Chicago’s West Side. Photo/ Eric Young Smith

Unstable, Unsafe Housing Harms Children’s Brain Development

Research is documenting the harmful effects on children when families must keep moving to find a safe, affordable home.

by Liz Duffrin

On a spring day in 2014, Latisha Lacey, a single mother, moved into a freshly rehabbed two-bedroom home on Chicago’s West Side. It was affordable at $850 a month, so as time passed she tried to ignore the drug dealers in the alley, the landlords’ advances, and the prostitutes he invited into the basement. But her active boys disturbed his trysts, she said, and her continued rejection angered him. One day, without explanation, he refused her rent check. A week before Christmas 2015, he evicted her.

That rental was her sixth in fourteen years. One place had been riddled with drug dealing, another with rats. In another, she broke her lease after a break-in, suspecting the maintenance man. Another had a bad cockroach infestation from a second-hand oven the landlord installed. Worse, a routine screening at the pediatrician’s office had discovered alarmingly high levels of lead in her toddler’s blood. City inspectors arrived at her building and found lead paint everywhere, but the landlord refused to abate it. After a year, Lacey heeded the doctor’s warning and moved out.

For children, the effects of this “toxic” stress can interfere with behavior and learning and undermine school performance.
Photo/ Eric Young Smith

“It’s stressful when you have to keep moving and moving with your kids,” she said.

The damaging health effects of substandard housing, especially lead poisoning and asthma, are well known. But in recent years, researchers have collected mounting evidence that poor-quality and unstable housing can create the kind of unrelenting stress capable of causing permanent biological harm that can lead to diabetes, heart disease, and depression later in life. Though researchers point out that there are many other factors that contribute to whether stress reaches toxic levels for one individual vs. another. For children, the effects of this “toxic” stress can also interfere with behavior and learning and undermine school performance. The damage to health and learning can persist into adulthood.

In low-income communities, the root causes of unrelieved stress can appear too daunting for health providers to address, said Earle Chambers, associate professor at the Albert Einstein College of Medicine in Bronx, New York.

“Providers tend to say, ‘Given that your circumstances are difficult, how do we help you manage it?’, rather than, ‘How do we change your living environment so it’s not so stressful?’”

Same Problem Everywhere

The scope of the problem is enormous. A recent report by the National Low Income Housing Coalition in Washington, D.C., found that of the 11.4 million extremely low-income renters in need, only 4 million could find an affordable apartment. Nationwide that translates into a shortage of 7.4 million affordable, available units. Extremely low income individuals are those earning less than 30 percent of area median income.

“We see the same problem in every state, in every city, in every congressional district — urban, rural, suburban,” said the coalition’s public policy director, Sarah Mickelson.

Lacey earns approximately 50 percent ($35,550) of Chicago’s median income for a family of three by working the night-shift full-time as a hospital security officer. She works overtime whenever she can, cleans homes on weekends, and keeps a constant lookout for more or better jobs. The ones she lands typically pay $11 to $15 an hour. Families earning even less have yet fewer good housing options.

Rebekah Levine Coley, a professor at Boston College Lynch School of Education, has documented a strong link between poor-quality housing and emotional and behavioral problems in children and youth. Poor housing is also associated with lower reading and math test scores among adolescents. Some of the effect of poor housing on young people comes from the stress it causes their parents, she finds.

Photo/ Eric Young Smith

Even after controlling for other potential sources of stress (such as divorce, remarriage, single parenting, income, and work schedules), parents living in substandard housing were more likely to report “anxiety, depression, and being unable to deal with the day-to-day demands of parenting and other key life tasks,” she said. “They are less able to parent and respond to their children’s needs.”

Lacey had always worked hard to care for her children, despite the stress, but in late 2015 with an eviction on her record, she was suddenly unable to provide them a home. Rejected by one landlord and rental company after the next, she sent her sons to live with her sister and moved in with friends. Her friends’ parents turned out to be drug users and stole from her. So she moved out and slept in her car for more than six months. “I felt it was safer,” she said.

Lacey continued to search for housing, but sporadically. “You get tired of people telling you, ‘no,’” she explained, her voice tightening. “You get tired of people rejecting you.”

Along with food, good housing is “the base you need to build on.”

Finally, she found a willing landlord and reunited her family. On about the second night, she was awakened by a sound like a break-in. Flicking on the light, “I saw this big old rat running through the kitchen,” she said. The whole building was infested, a neighbor reported. Within a week, she’d moved out. Her children went back to her sister’s.

Living apart was not the family’s only hardship. Four months before she was evicted, the father of her younger son was killed by gang members. The little boy, then five years old, had been close to his father. Now he was separated from his mother, too. He didn’t want to eat or sleep, Lacey said. At school, he was dazed and unable to concentrate. He sometimes cried in frustration or refused to follow directions. His teacher recommended that he repeat kindergarten.

