The Title V Maternal & Child Health (MCH) Services Block Grant program is vital in strengthening public health systems for those preparing to welcome a child, pregnant women, children, and families. The newest iteration of the Title V Block Grant performance measurement framework has a focus on improving the conditions that impact the health and well-being of MCH populations, that includes National Performance Measures on housing instability and food sufficiency. AMCHP is committed to supporting the MCH field in strengthening cross-sector collaboration, programs, and policies to improve housing and food access for MCH populations.
Current Initiatives
Food Security Overview
Food insecurity, defined as having unreliable access to a sufficient quantity of affordable and nutritious foods, is on the rise, with the rate of food insecurity among US households rising from 12.8% in 2022 to 13.5% in 2023, including over 14 million children 1 . This issue continues to affect communities in different ways. For example, people living in rural areas face higher rates of food insecurity than those in cities or suburbs. A federal report found that about 1 in 7 people in rural communities’ struggle with having enough food, compared to about 1 in 9 in suburban areas1. Factors that contribute to food insecurity include income, reliable transportation, and access to grocery stores. Additionally, rising food prices and other economic pressures have made it more difficult for many individuals and families to afford enough food.
Food insecurity influences a variety of health outcomes. Individuals experiencing food insecurity are at increased risk of chronic diseases 2 . For MCH populations, the effects of food insecurity are linked to a range of negative health outcomes, including a higher risk of developmental delays in children and increased complications during and after pregnancy 3,4. Food insecurity can lead to serious health effects for adolescents, including delays in growth and development, higher risk of chronic disease , and behavioral challenges 5. Children with more complex special healthcare needs are especially vulnerable, experiencing food insufficiency at twice the rate of other children, which can worsen health outcomes and limit the success of treatment 6.
AMCHP is dedicated to partnering with organizations and families to help identify policies and practices that Title V MCH programs can use to address food insecurity in their states.
Sources
- Rabbitt, M. P., Reed-Jones, M., Hales, L. J., & Burke, M. P. (2024). Household food security in the United States in 2023(Report No. ERR-337). U.S. Department of Agriculture, Economic Research Service. https://doi.org/10.32747/2024.8583175.ers
- Laraia, Barbara A (2013). Food Insecurity and Chronic Disease. Advances in Nutrition 4, no. 2: 203. https://doi.org/10.3945/an.112.003277.
- Laraia, Barbara A., Ryan Gamba, Carina Saraiva, Melanie S. Dove, Kristen Marchi, and Paula Braveman (2022). Severe Maternal Hardships Are Associated with Food Insecurity among Low-Income/Lower-Income Women during Pregnancy: Results from the 2012–2014 California Maternal Infant Health Assessment. BMC Pregnancy and Childbirth 22. https://doi.org/10.1186/s12884-022-04464-x.
- Rosen, F., Settel, L., Irvine, F., Miller, J. D., Koselka, E. P. D., & Young, S. L. (2023). Associations between food insecurity and child and parental physical, nutritional, psychosocial and economic well‑being globally during the first 1,000 days: A scoping review. Maternal & Child Nutrition. https://doi.org/10.1111/mcn.13574
- Nagata, J. , Hernandez, S., & Palar, K. (2023). Promoting food security among adolescents and young adults: A primer for pediatric and public health clinicians. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2024.03.012
- Balistreri, K S (2019). Food Insufficiency and Children with Special Healthcare Needs. Public Health. 2019 Feb;167:55-61. doi: 10.1016/j.puhe.2018.11.011. Epub 2019 Jan 9. PMID: 30639804; PMCID: PMC6419505.
Housing Overview
Recent data show that 12.1 million children in the U.S. experienced at least one form of housing instability in 2022 7. Housing quality, affordability, and stability have been shown to affect both physical and mental health outcomes8. Literature reviews of the relationship between housing and health identify several pathways through which housing impacts the health outcomes of MCH populations9. This includes the effects of poor housing conditions (e.g., exposure to toxins), the effects of being isolated in under resourced and unsafe neighborhood environments, and the psychological and material toll of housing insecurity (e.g., eviction, foreclosure, homelessness). Specifically, unstable and substandard housing is associated with adverse outcomes across MCH populations, including depression and anxiety among mothers10, 11, low infant birth weight and birth complications12, and developmental challenges13. Housing insecurity at age 5 was directly linked to increased risk of depression at age 15 and indirectly linked to adolescent behavioral problems through maternal involvement with the criminal justice and child welfare systems by age 914.
Sources
- Lebrun-Harris, Lydie A., Megan Sandel, Richard Sheward, Ana Poblacion, and Stephanie Ettinger de Cuba (2024). Prevalence and Correlates of Unstable Housing Among US Children. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2024.1159.
- Taylor, Lauren (2018). Housing And Health: An Overview Of The Literature. Health Affairs Health Policy Brief (blog). https://www.healthaffairs.org/do/10.1377/hpb20180313.396577/full/.
- Shaw, Mary (2004). Housing and Public Health. Annual Review of Public Health 25, no. Volume 25: 397–418. https://doi.org/10.1146/annurev.publhealth.25.101802.123036.
- Stuebe, Alison, Anna Creegan, Francoise Knox-Kazimierczuk, Meredith C. Smith, Sabia Wade, and Kristin Tully (2024). Cultivating Vital Conditions for Perinatal Well-Being and A Sustained Commitment To Reproductive Justice. Health Affairs 43, no. 4: 470–76. https://doi.org/10.1377/hlthaff.2023.01452.
- Association of Maternal and Child Health Programs (2020). Housing as Platform for Treatment and Recovery: Opportunities for Title V at the Intersection of Stable Housing, Mental Health, and Substance Use. Retrieved from: https://amchp.org/resources/housing%e2%80%8b-as-platform-for-treatment-and-recoveryopportunities-for-title-v-at-the-intersection-of-stable-housing-mental-health-and-substance-use/
- Leifheit, Kathryn M., Gabriel L. Schwartz, Craig E. Pollack, Kathryn J. Edin, Maureen M. Black, Jacky M. Jennings, and Keri N. Althoff (2020). Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes. International Journal of Environmental Research and Public Health 17, no. 22. https://doi.org/10.3390/ijerph17228659.
