Case Study

Hidden Health Risks: Food and Housing

Twins Jaxon and Jade are in your office for their 7-year Texas Health Steps preventive medical checkups. In reviewing their medical records, you note their address has changed twice since their last checkup and they are attending a different school this year. In addition to assessing the twins’ growth and development, this checkup provides you an opportunity to address environmental factors that can significantly affect their health.

Jaxon and Jade’s recent moves could be a sign of housing instability, which can range from living in unaffordable, crowded, or substandard housing to homelessness. Housing is widely acknowledged as a social determinant of health. About 10 percent of Texas children live in families that spend more than 50 percent of their income on housing – a key risk factor for housing instability. Lack of stable housing can affect a child’s health and development, including physical and behavioral health and access to adequate food and education (American Academy of Pediatrics [AAP], 2017).

Food insecurity, which is defined as the lack of resources for a household’s food, is common among families in unstable housing but can also be a problem for others. Nearly 25 percent of Texas children experience food insecurity and are at risk for physical, behavioral, and oral health consequences. However, food insecurity may be overlooked as a cause of health problems because it rarely affects traditional measurements of a child’s growth (AAP, 2015).

Housing instability and food insecurity can remain hidden risks that affect child health and development. Here are steps you can take to address these risks and promote better health for young patients.

Take the Related Courses listed below.

Prep your practice to screen and intervene.

Connect with community resources.

Why It Matters

Stable housing and adequate nutrition are fundamental to a healthy life. As a primary care provider, you have the opportunity to screen young patients for housing instability and food insecurity and to intervene as appropriate, including connecting families to community resources.

Related Courses


American Academy of Pediatrics. (2017). AAP policy statement: Providing Care for Children and Adolescents Facing Homelessness and Housing Insecurity. Pediatrics, 131(6), 1206-1210.

American Academy of Pediatrics. (2015). Promoting Food Security for All Children. Pediatrics, 136(5), e1431-e1438.

About Texas Health Steps

Texas Health Steps’ award-winning online program offers FREE CE courses for primary care providers and other health professionals. These courses offer updated clinical, regulatory, and best practice guidelines for a range of preventive health, oral health, mental health, and case management topics.