Findings published in Lancet Public Health showed that parental homelessness increased the risk for psychiatric disorders among children and adolescents.
“The effect of homelessness on children's health is difficult to measure, and there were methodological limitations in previous studies (eg, small sample sizes, and absence of comparison groups and adjustment for confounders),” Sandra Feodor Nilsson, MSc, from the department of clinical medicine at University of Copenhagen and Mental Health Centre Copenhagen at Copenhagen University Hospital, Denmark, and colleagues wrote. “Research into the associations between social determinants (including parental homelessness) and child psychiatric illness are scarce, especially studies outside the U.S.A.”
Researchers examined the association between a parent’s history of homelessness and their offspring's risk for psychiatric disorders during childhood and adolescence. They conducted a nationwide, register-based cohort study of 1,072,882 youths aged 0 to 16 years in Denmark from Jan. 1, 1999, to Dec. 31, 2015.
Overall, 17,238 (2%) children had at least one parent with a history of homelessness, and 56,330 (5%) children and adolescents had psychiatric disorder diagnosed during the study period. In those with a parent with a history of homelessness, the incidence of any psychiatric disorder was 15.1 cases per 1,000 person-years (95% CI, 14.4-15.8) compared with six per 1,000 person-years (95% CI, 6–6.1) in those whose parents were never homeless (incidence rate ratio [IRR] = 2.5; 95% CI, 2.3-2.7). After additional adjustment for parental psychiatric disorders and other factors, the increased risk remained.
The risk was increased for most psychiatric disorders. The risk for attachment disorder was highest when both parents had a history of homelessness (IRR = 32.5; 95% CI, 24.6-42.9). When only the mother had a history of homelessness, the highest risk was for substance use disorder (IRR = 6.9; 95% CI, 4.9-9.7). Among children of mothers with a history of both homelessness and a psychiatric disorder, 35.9% (95% CI, 27.1–44.8) received a psychiatric disorder diagnosis by the age of 15 years.
“These findings are relevant from a public health and policy perspective because they point to a need for improvement in the support of socially marginalized families,” Nilsson and colleagues wrote. “Public services could play an important role in providing the help these families need to reduce or even prevent the development of child and adolescent psychiatric problems. Moreover, research into and increased focus on the prevention of parental homelessness in high-income countries might also reduce the psychiatric morbidity in offspring.” – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.