For families dealing with multiple traumas and stressors, it might seem like housing is only one issue of many. But in fact, Chambers noted, not having stable, quality housing makes it difficult to begin addressing other issues. Along with food, he explained, good housing is “the base you need to build on.”

Less Brain Activity

Toxic stress harms the body measurably, scientists find. It shortens telomeres, the caps at the end of each strand of DNA, which accelerates aging. It floods the body with stress hormones, including cortisol, which can be detected in saliva.

Dr. Jack Shonkoff, director of the Center on the Developing Child at Harvard, has studied toxic stress in children. “What we’re understanding now,” he said, “is that if that [flight or fight] stress system is activated and prolonged early in life, it has a wear and tear effect on the body — it affects the development of the circuitry in the brain, the cardiovascular system, the immune response, and metabolic regulation. And these disruptions can have lifelong effects on learning, behavior, and both physical and mental health.”

Dr. Charles Nelson, professor of pediatrics and neuroscience at Harvard Medical School, said that chronically elevated levels of cortisol from stress can destroy the synapses between neurons in the brain which are necessary for learning. The results are visible even in infants.

Toxic stress has a long reach. The more adverse experiences in those early years, the greater the risk for diabetes and heart disease later on.

“We see less brain activity in the kids whose mothers show more stressful life events,” he explained.

Toxic stress can affect brain development in the short run, he added. “But it has a long reach as well. The more adverse experiences in those early years, the greater the risk for diabetes and heart disease later on.”

Caregivers can provide an important buffer against childhood stress through their attention and empathy, research finds. But housing instability makes that hard. Housing instability also often forces low-income families to switch schools and children to adapt to new curriculum, expectations, and peer groups. Research finds that each residential move in childhood is associated with the loss of half a year of learning. And three or more moves during childhood is associated with lower earnings and educational attainment later in life.

‘The Best Apartment’

In early 2017, Lacey submitted yet another rental application, this one to Lofts on Arthington, a mixed-income apartment building developed and managed by Mercy Housing Lakefront, an affordable housing developer with 52 sites in Wisconsin, Illinois, and Indiana.

Latisha Lacey and her son. Photo/ Eric Young Smith

The property manager at Arthington listened to Lacey’s story, tracked down her former landlord at his workplace, and arranged for her to hand-deliver a check for $1,100.

“He apologized,” Lacey reported dryly, and agreed to clear the eviction.

In April, Lacey and her boys moved into an airy three bedroom with high ceilings and exposed wood beams. The handsome brick building dates to the early 1900s and originally housed the Sears catalog printing facility. The building has laundry machines, an exercise room, a computer lab, a community center, and long carpeted hallways Lacey’s boys like to run through.

The apartment at $1,085 a month includes utilities, and so isn’t much more expensive than the apartment she was evicted from, she said.

“My little son says, ‘Mommy, this is the best apartment we ever had!’ We can’t ever move up out of here!’”

Since they moved in, he’s more engaged with school, she reported. Now in first grade, he’s eager to share what he’s learning. “He knows how to add, subtract, tell time. ‘It’s 10:30, what time do you have to get up, Mommy? That’s fun for him.’”

“Housing isn’t the end — it’s really a means to the end.”

At school, he still acts out in frustration sometimes, she said, adding that she plans to ask the case manager at Arthington Lofts for referrals to counselors.

A service coordinator and a case manager at the Lofts assist residents in finding employment, further education, financial counseling, and health and social services. So far, Lacey’s case manager has referred her to two jobs. The “trauma-informed” approach to services that Mercy Housing has adopted are designed to specifically target the toxic stress triggers that impact children so gravely.

Lofts on Arthington. Photo/ Eileen Molony.

“Housing isn’t the end — it’s really a means to the end,” Mark Angelini, president of Mercy Housing Lakefront, explained, “and the end is to help our residents live more healthful, independent, productive lives.”

Meeting the vast need for high-quality, affordable housing will take renewed efforts at the local and federal levels, experts said.

To start, Coley said, local officials need to step-up code enforcement of the “substantial amount of private and public housing that is in serious disrepair and does not meet existing standards.”

Federal funding for affordable housing also needs to be protected and expanded, said Angelini.

Eliminating substandard housing — the misery it causes and the human potential it robs — has straightforward solutions, the experts agreed.

“It’s not that we don’t know what needs to happen,” Mickelson explained. “We are just deeply and chronically underfunding those solutions.”


This article is part of Crosswalk, a gathering place for stories that illustrate the deep connection between health and place, curated by the Build Healthy Places Network.

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