The impact of homelessness and housing services on maternal and infant health

This submission seeks data to complete an NIH R01 project that received a score with a high likelihood of being funded during review and is currently pending with the Eunice Kennedy Schriver National Institute ofChild Health and Human Development (NICHD). Improving maternal, infant and child health and wellbeing (MCH) is an urgent public health priority, both across the U.S. and in New Jersey. Birthing people are experiencing increases in severe maternal morbidity (SMM) and other pregnancy-related health conditions, while infant mortality in the first year of life remains greater in the U.S. than in any other higher-income country. Advancing MCH requires addressing structural factors that affect health, including housing. Homelessness is a growing phenomenon in the U.S., and 2%-4% of all birthing people experience homelessness in the year prior to delivery. Health outcomes and behaviors associated with homelessness are known risk factors for pregnancy-related morbidity and adverse birth outcomes, but critical gaps in our understanding of how homelessness and housing services affect MCH limit our ability to intervene. We seek to assess how and when homelessness affects maternal and infant health, and whether Permanent Supportive Housing and Rapid Rehousing impact these outcomes. We do this by applying quasi-experimental methods to linked administrative data from New Jersey that include homeless and housing service information, Medicaid claims, all-payer hospital records, and birth records. Findings will be used to inform state and national policy to improve prenatal and postpartum care for birthing people and infants who have experienced homelessness.