ABSTRACT
Housing affects the health of children and youth. One-third of households in Canada live in substandard conditions or in housing need. The present statement reviews the literature documenting the impacts of housing on personal health and the health care system. Types of housing need are defined, including unsuitable or crowded housing, unaffordable housing and inadequate housing, or housing in need of major repairs. The health effects of each type of housing need, as well as of unsafe neighbourhoods, infestations and other environmental exposures are outlined. Paediatricians and other physicians caring for children need to understand the housing status of patients to fully determine their health issues and ability to access and engage in health care. Recommendations and sample tools to assess and address housing need at the patient, family, community and policy levels are described. Canada is the only G8 country without a national housing strategy. Recommendations also include advocating for enhanced action at all levels of government and for housing-supportive policies, including a national housing strategy.
Le logement a une incidence sur la santé des enfants et des adolescents. Le tiers des ménages canadiens habite dans des conditions déplorables ou éprouve des besoins en matière de logement. Le présent document contient une analyse bibliographique des répercussions du logement sur la santé personnelle et le système de santé. Les types de besoins en matière de logement sont définis, y compris les logements de taille inadéquate ou surpeuplés, les logements inabordables ou en mauvais état et ceux qui ont besoin de réparations majeures. Les effets de chaque type de besoins en matière de logement sur la santé, de même que les quartiers mal famés, les infestations et les autres expositions environnementales, sont présentés. Les pédiatres et les autres médecins qui s'occupent d'enfants doivent connaître les conditions de logement de leurs patients pour cerner leurs problèmes de santé ainsi que leur capacité d'obtenir des soins et de s'y conformer. Sont présentés des recommandations et des modèles d'outils pour évaluer les besoins en matière de logement et de politiques de la santé pour le patient, la famille et la collectivité, ainsi que pour y répondre. Le Canada est le seul pays du G8 à ne pas être doté d'une stratégie nationale en matière de logement. Les recommandations incluent également la nécessité de préconiser des mesures plus énergiques à tous les ordres de gouvernement et d'adopter des politiques en appui au logement, y compris une stratégie nationale en matière de logement.
ABSTRACT
BACKGROUND: Housing is a key determinant of child and youth health. A significant number of Canadian children and youth are living in housing need, but information regarding the housing status of children and youth in the Ottawa, Ontario, community is lacking. OBJECTIVE: To examine the housing status of children and youth accessing emergency health services at the Children's Hospital of Eastern Ontario (Ottawa, Ontario), and the factors associated with housing status. METHODS: Youth and families of children registered at the Children's Hospital of Eastern Ontario's emergency department were offered a questionnaire. Affordability, adequacy, suitability and stability of housing were evaluated through self-reporting. Housing need was defined as an inability to meet one or more of these criteria. Associations among housing and household composition, demographics and weight-for-age percentiles were examined. RESULTS: One thousand three hundred sixty surveys were completed. Fifty-four per cent of respondents (663 of 1224) were living in housing need, including 33% of respondents (381 of 1166) who were living in unaffordable housing. Single-parent families (OR 2.82), families with six or more members (OR 2.51) and families who rented (OR 5.27) were more likely to be living in housing need. Children and youth with a primary care physician were more likely to be living in stable housing (OR 0.41). Unsuitable housing was associated with extreme weight-forage percentiles (OR 1.90). CONCLUSION: More than one-half of the children and youth in the present study were living in housing need. Health care providers have a responsibility to identify and understand the determinants of health of their patients, including housing, and to work for the improved health of their patients and their communities.