Health starts at home

When you visit Boston Children’s at Martha Eliot for a well-child appointment, clinicians are just as likely to ask you about your housing situation as they are to measure your child’s height or weight. They’re not just making conversation: A growing body of evidence shows that access to stable and affordable housing can have a lasting impact on children’s health.

For instance, a recent study published this February in the journal Pediatrics found that in families that had been behind on their rent, moved multiple times, had a history of being homeless or faced a combination of these circumstances  both the adult caregivers and children were more likely to have poor health.

It makes sense, says Elise Gottesman, LICSW, social work manager for Boston Childrens at Martha Eliot in Jamaica Plain. “If you don’t know where you’re going to sleep at night, that can have a huge impact on the whole family,” she explains. “Interrupted school attendance, stress and worry can all affect children’s development and well-being.

To further explore this connection, Gottesman and her colleagues at Martha Eliot are partnering with Massachusetts Law Reform Institute, Horizons for Homeless Children and Jamaica Plain Neighborhood Development Corporation to conduct a three-year study of patient families who are homeless. By screening children under age five during well-child visits, they’ve learned that roughly half of their patients are in unstable housing situations.

Based on this finding, and with funding and technical support from the Boston Foundation and Boston Children’s Office of Community Health, 50 families from Martha Eliot are receiving support and resources, including access to a social worker, patient navigator and lawyer. These professionals assist families by helping them stay connected to their children’s health care resources while also helping them apply for affordable housing, access childcare and receive financial literacy and employment training. This investigation into the health impacts of addressing the conditions in which families live could help inform future programs, initiatives and polices.

streets of boston

Investing in families

In addition, the Massachusetts Department of Public Health’s approval process for our two new clinical buildings—one on our campus in Boston and the other in Brookline—requires that we invest 5% of the cost of those buildings into community health initiatives.   As a result, Boston Children’s established the Collaboration for Community Health Initiative, which will invest $53.4 million in children’s health over the next 10 years.  The strategy for distributing these funds was developed through a two-year community engagement and planning process.  This process highlighted among other things, the need to invest some of these funds in stable and affordable housing if we want to positively impact the health of children and families.

With this investment, the hospital will have an opportunity over the next several years to assess how investments in housing can promote the long-term health and well-being of children and families. The funds will support organizations, coalitions and agencies that are engaged in programs and/or in advocating for policies designed to keep families in their homes and address the root causes of homelessness.  For more details on the Collaboration for Community health, visit