Housing insecurity influences birth outcomes and maternal health

In Texas, 63% of single mothers who rent their homes are considered housing cost-burdened, and nearly 42% of these women live in poverty. Housing instability and evictions are significantly associated with preterm birth, poor mental health, low birth weights, higher neonatal intensive care unit (NICU) admissions and increased risk of complications.

Health care leaders’ crucial policies and pilot programs for safe housing are greatly improving the safety and health of families across the country. CareSource Bayou Health unites Legacy Community Health and CareSource to bring lifesaving programs to Texas.

How access to safe housing affects mothers and babies

Any duration of homelessness in a child’s life has adverse effects on physical, mental and developmental outcomes. A Houston ISD assessment revealed that over 7,200 students were homeless in the 2022 – 2023 school year, the highest number of homeless students in the past nine years.

When families experience the stress of insecure housing, health no longer becomes a priority. Instead, mothers are focused on finding somewhere safe to sleep, creating an immense amount of stress that can be detrimental to health. When families have stable housing, mothers are more likely to prioritize prenatal and preventative health care, ensuring more positive health outcomes.

Legacy Community Health serves many families who are struggling to meet their basic needs, including housing. Their social workers complete Family Needs Assessments for all pregnant women enrolled in Medicaid’s Children and Pregnant Women Case Management program. If a patient is dealing with housing instability, a social worker will connect them with appropriate resources and create a service plan alongside the patient.

Legacy Community Health’s strong foothold in the Texas market plays a key role in CareSource Bayou Health. The joint venture’s patient-centered care model pushes Texas families towards a life of greater self-sufficiency by addressing nonmedical drivers of health and removing barriers to quality health care. By combining the footprint of Legacy with the experience of CareSource, CareSource Bayou Health will be able to bring new and impactful programs to the people of Texas; like the CareSource program, Healthy Beginnings at Home.

Healthy Beginnings at Home provides safe and affordable housing to mothers

Healthy Beginnings at Home (HBAH), a pilot program first launched in 2018 in Columbus, Ohio by the infant mortality prevention collaborative CelebrateOne, focuses on improving birth outcomes and decreasing maternal mortality rates through access to rental assistance and housing stabilization services with the support of CareSource. The Coalition on Homelessness and Housing in Ohio (COHHIO) manages the current expansion of the program. HBAH was awarded the Housing and Urban Development Secretary’s Award for Public-Philanthropic Partnerships in 2021.

HBAH serves pregnant mothers facing homelessness and have an increased risk of complications in their first or second trimester with CareSource. The program addresses inequities in affordable housing access through a two-year housing intervention comprised of rental assistance and housing stabilization case management. Major successes in Ohio, including reduced preterm birth, zero infant mortalities and shorter NICU stays, have resulted in the program expanding to Indiana with the receipt of a $2.5 million Health Resources and Services Administration Catalyst for Infant Health Equity Grant.

Major research teams, including the Nationwide Children’s Hospital, the University of Delaware and the Health Policy Institute of Ohio, evaluated the results of the program through a control group of 50 women receiving their usual care and an intervention group of 50 women benefitting from community-based services, a rental subsidy and housing intervention. Mothers in both groups had access to the CareSource Life Services® program and could benefit from CareSource JobConnect™ to increase their skills and likelihood of long-term employment.

Findings from HBAH’s pilot program in Columbus revealed visible differences in birth outcomes between the groups. The intervention group experienced no fetal deaths and 78% of babies were born at full-term and at a healthy birth weight as compared to the control group which faced four fetal deaths and only 55% of babies being born at full-term and a healthy weight. Additionally, babies admitted to the NICU in the intervention group had 72% shorter NICU stays than babies in the control group. Further, mothers who received rental assistance had far lower health care spending.

For pregnant women, lack of stable housing is accompanied by dangerous health consequences. Safe and quality housing is essential for families to thrive, and results from the study revealed the serious impact housing can have on health. As the HBAH program expands, more mothers can have access to stable housing which may result in better birth outcomes and reduced infant and maternal mortality.

By connecting mothers and families to safe housing, Texas health care leaders are helping families thrive. Learn more about Healthy Beginnings at Home and CareSource’s impact on the program here.

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CareSource Bayou Health is a joint venture between CareSource and Legacy Community Health, combining both organizations' mission-driven approaches for a lasting difference in the health of members and communities.