A systematic review of the effects of housing support on social welfare outcomes in pregnancy and early childhood

Background

Homelessness during pregnancy and early childhood is associated with poorer social welfare outcomes for birth parents and their children. For these clients, contact with the child protection system is common. In some cases, children are removed.

Objective

To systematically review published literature investigating the impact of housing support during pregnancy and early childhood on child protection outcomes.

Participants

and setting: Provision of housing support for clients experiencing homelessness while pregnant or parenting young children (0–7 years) in high-income countries.

Methods

A systematic search of databases CINAHL and SocIndex for peer reviewed studies, with independent double-screening of retrieved studies and full-text review of eligible studies.

Findings

Of 793 screens and 37 studies with full-text review, two were eligible. Both were small, without a control group, and one was qualitative. There was no convincing evidence for impacts, and meta-analysis was not possible. In post-hoc reviews, five additional studies met all criteria except child protection outcomes. These studies’ findings suggested that, compared with controls, housing interventions led to faster initial improvements in housing status and decreased alcohol use, as well as decreases in child internalising and externalising behaviours.

Conclusions

There are promising indications that housing interventions generate benefits for clients experiencing homelessness while pregnant or parenting young children. However, high-quality longitudinal studies with robust intervention designs are lacking, likely due to the challenges inherent in embedding research to evaluate such programs. Given the importance of pregnancy and early childhood on children's development, existing housing support and policy implementation evaluations should be prioritised.