremony last week. We couldn’t have asked for a better message from that father. He encouraged the current residents to see our program as an opportunity and to take responsibility for their lives and their children’s. He certainly has. This particular father found a good job and is buying a house using his VA benefits.

From our perspective, the odds are on the side of this family. 80% of the residents who find a permanent home keep it for at least 5 years. The data from this study tells us that his child has a good chance to live a stable life and never be homeless again.